**Note: I am discussing children under the age of 18 in this post, not referring to adult children.**
Parenting is full of the unexpected: broken bones, bad grades, moving, breakups and more.
The life of a parent with a child with a mental illness is a bit more complicated. Watching for signs of self-injury, a meltdown that may require help from professionals, not knowing if your child will be “okay” the next day… it can be exhausting.
There is a point in which some of these parents have to make a decision to place their child in a mental health facility, for emergency short-term treatment or possibly long-term treatment. It’s heartbreaking and most don’t really want to. (Some do but that’s a whole different topic that I am not covering because it angers me so much. It would be more of a rant post.)
Thoughts From The Other Side
I’ve watched parents sign the paperwork in admitting while sobbing because they felt like they failed as a parent. Sometimes it’s the last option before something tragic happens to either the child, them and/or someone else, so no, it’s not exactly a failure as a parent. There is a point in which it is a parent issue that they just don’t want to face, but I digress. Those are the parents I’ve seen sign papers and walk out of the building without a second thought.
Some kids come in quietly, some fight the whole process from admitting to the unit. That is not pretty or fun for those involved in the physical managements. Kids don’t always understand why they are in these facilities. Parents are usually able to bring their children in, but some are brought in by ambulance due to the situation they are coming from. They might be coming from another facility, juvenile detention center or hospital.
Many of the kids I worked with stayed long term because of their complex issues- varying from mild to severe autism and other developmental disabilities. Before I went to that unit, I worked with kids with emotional and behavioral issues, so some of them had already been to foster care, juvenile detention, and other placements. The decision to come to this facility had been made for them, of course, based on several factors.
I met these kids after suicide attempts, crimes, fights and all sorts of things that you probably don’t want to think of, but yet, they still kept going, even on days that they just wanted to give up and shut down. We wouldn’t let that happen- thanks to a team of psychiatrists, nurses and of course, the mental health associates that the facility couldn’t function without.
If you’re super curious about what that job is like (it was literally the best job I’ve ever had and I still haven’t found another one I have liked nearly as much), please read Real Stories of a (Former) Mental Health Worker
There are some tips I will share if you ever have to take this step with your child:
- Please label your child’s clothing and other belongings with their initials with a permanent marker. The staff will wash clothes at least every other day and this helps a ton. Laundry is usually done at night (kids are sleeping and there is more time) and it’s easier to sort if you know what clothes belong to who.
- Psych nurses are angels.
- Mental health associates, for the most part, have bachelor’s degrees, or some college hours, so please remember that when interacting with them. I have one and so did all of my co-workers, we were required. Many family members didn’t treat us as such, but please respect us for our work. It’s hard.
- Please remember that the admissions office can only move so fast and that getting mad at the staff doesn’t help things, it just slows them down. There’s a lot that goes on in the background that you can’t see before your child goes to a unit/floor. It’s similar to a hospital.
- We don’t control the food that is made in the cafeteria.
- If you can, PLEASE make a list of likes/dislikes because this saves time and trials for everyone involved with your child. It helps even more if your child is non-verbal.
- You are not a terrible parent for admitting your child and do not be ashamed. There are groups you can reach out to. Please ask for support for yourself when your child is admitted or ask their social worker/case manager. That’s what they are there for.
- If your child has to be physically managed, please realize we don’t enjoy it. I absolutely hated having to be in managements. I can’t think of anyone who liked them. It is only allowed by a doctor’s order and has a ton of regulations and requirements behind them.
If you have questions or thoughts you want to get into, please email me! I’d love to discuss.
How Did We Get to This Point?
Everyone’s situation is different- I’ll just point this out before I get deep into the topic.
I’ve never had to think of hospitalizing Julian, thankfully. I can’t imagine a point in which he would need it. His meds are stable and his aggression levels went down a long time ago. I can’t remember the last time he got mad and turned a chair over.
Obviously, I’m going to recommend calling 911 immediately if things are life-threatening (someone has a weapon, actively hurting themselves, etc). There are some things that you can’t just wait in the ER for.
Otherwise, it may be a good idea to call your child’s mental health provider and/or go to an ER if:
- Extreme aggression/destruction
- Extreme alcohol and/or drug use
- Not eating/sleeping for a certain amount of time
- Severe psychiatric symptoms that have not responded to outpatient treatment
- Other issues that may be seen in your child that are more extreme than usual- self-injury, anxiety, etc.
Some of these may be bad reactions to medication, but it is still better to be checked out. I worked with a child that had hallucinations for two days before his mother took him to the ER. Turns out it was a bad reaction to his new anti-psychotic. He was taken off it immediately, then stayed a few days inpatient to stabilize on new medications.
The Hospitalization Process
Depending on the facility and many other factors, you and your child may have to wait a long time in the waiting room (also called admitting, if you’re at a private facility). You will have to stay with your child the whole time- filling out paperwork, dealing with insurance, and arranging the actual admission.
If you are in a hospital ER and your child is transferred, they will be taken by ambulance and you can follow or ride with them. Once your child is admitted, you will be given all the information you need on contacting your child. You will also be given a list on what your child can and cannot have, and believe me- if you try to give something to your child that is on the “Cannot have” list, it’s not getting to them. This is for your child’s safety, especially if your child has been hospitalized for suicide/self-harm reasons.
Shortly after admission (or in the morning, depending on the time), your child will be assigned a case manager/social worker. These people are fantastic and will do their best to help your child- contacting providers, making a discharge plan, among other tasks. This is the main contact person for you to contact about your child’s care. You can also talk to your child’s nurse.
Your child may or may not attend school while they are hospitalized- this depends on the length of their stay. Many private facilities have a school on the property. The facility I worked for had a K-12 school in the building and every child went throughout the school year, and a bit over the summer. If your child is there for a short stay, they may not attend. You may be asked to sign paperwork to allow for school records to be sent to the facility so your child can attend- they can’t go without it.
A treatment team consists of nurses, a psychiatrist, other staff and the social worker. They meet daily to talk about the progress of the patients on a unit, including your child. If your child needs something like medication changes, diet changes, etc., it’s discussed in this meeting.
Most parents feel guilty, relief, anxiety, sadness and maybe a mix of all these emotions while their child is hospitalized. This is okay. A mental health facility can be a bit intimidating, no matter how welcoming the staff is. Just remember that you can call at any time to check on your child, that you can visit and to take care of yourself. This is important. If you need help with other children and/or other tasks, ask for it. This is a rough time for the whole family.
The Path to Home
It may sound a little weird, but hospitals are required to start working on a discharge plan almost as soon as a patient is admitted. (I don’t run these places, I just worked in them.)
The planning includes information on medication, mental health treatment, placement (if needed), education, housing (if needed). You have to be a part of this process. If you think your child isn’t ready to be discharged, you can talk to the hospital’s complaint department.
When picking your child up, keep in mind that they have just been through a huge transition, whether this is their first or fifth time in treatment. Keep the first couple of days low-key so they can adjust to being home, in a quieter environment. Make appointments if needed and slowly adjust them back to the daily routine.
If you have questions, you can call the social worker that worked with your child and go from there. Don’t think you have to go at things alone.
Parenting can be a tough path- seek out help when you need it, support is always out there. Resources
Information courtesy of MD Coalition
Pics courtesy of Unsplash