Hospitalization for mental illness

[Anonymous]

OP, we hospitalized dd for 10 days when she was in 9th grade because she was suicidal. At the recommendation of her therapist, we took her to Dominion Hospital in Falls Church. It was the worst day of my life. Given that she was my kid, I expected that she would do therapy at some point but I never expected we'd have to hospitalize her. That was really hard.

But it turned out to be the best thing we could have done. She got on meds (which she hadn't taken before) which lightened her depression enough for her to start getting better. She had a long hard slog after that but now she's in her 20s and doing much better.

However, I think what you're facing has got to be much harder. We were very happy with dd's experience at Dominion but I don't know whether that would be the best place for your son. Just know that I'm thinking of you and hoping your son finds his way. It's very tough to be a parent and watch your child struggle like that. Good luck!

[Anonymous]

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

OP here. This is his fourth psychiatrist, although the first since he had a real breakdown in his ability to deal with anxiety at all. The biggest problem is his lack of sleep. The doc keeps tinkering with his meds, but nothing seems to enable him to sleep at night and function during the day (the meds that make him sleep render him totally nonfunctional).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

OP here. This is his fourth psychiatrist, although the first since he had a real breakdown in his ability to deal with anxiety at all. The biggest problem is his lack of sleep. The doc keeps tinkering with his meds, but nothing seems to enable him to sleep at night and function during the day (the meds that make him sleep render him totally nonfunctional).

OP, I'm really, really sorry. I was going to suggest a second opinion, too, but you've already been down that road. I'm guessing he's had a thorough physical recently, which he should if not. PPs are right in that most inpatient programs are geared towards crisis stabilization. There may be longer-term options, but you'd pay out of pocket for those, i.e., no insurance company is going to pay absent an imminent threat to self or others, and even then, it's just until "stable" and then out.

What about a sleep study? Any research studies (assuming you're local, see what's at NIH, for example)? Is he seeing a psychotherapist, too--or are you, at least for support? Are you in touch with NAMI? I know these are not solutions, thinking more about getting you support through various means. And you may have done them all, throwing them out in case not. We are so far behind in our treatment of severe psychiatric disease.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

OP here. This is his fourth psychiatrist, although the first since he had a real breakdown in his ability to deal with anxiety at all. The biggest problem is his lack of sleep. The doc keeps tinkering with his meds, but nothing seems to enable him to sleep at night and function during the day (the meds that make him sleep render him totally nonfunctional).

Have you talked to the doc about the big guns, like Abilify? Have you done a genetic test for med absorbtion (genesight)?

[Anonymous]

Does he have an IEP? What about a boarding school/residential program?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

OP here. This is his fourth psychiatrist, although the first since he had a real breakdown in his ability to deal with anxiety at all. The biggest problem is his lack of sleep. The doc keeps tinkering with his meds, but nothing seems to enable him to sleep at night and function during the day (the meds that make him sleep render him totally nonfunctional).

Have you talked to the doc about the big guns, like Abilify? Have you done a genetic test for med absorbtion (genesight)?

Was going to suggest something similar. My DD had SSRI-resistant anxiety and was put on Zyprexa, an anti-psychotic. While I am not a fan of this class of drugs (and have written here before about that, extreme caution is required), Zyprexa has helped a lot and she is now on a quite low dose doing fine. Her anxiety attacks were terrible and very destructive. Not rage exactly but she would scream hateful things and would systematically and almost robotically trash everything around her as though she were in a trance.

[Anonymous]

So far docs have been unanimous that he is not schizophrenic or bipolar--so not sure abilify is the right thing yet. Too soon to tell yet if last night changes that view.
I think perhaps based on what I'm hearing here is that what he needs is a residential program, rather than crisis hospitalization. Any suggestions as to how to begin that process? I do not want to warehouse him--I contine to have hope that he can get through this. But he will fight it every step of the way.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

OP here. This is his fourth psychiatrist, although the first since he had a real breakdown in his ability to deal with anxiety at all. The biggest problem is his lack of sleep. The doc keeps tinkering with his meds, but nothing seems to enable him to sleep at night and function during the day (the meds that make him sleep render him totally nonfunctional).

Have you talked to the doc about the big guns, like Abilify? Have you done a genetic test for med absorbtion (genesight)?

Was going to suggest something similar. My DD had SSRI-resistant anxiety and was put on Zyprexa, an anti-psychotic. While I am not a fan of this class of drugs (and have written here before about that, extreme caution is required), Zyprexa has helped a lot and she is now on a quite low dose doing fine. Her anxiety attacks were terrible and very destructive. Not rage exactly but she would scream hateful things and would systematically and almost robotically trash everything around her as though she were in a trance.

Hmm...this is really interesting and helpful.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

OP here. This is his fourth psychiatrist, although the first since he had a real breakdown in his ability to deal with anxiety at all. The biggest problem is his lack of sleep. The doc keeps tinkering with his meds, but nothing seems to enable him to sleep at night and function during the day (the meds that make him sleep render him totally nonfunctional).

Have you talked to the doc about the big guns, like Abilify? Have you done a genetic test for med absorbtion (genesight)?

Was going to suggest something similar. My DD had SSRI-resistant anxiety and was put on Zyprexa, an anti-psychotic. While I am not a fan of this class of drugs (and have written here before about that, extreme caution is required), Zyprexa has helped a lot and she is now on a quite low dose doing fine. Her anxiety attacks were terrible and very destructive. Not rage exactly but she would scream hateful things and would systematically and almost robotically trash everything around her as though she were in a trance.

Hmm...this is really interesting and helpful.

You are not alone, OP. There are some of us who dealt with similar issues. I would do the genetic test and discuss additional meds, like antipsychotics. They are not used just for bipolar or schizophrenia. As add-ons they sometimes are effective for anxiety and depression. Is he on Ativan or similar? One combo that might work is Zoloft, Abilify and Ativan. I would try and sort the meds first. if you have the capacity to supervise, then at home. If not, then try to get him in inpatient program.

[Anonymous]

If you do residential, the emphasis has to be on mental health, not the type of RTCs hard to handle kids are sent to. Their medical care is often abysmal and the psychiatric care is extremely spotty--sometimes nonexistent or if you are lucky there is a psychiatrist who comes once a week. Considering many of them are in the middle of nowhere Utah, you can imagine the doctors they have.

I would look at something like this at McLean Hospital in Boston:

http://www.mcleanhospital.org/programs/adolescent-art

If drugs are at all an issue there are other programs at McLean.

[Anonymous]

My experience is from 20 years ago. I was 15. My parents put my in Shepard Pratt for 9 weeks. I don't know if this program still exists. It was at the recommendation of my psychiatrist. Looking back I know now that my school teachers and counselors were also involved in the decision and it was timed to coincided with a quarter at school.

Honestly, for the first 2-3 week it SUCKED! I was miserable. I had limited privileges. But as the weeks went on, I learned so many coping skills. By the time I was discharged I was elevated to a level that allowed me to wander the grounds with my room mate for about 30 minutes at a time. I was also allowed to walk myself to the school building and to meals. For in-patient privileges, these are huge.

Discharge and re-entry into normal life was very difficult. I learned to rely on the structure and routine of the facility. But my therapist from SP saw me as an out patient 3x/week at first. Then we tapered down to 2x and finally 1x.

I was severely depressed and had attempted suicide a number of times before my parents made this decision. I know it was hard for them but it was probably the best thing that they could have done for me.

I didn't know the words for my feelings or how to express them. Once I learned how to express myself, I found that people were willing to listen and help. The individual therapy, the group therapy, and the general being around others liked me helped me a way that years of previous out patient therapy could not help me.

I stayed with my SP therapist as an out patient until I graduated HS. I did fine in college but fell apart in grad school again. The difference this time was that I recognized what was happening and knew who and how to ask for help before I started drowning.

If this program still exists, I highly recommend it.

[Anonymous]

^^Meant to add if money is not an issue at all, an alternative is the Pavilion at McLean. This is a two week intensive evaluation for mental health that looks at physical health as well. You could go with him and you stay in a nice house like setting while all the appointments, therapy sessions etc are going on. It is not being locked away somewhere, so would be much easier to get him there. They sometimes will take someone as young as 17.

But it pricey beyond what you might imagine, so you really have to have a lot of spare resources.

[Anonymous]

OP, an educational consultant can be a good resource if you are thinking along the lines of a therapeutic boarding school or an RTC. Most of them will do a free initial call where they will lay out the application process for you.

[Anonymous]

OP here. Does anyone know whether Shepherd Pratt takes patients from outside MD? It might be a good choice. (That said, we may be doing an emergency hospitalization tonight.)