Thank you for the added information. It helps a lot in helping you with this issue.
First, let me say I can imagine how frustrating and worrisome this situation must be for you. On the one hand he is an adult and because of the patients rights climate we have today he legally has responsibility to care for himself if he does not want treatment unless he is presenting a clear, stated danger to himself or others. But on the other hand he is not really able to care for himself in a healthy way. I wish this was a rare situation, but it is estimated to be a significant portion of the homeless population and those who are chronically in shelters.
And this is actually the key to my answer to you that you need to consider and think about. Your concerns seem correct. Many are homeless because family members came to the conclusion that continuing to prop up the patient only let him stay untreated and barely functional with little incentive to change. This is because of a condition called anosognosia that is unfortunately common in schizophrenia. More on this in a minute. But it is important for you to not become adversarial about this. To have him feel that you are on his side even if and when you cut off material help to him. Why?
Because taking his meds, staying true to the treatment, and staying stable, is his lesson to be learned and he will not learn it from being lectured to about it or have his errors pointed out. He will become defensive. So it is vital for you not to take his situation personally and to always make him feel as if he is in charge of himself.
One of the problems here is that with many schizophrenia disorders sufferers, manipulating the situation to avoid medication or treatment in general is part of the disorder, the anosognosia I mentioned above. It is very pernicious and very difficult to treat. I would like to recommend to you the work of Dr. Xavier Amador. I think that in this area of treatment resistance he has been invaluable to all of us working with schizophrenia. I know some people don't go for his style, but I have found it very valuable and I think you will see its value as well. Dr. Amador's whole approach is to find the way to make treatment a win-win situation. Because for him, treatment is only for others' sakes: family, doctors, etc. Not for himself. The meds probably cause whole sorts of side effects he doesn't like. And this is going to be true of any meds the doctors come up with. Because resistance is often part of the illness and all meds have side effects.
So this approach can help you very much. But not only you personally, but the whole family. Here are his two most known books:
I am Not Sick, I Don't Need Help. This is the book that made Dr. Amador famous. It details a bit the story of his brother, who will remind of you of Leo probably in some aspects. Amazon page for it:
The other book is I'm Right You're Wrong, Now what? Break the Impasse and Get What You Need. Amazon page:
Here is his organization's website that has wonderful resources available:
Okay, I wish you the very best!
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