How do I get my husband to seek psychiatric/psychological help when he is convinced that he is fine? He is an alcoholic/drug user, he has many deeply rooted problems, and lately he has become violent and erratic. He blows up easily at nothing, he is paranoid, and I think he is losing control. I am afraid, and I don't know what to do. I have tried speaking to his family, and they don't seem to care. How can I get him to seek help, or even get help for myself (I am a mild depressive)? We have little money for expenses.

-- M.L.

One of the first things I'd recommend your doing is to start attending Al-Anon group meetings in your community or the nearest city. Al-Anon, as you may know, is the 12-step self-help program for family members and loved ones of alcoholics. It's a companion program, so to speak, of Alcoholics Anonymous (AA). Both Al-Anon and AA are free. You can find out where and when the groups meet by checking the listings in your local newspaper or calling the phone number listed for Alcoholics Anonymous in your area. Your local community mental health center or hospital (especially if it has substance abuse programs) may also be able to provide that information.

Al-Anon meetings can give you support in dealing with your husband and a better understanding of what you can do to take care of yourself. With that support in place, you might then consult with a local substance abuse expert about options for yourself and your husband. You may be able to get reduced-fee services from your local community mental health center or other agencies that offer sliding-scale fees.

Some drug and alcohol abuse treatment programs offer free consultations or even coaching in conducting what is called an "intervention" with the alcoholic/addict. Interventions usually involve family and friends working together to meet with the alcoholic/addict and confront him or her with evidence of addiction, urging treatment and sobriety. Of course, the drug and alcohol programs that offer such consultations usually hope the alcoholic/addict will enter their program. An intervention may be difficult for you to orchestrate, however, if your husband's family is unsupportive.

Another possibility is to meet his insistence that he's "fine" with a request that he get a professional opinion on that. A licensed psychologist, clinical social worker or other mental health professional can evaluate him for substance abuse or dependence and give him -- and you -- a professional opinion and recommendations. (A mental health professional not affiliated with any treatment program might appear more "neutral" to him.)

If your husband is unwilling to seek professional consultation or to try a free program such as Alcoholics Anonymous himself, then you will need to decide what steps are necessary to take care of yourself and any children you have. Al-Anon and your own consultation with a licensed mental health professional may help you with that decision-making process. Good luck.