My (36nb) brother (35m) is deteriorating physically and mentally, and I can’t figure out how to help him or get my family to get him help.

As the title says, I’m a 36 year old trans/non-binary person with a younger brother, who is 35. My brother and I were never close growing up for various reasons probably not related to the issue at hand (despite being close in age), but as adults he was one of my favorite people. He used to be very smart, kind, clever, outgoing, interesting, and funny as hell. I constantly told my friends (who hadn’t met him themselves) about what a great guy he was, and on top of that, he was incredibly humble. He actually saved my life not once, but twice, but due to his nature he shrugs that off and doesn’t want to talk about it (once he gave me the Heimlich when I was choking, another time he intervened when someone was stalking/threatening me and got me to safety).

That said, he’s never been a perfect guy. Despite being so smart, he failed his senior year of high school and wound up dropping out and getting a GED rather than repeating it (not that there’s anything wrong with that), and then proceeded to fail out of college because he refused to do any of his classwork in his first semester. He had some really amazing jobs in the tech field that even had him rubbing elbows with celebrities (although his humble nature made that awkward for him) but he got them through a combination of luck and his charisma(and, of course, his genuine skill). Just setting the scene that he’s always had some problems when it comes to getting himself together, but he always managed in the end. On top of that, he dated and had at least two long-term relationships, and maintained a large circle of friends, some of which he’s been friends with since elementary school.

Starting about seven years ago, everything just seemed to come crashing down. He had gotten a job in NYC where he traveled a lot, and he was profoundly unhappy both living there (we grew up in a rural area) and with the travel. He successfully got his boss to transfer him back to our home state, but once he was here, he quietly quit entirely. He would constantly ask my mom (50f, yes, you did the math right) for money for food or to order him pizza online, and eventually he was evicted from his apartment down there and the car my mom had co-signed the loan on defaulted and was repossessed. My mother went downstate to pick him up and it wasn’t at his apartment: it was at a truck stop where she said he seemed to come out of the bushes, nothing with him but a backpack with some of his possessions, looking like he hadn’t slept or shaved in days and smelling like he hadn’t bathed. She brought him home, where she was living with my grandmother (70f) and, at the time, me. I wound up giving him some of my old clothes and buying him a few new shirts and stuff just to get him settled in. He was invited to go into his place one last time to get his things, and he had to be cajoled into going and still left most of his stuff, some of which he’d had since childhood or had sentimental value.

He got a job at Walmart and became a manager of the electronics department very rapidly, again due to his skills and his natural charisma. He also started seeing a girl, however she worked there, and that was a conflict of interest with him technically being her boss. He didn’t even quit, he just walked out of the job. He had been renting the apartment next to us at the time (it was a duplex), but he also got evicted from there, and sometime in all of that, his relationship ended (I don’t know the details of who ended it or when in that timeline). This lead to him moving in with us again full time.

And this brings us, gradually, to where he his now. Over the course of about five years living with my grandmother and mother (I moved out four years ago and he moved into my old room after sleeping on the couch), he has done nothing to get a job. His sense of humor has vanished, and he has gotten angry and aggressive (never physical, but he snaps at people with little to no provocation and will storm off). He does no chores, no cooking (something he used to love to do), and it took a lot of prodding to get him to file for state assistance just to get medical insurance of some kind. My mother and grandmother can go days without seeing him, saying he just stays in his room smoking pot and playing video games (all single player, he doesn’t even interact with people online). Weed is legal in my state and there is a dispensary almost right in front of the house, but where he gets the money is a semi-mystery (things in the attic have gone missing when my grandmother searches for them so she is 90% certain he is selling things to pay for his weed and video games).

He rarely bathes, doesn’t shave or get his hair cut, and for the past several months it has been noted that he almost never eats. He has been diagnosed with anxiety and put on medication for it by his regular doctor, but despite the fact that he shakes like a leaf when he is out in public, he insists that medicine was for migraines and he doesn’t need it anymore. He also went for a regular physical and after his bloodwork came back, the doctor called him and told him to get to the ER right away as his potassium was fatally low, and he was generally malnourished when he got there (he did go).

My grandmother and mother are fed up with his attitude, but my grandmother is also worried about finding him dead in his room one of these days, either because of his poor health or because he has taken his own life, and I have feared this for even longer (I also have a long history of mental illness and hospitalization). I try to reach out to him but I can only say so much before he shuts me down. I can only say, possibly because of my history of mental illness, he is not nearly as rude or angry around me as he is my grandmother and mother. It’s lead to me being afraid to approach things with him because I think he sort of views me as the last person he can be around without being pestered about needing to do something or get help.

I have tried to encourage my grandmother and my mother (who I am LC with, another story) to join me in arranging some sort of intervention for him, but despite both of them working in the mental health field, they are also very afraid of approaching him or creating any more friction in the household or overall “rocking the boat”. They keep telling me that you can’t get someone to get help if they don’t want it, and I know that’s true, but I don’t think he appreciates just how worried we are for him or how much we still all care for him. I feel like he needs a push toward getting help, but even if I decide to get the courage to approach him about it alone and risk what little relationship we have, I feel like it won’t be as effective as if we all approached him together. Many times he’s talked like he views my grandmother and even my mother (he’s always been a mama’s boy) as being out to get him because they are frustrated with how he treats them or try to encourage him to do something, anything.

I am worried sick about him. I don’t want to bury my younger brother or end up saying all those nice things I said in the first paragraph in a eulogy for him. I don’t know what I can say or do to encourage him to finally get the help he needs, or get others to help me in that regard (I’m afraid despite being close to my grandmother, I don’t think my family takes me very seriously because, again, I have my own history of mental illness and disability). Is there anything anyone can offer to help me? Any advice on how to get through to him? Anyone who has been in a similar situation and had something work for them? My mother says it feels like he left his soul in New York City, since it was when he came back from there that his downward spiral was really noticeable, but I don’t think anything specific happened to him there, it was just the timing.

TL;DR: My brother is deteriorating mentally and physically, and I need help convincing him to get help or convincing others to join me for an intervention for him.