From my experience volunteering at the shelter, it's almost impossible to convince some people they are suffering from mental illness. They think the problem is the rest of the world, not their illness. They are distrustful of doctors. Some people don't even believe mental illness is a real thing. Others realize they are ill, but refuse treatment due to side effects, and won't go to counseling because they don't want to open up to a stranger. I don't think we will ever go back to the days of involuntary commitment of longer than three days. If a person can be medicated for three days, the hope is that the medications will help them see things more clearly and finally understand the need for continued treatment after their release. Sometimes a judge can mandate t counseling, but rarely medications. I hope Josh gets the treatment he needs, and that you, your sister, and everyone involved stays safe.