Hello, I am so sorry your family is facing this right now. You must be scared and overwhelmed.
Do you know if your borther has a power of attorney for healthcare created? If so, take time to review it to see who he has designated and if it gives authority regarding mental health. Usually, the POA documents require someone to be deemed 'incompetent" or unable to make thier own medical decisions in order to be actuive, but if he is actively delusional and out of touch with reality, there is a good chance he could be deemed temporarily incompetent thus giving his POA power to act over his mental health treatment including pursuit of hospitalization. obviously, the key here is that he still needs to be evaluated.
All states have differing rules to follow with regards ***** ***** mental health ordinances. I would contact your local police for some help knowing what your options are and even getting him to a hospital as we all agree that he needs to be thoroughly evaluated. The other option to get this information would be the social worker at your nearest psychiatric emergency department. Make sure you tell the police or emergency department team member that you are concerned about his safety or that of others and provide support, such as the poem or other things you have witnessed. If he is truly a risk or police can recognize that he is manic or not in control of his thinking, then they can take him directly to the hospital. While he may still oppose this, people are less likely to stand up to this authority as opposed to a concerned family. If there is a more intensive process that must be followed according to the ordinance for mental heath in your area, then the police can help you get started on this even if it entails needing to appeal for his hospitalziation with the courts before the police with intervene.
This is a very hard time for you and I appreciate that you would want an easy solution that can be implemented quickly. Unfortunately, when people oppose care, they have this right unless there is a safety issue and/or it has been temporarily redacted under the courts or under the guidance of a power of attorney. Don't heistate to contact the police or your local ED for help. Of course, you just want your brother back to normal, safe and healthy. It is hard because generally spekaing, the system puts the individual's right to refuse care at the highest part of the hierarchy and people in your brohter's state just may not be able to see their need. This is where the legal process can support your family - you just need the details on how to go about initiating that process.
Hope this helps,