Thank you for writing in here.
I am so sorry to hear about your 22 year old son's situation.
It sounds like he has psychotic features - auditory hallucinations.
Excess use of alcohol and drug use may have caused psychotic features over time.
A number of studies show that drug use may aggravate mood disorder and cause psychosis
in people. (For example, see the link http://www.sciencedaily.com/news/mind_brain/marijuana/)
He resists seeing a psychiatrist. I wonder if he sees his primary care doctor then.
First, I would advise your son to get a physical check-up from your primary care doctor to detect and rule out any medical condition that may cause or contribute to his psychotic features.
He may need to work with a psychiatrist and a psychologist specializing in addiction and/or psychotic disorder.
You may call his insurance company and get a list of providers (a certified alcohol counselor, and a psychologist) in his area.
If he has no health insurance and need a low fee counseling,
you may call The United Way toll free # XXXXX (dial 2-1-1) to find community mental health centers in his area where he can alcohol abuse
and/or dual diagnosis treatment for a low fee.
Also, he will benefit from attending a support group for young adults with similar problems. Free social support recovery groups are available in nearly every community and can used as a supplement to a more comprehensive outpatient treatment. If you like to find a support group for him, check Mental Health America website section (http://www.mentalhealthamerica.net/go/find_support_group) - Find a group in your area.
He also may need comprehensive, community-based psychiatric treatment, rehabilitation, and support in a community clinic (a community behavioral health program). The services he may need are, Assertive Community Treatment (ACT), Psychosocial Rehabilitation, and Social skills Training. ACT includes case management, ongoing assessments, medication support, supportive counseling, employment and housing assistance, family support and education, substance abuse
services, and other services as needed to support the individual's ability to live successfully in the community. Clients and their family members are viewed as collaborative partners in the treatment planning and intervention process. ACT services are available 24 hours per day 365 days per year.
If your son is dangerous to self (and others) due to his mental condition, please call a local mobile crisis team or psychiatric emergency response team designated by his city and county to initiate psychiatric assessment and involuntary hospitalization.
Or, seek help immediately. Call 1-800-273-TALK (8255) to reach a 24 hour crisis center or dial 911 for immediate assistance.
I hope he gets well.
Please let me know if you have more questions or I have overlooked any. Warm regards,