Anyone had to deal with somebody having established, persistent delusions....

A sometime band member was a deep-cycling bipolar with paranoid schiz overtones, on heavy meds, with "past" addictions. Then he was pretty heavily medicated for rheumatoid arthritis and some bone issues and thus-- to be brief-- very unpredictable.

We had to learn as a group how and when to invite him to play or jam.... how to help him participate positively.... how to develop boundaries.....

What ended up happening ove the several years he was around was that on his better days one could discuss policy with him, and then recall it to his mind on the bad days. He really WANTED things to work-- not always the case with others I am sure-- and that made him more reachable as he'd slide across from one extreme to the other..... the positive experiences accumulated so that he eventually learned, himself, when to come and when to stay home, pretty much.

Where the boundaries were laid had to do with the reality that some get-togethers were for US, and some were for others (audience, singalongers).... If it was a "just-us" jam of course he was welcome in pretty much any shape. But if it was anything close to a perfomance situation, we all agreed that he had to be in pretty good shape in order to participate-- had to be able to keep his attention manageably off of himself and his inner processes and on the outside world (and the band leader's guidance). I steered him through many a close-call situation, with his full cooperation, because I "understood" his situation pretty well and we had a good rapport.

So, it's complicated, and there are a lot of aspects to address, and you just do the nest you can.

~Susan