When someone has a mental illness and doesn't acknowledge it, a thorny question arises: Should someone else force that person to get treatment?

Take Eliott Dunwody's younger brother, Alfred, for example. Now 39, Alfred has lived for years with schizophrenia.

"He's our sibling, he's our brother," Dunwody says. "We want to see him and talk to him, but you can't carry on a conversation with him. Sometimes he hears voices so loudly, you have to yell at him to get over the voices that are in his head."

Dunwody, who recently retired from the Bibb County Sheriff's Office, says his brother has roamed the nation for years, living on the streets, getting into fights, going in and out of jail, losing touch with his family and generally refusing treatment for his illness. Occasionally, when he is on psychotropic medication, his symptoms subside and he is coherent.

Most of the time, Alfred's relatives have no idea where he is. They are heartbroken at his plight.

Alfred's family has tried to get him to stay in treatment, but he never does. In times past, when he would come into town, the family would get a court order to have him treated at Coliseum Medical Centers or The Medical Center of Central Georgia.

"But we couldn't keep him there," Dunwody says. "We weren't trying to institutionalize him. We were just trying to get him into some type of program."

Dunwody fears that without long-term intervention, the family will get a phone call someday from a distant city with bad news.

"If we don't do anything, this is not gonna be a happy ending," he says. "But we can't even try and do anything now, because the law is against us."

The law permits a court to order mandatory treatment - either in a hospital or in a community center - if a person has a mental illness and poses a danger to himself or others.

But the law also requires treatment in the "least restrictive" appropriate setting, and allows the patient to be released once the danger is past.

The legal standards prevent the abuses of decades past, when a family could have a troublesome relative locked up in a place like Central State Hospital for life without much hope of review.

Bibb County Probate Judge Bill Self shares the frustration of families who come to his court and get an order to hospitalize a relative, only to see that relative released quickly and without much improvement in their state of mind.

"It's very frustrating," he says. "Then the family complains that the patient wasn't kept in the hospital long enough. They typically will make that complaint to me: 'You sent that patient over there and he wasn't kept but three days and he's back out and he's gonna be off his medications in a week. Why didn't you make him stay there longer?' Well, that is beyond my power under the law."

Self would like to see more use of a provision called mandatory outpatient treatment. It provides a middle ground, he says: Leverage to impose treatment on a person who needs it without the constriction and expense of a hospital stay.

"Unfortunately, it's used so seldom it's hard to gauge its success," Self says. "But the idea behind it is to prevent the patient from becoming destabilized to the extent that rehospitalization becomes necessary."

Frank Fields, director of River Edge Behavioral Health Center, says the reason it isn't used much in Georgia is cost. He would have to provide an attorney for the prospective mental health client. He says his center can't afford the expense.

"I wouldn't start paying attorneys to do that," he says. "I don't think it would be worth the investment for me."

Dr. E. Fuller Torrey, a nationally known advocate for people with mental illness, is a strong believer that sometimes a mentally ill person must be ordered to have treatment, even if he or she doesn't want it.

"We changed the laws to make it virtually impossible to treat anyone against their will, even if they have no awareness of their illness," he says. "So it is extremely difficult to get anybody into treatment once they have been released, until they have actually done something to bring themselves into the criminal justice system.

"It is so bad that families are being told, not rarely in the United States, 'Look, Mrs. Jones, there is no way we can get your son into treatment given the laws in our state. The best thing you can do is get him arrested. Because once he's arrested and in the criminal justice system, then we have some hold over him.' "

The question of mandatory treatment divides even those who agree in many other respects about the need for better mental health services in the United States.

Larry Fricks, a consumer specialist with the Georgia Department of Human Resources, believes that better services are the answer, not mandatory treatment.

"There have been national studies that show that by easing the commitment laws, you really did not improve the outcomes," he says. "But if you provide a recovery-oriented community service system that is responsive and really wraps around the individual, that's when you'll get the (desired) outcome."

None of which is much comfort to Elliott Dunwody and his family. He just wants to find the leverage to compel Alfred to sit still long enough to clear his head.

"It would be good for us," he says. "It would be good for the taxpayers, and it would be good for the system."