Welcome to the bb forums. I am very sorry to hear that your son is so unwell and that you are both in so much pain.
I understand your fear, frustration and anxiety as I care for a child with anxiety and OCD and we have been through rough patches where she has resisted help and I feared for her life. It’s not easy, I know.
Even though your son is refusing treatment, I highly recommend that you and your wife seek the services of a mental health practitioner. This person can guide and coach you on how best to support your son. You will both need to be on the same page to provide effective support, which is why I suggest you both go.
I would also suggest you have a look at the bb ap, Beyond Now. It’s a suicide prevention safety tool. Even if your son won’t engage, it will help you both to have a look and to think about a number of important issues and be prepared. On the same note, you can take some practical steps to enhance home safety (eg remove sharp objects and prescription drugs) and/or enter the numbers in your phone for local emergency mental health services.
If your son isn’t working, I’m wondering how he can afford drugs, alcohol and vaping? If you have control in this space, I would encourage you to use it. Obviously none of those activities are going to help.
As you already know you can’t force your son to speak with a professional. Not even to speak with you. But if you can engage him in a shared activity (eg a walk, cooking, a drive, a meal, etc) you will have a space and opportunity to talk.
Let him know he’s loved and that you are there for him. Don’t push. If he opens up about anything just listen and try to keep him talking with open ended questions. Create as many opportunities as you can.
Can you think of any other person you trust to try and engage with him? An Uncle, cousin, neighbour or friend? When my daughter was really struggling an older cousin played a key support role. Just a thought.
I think you might need to be really patient but persistent. If you know why he’s refusing help (eg stigma, denial, etc) it will really help you to tailor your messages.
I know you love your son and you want “him” back. Please know that this is possible with love, effort and eventually the right treatment. Hang in there.
Please post any time. Our community will walk with you.
Kind thoughts to you