Dealing With the Unexpected: Mental Health Hospitalization and Your Child

**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:

  • Hallucinations/delusions
  • 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

A Parent’s Guide to Screen-Free Activities

It seems as if our kids were born with the ability to work a tablet, computer and/or phone.

Or is it just my kids?

It’s a well-known fact that most kids are very attached to anything with a screen and a keyboard, so I’ll spare all of us the research. The question is, how do we get our kids AWAY from the screen?

*pause*

*crickets*

Sigh

There’s Fun Beyond The Screen

I promise there is.

Our kids might not see this, especially if they’re teens and love Netflix, but there’s really a whole world out there. I have a kid on the autism spectrum, so this is double the fun.

Tips for getting your child off the screen:

  • Have another, more fun, activity lined up. This one is pretty obvious. It’s a clear winner at my house. Know your kid- what do they like? What is something you know will interest them for a couple hours (or however long) to keep them off the screen and engaged? Try something new, you never know what might get their minds going. At my house, this includes nerf guns, parks, walks and simply telling Julian to ride his bike.
  • Find apps with built-in timers. Some apps have these and automatically shut off after a certain amount of time and then the fun part- making sure your kid doesn’t go straight into another app.
  • Find a stopping point. This works wonderfully with kids who do not do well with interruptions or transitions. If you can have them stop at a certain episode, level or other points, it may be easier for them to stop. It can be super frustrating to have to stop in the middle of something.
  • Discuss consequences and follow through. Every parent knows that kids need consequences. If your child doesn’t follow through with your rules on not stopping, limits, etc., then it is time for a consequence.
  • Try limiting your own screen time. Look at how much time you spend on your phone/tablet.
  • Ban electronics at mealtimes. Some families allow electronics at the dinner table, which limits conversation at the main time of the day that everyone is together.

A note for parents of kids with autism: This can be a special kind of challenge because some kids use iPads to communicate, some behaviors can be stopped (short-term) by handing the child a device, and it can also be used as a reinforcer for good behavior.

Also, some kids with autism are great with computers. You may have to get outside assistance to modify the behaviors your child has, depending on the severity. This information is from Psych Central

Alternatives to The Screen

This is where the fun comes in- what can kids do besides play or watch things on a screen?

Plenty. Here are some ideas.

  • Read a book
  • Draw/color (there are SO MANY awesome coloring books out there)
  • Painting rocks (check out Pinterest)
  • Go through old clothes/toys to donate
  • Take a walk, go for a run, ride a bike
  • Picking apples, other fruits
  • Plant a garden
  • Birdwatching
  • Learn a new skill/hobby
  • Watch the clouds

It can be hard to put down the screen at first, but the memories you make as a family are definitely worth it.

Do you have any activities to add? List them in the comments!

Pics courtesy of unsplash

Book Review: “Fall to Pieces”

I love to read memoirs. For some reason, I really enjoy reading memoirs of those with addiction, and this was before my drinking became a problem. I’ve read “Life” by Keith Richards, which was fantastic but took three weeks because it’s over 500 pages.

I’ve also read Nikki Sixx’s book, “The Heroin Diaries”. It was a bit wild, but still very interesting. I’m just waiting for a member of Fleetwood Mac to come out with their memoirs. If anyone knows of one, please let me know.

I”ve read “Fall to Pieces” before, but it was a bit different re-reading it this time. This book was written by Mary Forsberg Weiland, the first wife of Scott Weiland.

He was the lead singer for Stone Temple Pilots, one of the best rock bands of the 90s. If you’re too young to know who this band is, you might want to go on YouTube. They were a great band. Scott died in December 2015, unfortunately from an overdose.

Book cover

The book opens with a very descriptive explanation of her childhood in California, a bit in New Jersey after her mom’s remarriage and, of course, when she met Scott.

Mary also became a model while moving around and became quite successful while still a teen. She also met her best friends during this time. She became friends with Anthony Kiedis, lead singer of Red Hot Chili Peppers. They have remained friends for many years.

It wasn’t until I read Scar Tissue, his autobiography, that I understood all the while Anthony was being my true friend, his own soul was being badly shaken.”

This stood out. We don’t always know what our friends are going through, much less anyone else. People hide things but still make things look at least bearable. I’ve been there for my friends through their own issues but yet struggling through my own.

The story of her relationship and later, marriage, with Scott, is so well detailed. She tells of the good, bad and in between. They were together off and on nearly a decade before marrying, and they had two kids together- a daughter and a son.

During this time, Mary drank and used a lot of substances. She knew it wasn’t the best way to live, but it took multiple attempts to finally stop using.

Mary also has had a long battle with bipolar disorder, possibly beginning when she was a teen. It’s hard for her or anyone else to know. She wasn’t diagnosed until well into adulthood, and this is well documented in the book. She struggled to accept this diagnosis along with being an addict.

Many people with either issue do. I will say she is being treated and is sober, but I won’t spoil the ending for you on how she got there.

Mary shared a quote from a community college class:

“In recovery, we look for progress, not perfection.”

Collage 2018-04-15 14_57_12.jpg

This is very accurate. Nobody is perfect, and anyone recovering from any kind of addiction certainly isn’t. Progress is what counts the most. It is not close to easy, and anyone who tells you it is- they are not entirely correct.

One of my best friends, Tyson, once asked me if I was okay while sitting at dinner and the talk to turned to beer for a while. I wasn’t a fan of beer to begin with, and he knows this, but he was making sure I wasn’t thinking about having a drink.

I wasn’t, but I am very grateful that he asked. It took a year before I could even go into a sports bar. “One day at a time” is the best quote I have ever heard that applies to recovery.

As many of us know, Scott and Mary did not work out (the section about the end of their marriage is a sad one) but they were able to co-parent, at least as of the writing of this book. I’m one of the millions of fans that were saddened to hear of Scott’s death. He was incredibly talented, like many others, but yet, he had an addiction that he was never quite able to end.

Pic courtesy of Google

The Deeper Thoughts of A Special Needs Mom

I’ve talked about Julian, and to a smaller extent, Lily, a lot. If you’ve missed Lily’s story, you can catch up in these stories:

Special Needs Round Two

Thoughts on a Second Diagnosis

It’s a lot to deal with. I didn’t wake up one day and wish for not one, but two kids with special needs plus a third with a heart condition. I promise you, I didn’t.

Cameron’s SVT is pretty much manageable, but it’s still super scary when your kid texts you at school because his heart feels funny and you’re a half-hour away trying to watch “The Act” with a friend. (I recommend that show if you’re ready to throw things at your TV.)

I’ve heard pretty much everything since I even had a thought that things weren’t 100% okay with Julian when he was somewhere around four years old. Lily was about a year when I noticed things were less than perfect with her development.

One of Matthew’s aunts hinted that having her three weeks early plus my heavy activity while I was pregnant with her might have led to her not doing what she should.

I almost punched her. Matthew grabbed our coats and we went for the door. Mama Bear was ready to roar.

Not long afterward, Lily was evaluated and of course, I didn’t do a single thing to cause her delays. She was born three weeks early, but that’s not early enough to cause the severe global delays she had. His aunt can go have several seats because Lily has since kicked her brothers’ butts in grades and speaks wonderfully. Two years of speech therapy will do that for you.

When you have a kid that consistently has meltdowns, tears your house apart, runs off in public and does other things that make people go “hmmm”, you’re going to hear a lot of different opinions. I heard almost everything before and after Julian’s diagnosis, even after I put him on meds, even from Matthew, which contributed to our marriage falling apart.

Sad

The Battle In My Mind

I heard a lot internally, also. This is the stuff that will rip you into shreds. It ripped me in half. I read books. I cried. I yelled. (I’m still working on this one, because, well, I’m not perfect.)

I talked to my mom, who understands Julian on a level that I am not sure I ever will. She says she was like him as a kid but didn’t have a mom that tried to understand her like I do Julian. Even though I worked with kids that were like him but bigger, I still didn’t get it. I was lost. So was he. I kept hearing these thoughts:

“You’re a terrible mom.”

You can’t handle Julian and Lily.”

The house is a mess and so are these kids.”

“You’re not good enough”

No wonder I was depressed, and Matthew wasn’t helping. I was trying to help Julian on my own. Lily had therapists left and right, and she did great in First Steps, but I was entirely on my own with Julian. I had some moral support on the bad days from friends and my mom, but I stopped going to Matthew because I knew I wouldn’t get it.

Julian finally got diagnosed in late 2011 and his evaluation was one of the best parenting decisions I’ve ever made. The story of that can be found in Looking at the Bright Side

Getting him on medication is a decision that I do not regret and to this day, I’m glad that I did. Some kids with severe ADHD can function well without meds and that’s great, but as of now, it just isn’t a possibility.

Maybe when Julian gets older, we can revisit meds, but for right now, I’m not willing to take him off. Clonidine is a great medication for impulse control and sleep- he has not been a great sleeper since he was a toddler, and whew, he needed something for impulse control.

Hearing From the Outside World

In the almost eight years since his diagnoses, I’ve heard so much, positive and negative about them. At this point, I’ve probably heard everything, so I no longer care. These are just a few that stick out:

“I’m sorry”- well, I’m not. I am not sorry that my son has an awesome brain that not a lot of us can understand. I would not change him, but I would change his struggles.

I couldn’t do it“- it’s not as hard as you think. Some people really are not meant to parent kids with special needs. If you watch the news, you can see this. Being the mom to two kids with special needs is hard.

It’s really hard when both have a rough day and all I want to do is cry. Instead, I just do my best and everyone goes to bed early. I have a support system that now includes Matthew, my mom, and great friends.

“He doesn’t look autistic”- this makes me want to punch people. First of all, there isn’t a “look” that people with autism have. They look like everyone else. Second, I’ve put years of hard work, money and my marriage on the line (right down to divorce papers) to make sure he is happy, medicated and has skills to live the best life he possibly can. Why wouldn’t I?

“Does he really need the meds?” This one was from my mother in law. She wouldn’t give him his meds on sleepovers but yet complained that Julian wouldn’t sleep. Matthew and I told her either stop complaining or give him his meds- guess who sleeps great now?

I don’t explain anymore to people why I decided on meds, I simply ask them if they want to come to my house on a day in which he hasn’t had meds in two days. (This is not a thing, by the way.)

“How do you do it?” This is annoying. I parent just like everyone else- I get out of bed and hope for the best. Honestly. Pepsi helps. Staying sober is a huge thing. When I was working with kids with developmental disabilities, I will admit, that was rough.

I would come home from a full day, sometimes 12 hours, then have to deal with Julian. (Lily was much easier.) I was mentally and physically drained a lot, and I almost asked to not go to those units, but I loved the work. I eventually transferred to one of those units about a year after Julian’s diagnoses.

At this point, I keep a consistent routine, both kids in their therapies, Julian’s medications consistent and just keep moving. Three kids is a bit of a circus without special needs, but having two with ADD, ADHD and autism is a whole different game.

It requires patience and empathy that I didn’t think I possessed, but here I am. Some days entirely suck, but then, I am dealing with two teens and a preteen.

“ADHD is not really a thing.” Okay then, please come clean Lily’s room, because she cannot without a list explicitly telling her what to do. I also have to take her tablet. She gets distracted so easily that I have to constantly check on her, which annoys her but the job gets done, right? Plus, come wake her up for school. No other explanation needed.

I’m already trying to figure out her morning routine for middle school because it will have be a lot different from the elementary school one.

If you want to experience it from Julian’s perspective, try being super smart, but bored as hell after you finish your work at school, even when the teacher offers you more stuff. Try being hyperfocused on things but not being able to finish them because you, like your sister, get distracted easily.

As a five-year-old, try running off in a parking lot after a bird and not realizing there are cars that can back out at any minute and hit you because all you want is that bird. Oh, and throw in autism. It’s a lot. I don’t know how Julian does it. He prefers to stay at home but will go out if there’s not a lot of people involved.

This stuff happens, everyone. I had to chase Julian through parking lots more than once because he darted off. He’s always been a fast runner. Luckily, he’s stopped this. Whew.

Even with meds, he struggles. They don’t cure ADHD, but they definitely help. I wasn’t looking for a cure- just something to help him not be so aggressive, impulsive, calm enough to sit and learn, and most importantly, sleep. As the years have passed, Julian has calmed down quite a bit, which is a bit of a relief.

Flower

A Few Kind Words

If you’re reading this and you’re not the parent of a special needs kid, please take this as what not to say to someone who is. There are other things you can say that are so much nicer, like:

  • “How is your child doing?”
  • “Is there anything I need to know or learn about your child’s diagnosis?”
  • “Let me know if you need to vent/get out/anything else” (this is so freaking important and believe me, we need this)
  • “You can do this.”
  • “How can we include your child?”
  • “Neat accessories”.. if they have them

These are just a few suggestions. I’ve had parents ask how they can accommodate Julian over the years on playdates and parties and I have appreciated this so much. My father in law has indulged his love for destroying things by bringing him things from his old workplace to take apart.

I’m just a mom, trying to get through parenting. It’s a weird world out there.

What annoying things have you heard while parenting? It doesn’t have to be special needs related, because every parent has heard something annoying. Feel free to share.