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

Talking About Pride

Coming Out of the Closet

I decided to use an actual definition for this one, because I understand that not everyone may be clear on this one. I also think it’s the respectful thing to do. I’ve got friends and family members in the community, so I’m very clear on what this term means. Planned Parenthood- Coming Out Definition

It’s a hard process. Some people choose to wait until a certain time, some never do. It’s an individual choice, and should be respected. If someone comes out to you, please respect that person’s decision to tell you, even if it isn’t within your own values. It takes a lot to say “I’m a lesbian” or “I like guys”, or however it is said.

There is a lot of fear in coming out, however. Many people fear these things:

  • not being accepted. If there is a history of hearing homophobic slurs throughout life, it’s going to be hard to go against that.
  • getting cut off financially/becoming homeless- especially in teens and college students. Some wait until after college for this reason.
  • anxiety, depression or other mental health issues worsening afterwards due to above issues.

There is so much more support these days for the LGBTQ+ community. I feel there is a long way to go in the legal world, but it’s coming.

Marriages were a huge issue a couple years ago and I shed tears when they became legal everywhere. I believe some states are still trying to fight that one. Macklemore had it right when he said in “Same Love”- “No freedom until we’re equal/ Damn right I support it”.

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Pride Events

Have you ever been to a Pride event? I have been to quite a few. Louisville is a big city and every June, there’s a huge Pride event. The event has lots of food (my main requirement for anything), music and a lot of other fun things.

I usually see a lot of friends while I’m there. It’s so much fun. If you’ve never been, and you’re comfortable going, go. If you aren’t sure if there is an event near you, try looking on Google “pride events” and your city or the nearest city to you. Not everyone lives in or near a big city.

These events began as a way for people to get together, have fun, be themselves, meet others and not fear being judged or getting hurt. Of course, this didn’t always go well but over the years, the events have become safer. There will always be those that oppose these events.

The Kid Version

I have a friend, Kate, that is happily raising a son, with her wife, Christy. Lucas just turned two, and he is the happiest toddler that I’ve seen in a long time.

I hope he stays that adorably happy. They got married in Hawaii a few years ago and the pictures were adorable. I know they have struggles like everyone else, but they’re one of the cutest couples I’ve ever known. Lucas is like every other toddler out there- he just has two loving moms.

I wrote a post not long ago, LGBTQ Kids: A Guide for those who need a bit of help figuring out how to navigate the waters of having a child that identifies as LGBTQ.

This is becoming more common than people realize and I wanted to bring that to your, my readers’, attention. If you know someone who could benefit from it, feel free to send them the link.

I think it could help parents who aren’t sure what to do. We don’t always know what to do as parents, or even aunts, uncles, and so on. That’s okay. That’s why we ask others for ideas and read up.

Kids are pretty smart. They can tell who accepts them and who doesn’t. They’ll stay closest to those that do. All kids, no matter their sexuality, need someone who loves and accepts them exactly for who they are. They don’t need or deserve ridicule for who they love. They have enough to worry about.

Mental Health Issues in The Community

Anxiety and depression are common in many people. When you are struggling with hiding who you are (or feeling like you have to), losing someone you love and having to start over in a small pool of people and not feeling fully accepted,things can get very hard.

Drugs, alcohol and self-harm are three coping skills that are used by this population. Sometimes it can be deadly. There are therapists that specialize in LGBTQ issues.

This may be a good time to look into how you can become an ally or otherwise support the LGBTQ people in your life. How can you be an ally?

Pics courtesy of Unsplash

Support Groups: What’s in it for You?

We are not meant to go through certain events alone- serious illness, loss, kids with disabilities and other events that shape our lives. This is when the power of numbers comes in. Being around others in a similar situation can be comforting and sharing your thoughts can help with processing. It can also help someone else realize they are not alone.

Yoga Class and Hope

I haven’t been to an AA meeting since I have stopped drinking. I considered it but realized it isn’t for me. I have read the Big Book and went back for a re-reading. I did, however, randomly find a 12 Step Yoga for Recovery group on Facebook. I was a bit nervous when I went the first time. I’m a bit nervous around people that I don’t know, so it took me a few Sundays to say anything besides my name.

I’ve gone almost every Sunday since November and I really enjoy it. I don’t speak every week, but I do like reading one of the two reflections that are meditated upon. This meeting gives me a chance to think about subjects that I haven’t thought about in a while or, sometimes, not at all. I don’t mind this, because new thoughts can be good. From time to time, the topics may stick with me throughout the week- not in a bad way, but in a way that makes me think about making myself a better person.

I started attending the group for two reasons: I like yoga (and needed a beginner class) and I was struggling. It’s entirely possible I would have relapsed without going to this group. I needed extra support that only others battling the same thoughts and emotions could give me. In the months since I think I’ve lost a few pounds and I’ve become somewhat more flexible.

My airplane pose will probably always be awful on the right side, but I can do a terrific downward dog. I have to sit out the sideways plank because I appreciate being able to use my wrists, but my tree pose is slightly improving. I’m pretty sure my future hip replacement is going to be caused by too many Sundays in the half pigeon pose.

I still don’t say much, but I do like listening to other people’s stories. I got my two year (and first ever) chip at a meeting in January, and next up is July when I hit two and a half years of sobriety. The stories I hear give me hope on the Sundays that I come in struggling and I hope that when I actually do speak, I do the same for someone else.

Chairs

Finding a Group for You

Support groups can be online or in person. Online can be a great option if you are in a rural area or otherwise unable to leave home to get to an in-person support group. Most groups are held at hospitals, community centers, churches, or other locations. They can also be led by group members or other facilitators like a nurse, social worker or other professional.

These groups are not the same as group therapy, as those groups are a specific type of treatment for people with similar diagnoses led by a licensed medical professional. Support groups are meant to be informative.

As with most things, going to a support group can have benefits and risks.

Benefits:

  • Feeling less lonely or judged
  • Talking openly and honestly about your feelings
  • Learning new skills to cope with challenges
  • Improving understanding of a disease/condition and your own experience
  • Learning about resources
  • Staying motivated and gaining hope

Risks:

  • Disruptive group members
  • Lack of confidentiality in some groups
  • Interpersonal conflicts
  • Inappropriate medical advice
  • Comparisons of “who has it worse”

You can tell if a support group is risky if you are pressured to pay high fees to attend, are promised a cure and/or are pressured to buy products. Information found at Mayo Clinic

You got this

Making the Most of Your New Support

Once you find a support group, it’s time to make it work. Talking about your struggles in front of strangers is hard. You don’t have to say more than you want to, but even a little helps when you feel you can. It may help lift a weight off your shoulder that you may not know you had.

Most facilitators are used to new people in the group and can guide you through the rules and processes. If the group isn’t for you, you’ll find out in a few sessions. You don’t have to do everything that is suggested- absorb what works and let the rest go.

Enjoy the new perspectives in your life and thoughts they bring.

Pics courtesy of Unsplash

Have you been to a support group? Did it help?

Don't allow your child to be left out of family activities

Helping Your Family Understand Your Child’s Special Needs

Family can be supportive in the best circumstances, but in the worst, can be standoffish and even cruel. When your child receives a special needs diagnosis, it’s hard on everyone. It’s life changing and you will need plenty of support.

Many people, myself included, turn to their family for this support. Some get extremely lucky and their families do everything they can to help out, but some families aren’t as lucky for a few different reasons- distance, lack of family closeness, or just not wanting to get involved because they don’t understand the diagnosis. This can be deliberate.

Storytime!

Julian was diagnosed at five years old and most of Matthew’s family, including his mother, would not listen to anything either of us had to say about ADHD or autism. They thought he was just “hyper” or we just needed to discipline him more.

Okay, then.

He’s been on medication since shortly after his diagnosis, and on sleepovers, my mother in law wouldn’t take those meds with her, even though we explained how to give them. It’s not that hard. One morning, she complained for about the 900th time that Julian barely slept.

Really? I wonder why. He didn’t get his meds.

Matthew had run out of patience at this point, and he’s a very patient man. He looked his mother in the eye and told her that he did not want to hear another word about this if she wasn’t going to give him his meds. She was well aware of how to give him his meds, she just didn’t want to deal with it. She didn’t see the issue- remember, ADHD and autism aren’t a thing.

Julian has not left for a sleepover without his meds since.

The message behind this story? When you decide not to learn about a child’s medication because you don’t see the need for them, it will backfire. Just because you don’t think it’s real, doesn’t mean it isn’t. *gets off soapbox.. storytime over*

Talking to your family about your child's disability

Educate, Educate and Educate Some More

This begins with you, the parent. As soon as your child has a diagnosis, it’s time to do a lot of reading. Depending on the diagnosis, there are books out there you can read, maybe even a podcast or two if you are a fan of those. Learn how to use equipment, read up on sensory bottles, whatever it takes. If you need to, ask for help from your child’s pediatrician, specialists, etc. They are there to be a resource for you.

The more you know, the more you can help your child. They can’t always speak up for themselves, especially around a family that doesn’t understand. Don’t be afraid to challenge these family members- I’m not and they know it. I’m not saying to be rude in this challenge, but definitely come prepared with answers and don’t let anyone walk all over you. Have someone with you as backup if you’re not big on confrontation.

Some people are simply afraid. If they don’t know how to care for a child that needs medical equipment, has a severe food allergy, or is non-verbal, they stay away. If they are interested, have them come to a medical or therapy appointment. This can help them adjust a bit easier to your child’s world and get some questions answered.

The hardest explanation, I believe, is when your child has an “invisible” diagnosis. Julian is one of these kids, and it can be somewhat draining to explain that just because you can’t “see” ADHD and autism, doesn’t mean he doesn’t have it. I don’t think they really want to see him in the middle of a meltdown, because they would have no idea on how to deal.

They do not see the years of therapy, meds, money spent on both, my tears, the fights I had with Matthew to even get him diagnosed, the time I have spent in IEP meetings (or time I spent getting him one) and the sheer energy I have put into making sure he is the adorably funny kid he is.

Create Some Space

Some parents just aren’t able to make things work with their families even after trying to educate, and this may be the result of or part of other issues. This isn’t great, but it happens. It may be time to take a step back from these family members until things improve. This may be painful but the best option for you and your child. It may be stressful for everyone involved to continue to try to make things work when it’s obvious it won’t.

Don't allow your child to be left out of family activities

Build Your Own Circle of Support

Luckily, my mom and sisters are a great support. My mom and Julian are very close. I’ve also been able to create a circle of friends who get what I deal with on a daily basis- their kids are also on the spectrum. I know I can text or call them and they’re available. That is a wonderful feeling. I know that even on a crappy day, I’m not alone and one of them is probably having a day like mine. In fact, one has two kids on the spectrum, so his house is never dull.

Outside of that group, I’ve also joined a few Facebook groups, and they have been a good source of support for questions about ADHD. I’ve also joined some subreddits on the same topics. Internet groups can be a wonderful source of support, especially if you are in a rural area. This can give you a sense of community even if you’re not near an urban area.

If you are in a larger city, I recommend checking out parent groups that center around your child’s diagnosis. I participate in a walk every year with a local autism organization and love it. This year, Julian joined me- I was surprised because he hates being awake before 9 AM on a Saturday, but I was happy to get in the solo time with him. You can find these groups by Googling your city + diagnosis + organization, or a similar search.

I do have friends that either don’t have kids or have kids that aren’t on the spectrum or don’t have ADHD. This is also good. It’s refreshing and they keep me laughing. They cheer us on and cheer me up on the bad days. Everyone should have this. I highly advise finding friends like these.

It’s Fine if Not Everyone Gets It

Your family is meant to be there for you no matter what, but sadly, this doesn’t always work out. Do what you can to educate and include, but don’t stress about the rest. You have much bigger things to worry about- taking care of yourself and your child. Your family will be the ones missing out if they don’t want to come along for the ride.

Recommended Reading: Adjusting to a New World

Twin Mummy and Daddy

My Random Musings

Getting Assistance for Your Child: Essential Questions to Ask

It’s Not a Parenting Failure to Get Help

I once told my mother that there is a reason that people spend a long time in school, take really hard tests (in some cases, more than once. I’ve been told the BCBA exam is horribly difficult) and get observed for a lot of hours to become mental health professionals. They are dedicated to what they want to do. They have to continue that education by taking classes and renewing their licenses every so often. States want to make sure these professionals know what they are doing and do so ethically. I also told her that there is only so much that I can do as a parent, even knowing what I do. There are a lot of things that I don’t know, and that’s why I felt that at one point, it was time to get outside help for my kids.

In Lily’s case, there wasn’t much of an option. Her delays were severe and required outside help. She needed help learning how to walk, talk and do other tasks that I couldn’t have taught her on my own. In the beginning, I really did blame myself, but after hearing that there was no way I caused her delays, I felt a lot better.

Julian definitely caused some debate. I knew what I was working with after he was diagnosed, and yes, I could have worked with him on my own. With two other kids and a full-time job, plus not really knowing what to do or how to do it, it really was time for the pros. He’s been to group therapy for social skills, which helped a lot. Every Tuesday for almost his entire third-grade year, he got out of school early to go to group. He learned how to interact with others appropriately, to speak up, along with other things. Julian is a quiet kid by nature, and we’re okay with this.

I just don’t want him to be so quiet that he is ignored or entirely left out. He has also seen a psychiatrist, and we loved her. Unfortunately, she had to stop seeing patients after some post-birth complications, so now he sees a psychiatric nurse practitioner.

It is okay to get outside help. We’re not just parents- we are also humans. We don’t know everything, and that’s okay. Your child will benefit greatly from outside services.

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Finding Assistance

There are many ways to find providers, it mainly depends on what you need and if you already have someone helping you, like a social worker or someone similar. If you’re looking on your own, it always helps to start by asking other parents you know that are in a similar situation. You can also ask your child’s pediatrician.

That’s where we started with both Lily and Julian. We moved around a bit by referral. It just so happens I used to work with the psychiatrist that started the practice that Julian is at now. (He’s absolutely great, but for obvious reasons, he can’t see Julian.) If nothing else, there is always Google. Google is everyone’s friend.

A Few Definitions:

Provider- a professional that provides some sort of service for your child

BCBA- Board Certified Behavior Analyst (these people do great things, lots of behavior modification, addressing challenging behavior, among other things)

DSP- Direct Support Provider (people who come into your home and work with your child on life skills, social skills and other things they may need. I worked as one for about a year and it was a lot of fun.)

Respite Care- to give parents or other caregivers time to care for themselves, run errands, etc while their child is being cared for.

I highly recommend checking with your health insurance carrier/Medicaid to see what is covered. These services can get very expensive, and insurance paperwork can be a huge challenge. Waiting lists are a thing and can be very long. It can be a bit weird seeing people you don’t know in your home and working with your child. This may take a while to adjust, especially if there are multiple people. Lily had three therapists a week at one point and it was a very weird thing. If you need to set limits, set them and be as firm as you need to be.

What You Should Ask

There are some questions that can’t be missed like:

  • What is your availability?
  • What experience do you have with this population?
  • Are there behaviors that you feel are too challenging for you? Everyone has their limits, and this is okay. My personal limit is spitting. Can’t do it.
  • How do you view your relationship with the rest of the family- siblings, parents, etc?
  • Best way to reach you? Phone, email, text?
  • How will you update me on my child’s progress/needs?
  • Emergency preparedness? Most agencies have trained their workers on a plan for this, so make sure to ask. The practice I worked for had a very detailed plan for injuries, weather and other emergencies.
  • References.

Of course, follow your intuition on the people/places you look at. If it doesn’t look right for you, most likely it isn’t. You will know when you find the right place or person for your child. Call those references. Read through the notes you made during the interviews. Do your research. You’ll thank yourself later. If you are looking for your child to be part of a practice, the questions above will be slightly different. Most places will allow a walk-through and give you someone to talk to. They’ll be able to answer questions, give you information to take home, and follow up.

The road of parenting is sometimes a rough and bumpy one. Looking for outside help is just a small speed bump.

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Information courtesy of Seattle Children’s Blog

Pics courtesy of Unsplash

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