Dear Jacob:
You care so much about your friend, concerned about him, wish he would be doing so much better than he is doing and it seems to me like there is nothing you can do to help him. Maybe listening to him, just letting him talk, showing your empathy for him, maybe asking him what you can do to help him- asking him…
anita

Dear Jacob:
I have a very active analytical mind. I would probably ask him when his trouble started. i would be curious if his parent/s mistreated him (can happen in an advantaged family as you put it). I would try to dig deep enough to find out the origin of the trouble and then (I shouldn’t but) I would try- if I follow my past patterns- to FIX him. Then I would fail, of course, feel frustrated and angry at him for not …. listening to me and following my lead and instructions about how he should heal himself. I would find myself having wasted a lot of my time and energy for nothing- he would be in the same spot- not in a better spot and I would be exhausted and distressed.

If I was the more effective me in that situation… I would say: I am sorry to see you in so much pain. How can I help?” And if he gives me a specific answer and it is doable for me and I think it may help him if I do as he asked, then I will.
anita
anita

Dear Jacob:
Mental illness is very common, unfortunately. Mental distress is very common- read the threads here on tiny buddha from 2013 and on and you can see how common it is. This is very unfortunate. I wish it wasn’t so, yet what can you do about it? Heal yourself from what you need to heal from, take care of yourself and then try to help others… in moderation, while not losing yourself.

He wants to be institutionalized, you write, probably feels out of control and needs the structure. I hope he does get institutionalized then. you wrote that his parents are well off, I think? Then maybe they can find a good institution for him- where he can get the structure he needs and the healing so that he can later function better on the outside.
anita