I don't have much to add except that, in both of the OP's cases (friend with the troubled son; friend with the troubled daughter), please do remember that your friends don't tell you everything.

Many people conceal details re. mental illness or feel obligated to "sunny it up" for people outside the family. Sad but true.

So keep in mind that people may be far less "in denial" about their family situation than you realize. I doubt you have the full story in either case.

And good-quality long-term residential care that's is insanely expensive. It's drained many a family.

If anyone knows how much a program like Menninger costs I'd be curious to know. One PP said about 1K per day. So that would be 60K for the 2 month program. That's a lot of money. OP did your friend discuss how they would pay for such a program? Mortage their house maybe? I can see how someone would try other things first in the hopes that he can function better.

By the way going to ETC ("shock" therapy as you call it) is not something someone in "total denial" or passive about a problem would pursue. Nobody does this casually. As I recall when we looked into it for my mother, it involves treatment several times per week with full anesthesia each time, involves an entire day for prep, treatment, etc, and goes on for over a month or two. OP your friend is taking her son to these appointments I presume. Also there are risks for memory loss (this may have improved since we looked into it) and nobody enjoys it. Seriously, these people are not in denial. They are taking their son's wellbeing very seriously and clearly love him very much. I hope their situation improves. The residential programs sound good but what happens after 2 months. Ideally the patient is better off and can take steps toward independence. But mental illness is something that can keep circling back, or can always be there. It takes a toll on families. Life can be like that. It's hard but things could be worse. Be supportive and have honest frank discussions with your friend and LISTEN to what she says. You can make suggestions or ask why they haven't done x, y, or z, as a friend who wants to understand and be supportive. But don't assume you know more. PUt yourself in her shoes. What would you do? And what if that didn't work? What would you do then? And so on. Sounds like she is doing the best she can.

Anonymous wrote:

Anonymous wrote:Can someone please explain what residential or institutional treatment is for this type of situation?? My mother has had scizoaffective disorder since I was a teenager. All I ever knew about were psychiatric wards of hospitals for generally short days--between a few days to a few weeks--and nursing homes for psych patients on Medicaid. The conditions are deplorable and there is nothing there therapeutic except meds. Generally private payment costs tens of thousands of dollars until all assets are spent and you go on Medicaid. Then hospitals will only admit if they have Medicaid beds available. Otherwise you're SOL.

What are these residential programs OP, how much do they cost roughly, and how easy are they to access?

Most residential treatment facilities are very nice places. The staff makes sure that the residents/patients have no access or ability to cut or hurt themselves or drink alcohol or do drugs. Menninger Clinic is one example.

What do they do in these places and how much do they cost? How long do patients stay there? What types of illnesses do they treat? I doubt insurance covers them if insurance doesn't cover more than brief stays in psychiatric hospitals/wards.

Anonymous wrote:Can someone please explain what residential or institutional treatment is for this type of situation?? My mother has had scizoaffective disorder since I was a teenager. All I ever knew about were psychiatric wards of hospitals for generally short days--between a few days to a few weeks--and nursing homes for psych patients on Medicaid. The conditions are deplorable and there is nothing there therapeutic except meds. Generally private payment costs tens of thousands of dollars until all assets are spent and you go on Medicaid. Then hospitals will only admit if they have Medicaid beds available. Otherwise you're SOL.

What are these residential programs OP, how much do they cost roughly, and how easy are they to access?

Most residential treatment facilities are very nice places. The staff makes sure that the residents/patients have no access or ability to cut or hurt themselves or drink alcohol or do drugs. Menninger Clinic is one example.

Anonymous wrote:Hi its OP here and I want to say thank you to most of you who offered good advice, given me a lot to think about.

I am walkinga fine line between saying nothing and just continuing to support her as I have to saying something.

We both know someone who a few years ago was in a similiar situation but with a daughter. The mom just refused to see and acknowledge how bad it was, maybe living with it every day she just got used to that as being her new norm.

People were very hushed about it because they saw the wall she put up. Sadly the D committed suicide about a year later, no one thought it was "that bad" and needless to say it has devastated that entire family. I keep thinking about them, maybe someone close to them SHOULD have spoken up and said something, urged them to do more, etc........

I am not saying that is the answer and it would solve anything, but I never want to feel like I didn't do all I could, that was the main reason I wrote this post and wanted to get peoples honest opinions. Thank you.

OP, you sound like you just don't get it. What exactly does "do more" mean to you? Do you know exactly what this young man's doctors have suggested, tried, etc.?
Are you an expert in schizophrenia and know there is something that they know about that they have not tried and is likely to be successful?
Do you really believe that they don't know that their ENTIRE family is in crisis? Do you not think that they want to find something to help them?
Exactly what is it that you plan on saying? Or are you under the delusion that you should just say "something" as if just saying "something" is going to magically make this boy not crazy??

OP, I totally get that you're coming from a place of love and concern, and empathy for all that they are going through. I also agree that the toll on the marriage and the younger child is horrible--its unfair when any one person in the family drowns out all the needs of everyone else. Part of being a parent is making horrible, difficult choices in the best interests of your kids. You might take that to mean "do everything humanly possible to save the older kid by re-arranging everyone's entire life around it"--which is what has happened, it sounds (mom quit job, dad is a shell, younger sibling a hot mess now too), but I take it to mean "what is in the best interest of this family over all?". And to me, the only thing worse than never being able to help one child, is not helping one and actively harming the other through neglect and exposure to a horrendous situation.

but anyway. I think the key point here is that the parents have not tried everything--they have tried things that haven't worked. They have mentioned on and off residential programs but have not pulled the trigger. OP is not sure why, but guesses its both $ and guilt.

OP, the best you can do is be super supportive, protect the younger one as much as possible, and draw out your friend on the issues of residential. I for one would be willing to say to someone I loved "I love you and its heartbreaking to see your family being slowly destroyed by your son's mental illness. I know you are the most loving committed parent you can be, and so the idea of residential treatment may be untenable, but I hope we can have a conversation about it. Do you think it might be a good option? Have you spoken with X's doctors about it? If I can do anything to help, include research options, I will."

and then, take that younger kid out of there as much as possible.

Can someone please explain what residential or institutional treatment is for this type of situation?? My mother has had scizoaffective disorder since I was a teenager. All I ever knew about were psychiatric wards of hospitals for generally short days--between a few days to a few weeks--and nursing homes for psych patients on Medicaid. The conditions are deplorable and there is nothing there therapeutic except meds. Generally private payment costs tens of thousands of dollars until all assets are spent and you go on Medicaid. Then hospitals will only admit if they have Medicaid beds available. Otherwise you're SOL.

What are these residential programs OP, how much do they cost roughly, and how easy are they to access?

Hi its OP here and I want to say thank you to most of you who offered good advice, given me a lot to think about.

I am walkinga fine line between saying nothing and just continuing to support her as I have to saying something.

We both know someone who a few years ago was in a similiar situation but with a daughter. The mom just refused to see and acknowledge how bad it was, maybe living with it every day she just got used to that as being her new norm.

People were very hushed about it because they saw the wall she put up. Sadly the D committed suicide about a year later, no one thought it was "that bad" and needless to say it has devastated that entire family. I keep thinking about them, maybe someone close to them SHOULD have spoken up and said something, urged them to do more, etc........

I am not saying that is the answer and it would solve anything, but I never want to feel like I didn't do all I could, that was the main reason I wrote this post and wanted to get peoples honest opinions. Thank you.

Anonymous wrote:Bottom line is she is YOUR friend and you should do what is in your heart, if it is coming from a good and sincere place there is nothing wrong with it. Say your piece and let her digest what you have suggested. Don't try to push your ideas onto her but maybe start with telling her you have watched this horrible thing wreak havoc on their family and how painful it must be,etc...then break into what you want to tell her.

I was in a similar boat about 9 years ago with a friend but before I could voice my opinion he was entered into a facility in AZ. Last I heard he is doing really well. It is very sad and very hard to get over but it can be done, albeit at a cost and that does not only involved money but often shattered dreams (parents) and disillusioned views of the family dynamic (siblings). Sadly everyone in the family pays a steep price.

But think VERY hard about what it is that you want to tell her. Unlike the OP, I agree with the posters who say that this family is NOT in denial--they are well aware of their older son's problems, they are actively trying to do something, and they are stuck in a system that makes getting proper mental health treatment for an adult incredibly expensive and difficult. What fantastic insight does the OP have that she thinks that neither they nor their doctors have thought of? What does she know about their situation that they don't? That it's hard on everyone? That they are exhausted and stressed and anxious? That their younger son is getting short shrift? Trust me, they know all these things. They live them every day. OP needs to think long and hard before she presumes to offer them advice.

Bottom line is she is YOUR friend and you should do what is in your heart, if it is coming from a good and sincere place there is nothing wrong with it. Say your piece and let her digest what you have suggested. Don't try to push your ideas onto her but maybe start with telling her you have watched this horrible thing wreak havoc on their family and how painful it must be,etc...then break into what you want to tell her.

I was in a similar boat about 9 years ago with a friend but before I could voice my opinion he was entered into a facility in AZ. Last I heard he is doing really well. It is very sad and very hard to get over but it can be done, albeit at a cost and that does not only involved money but often shattered dreams (parents) and disillusioned views of the family dynamic (siblings). Sadly everyone in the family pays a steep price.

I like how so many on here have completely disregarded how fucked up this situation is for the younger son, and what the impacts of that are and will be for him. Too busy calling OP names to be at all helpful or sympathetic to the other child.

Anonymous wrote:

Anonymous wrote:Wow OP. You are not a friend. You sound like a judgemental bitch. Would love to see what you would do in her situation.

How does OP sound like a bitch? Am i missing something here? She is trying to help a friend. We all know that sometimes in the name of love we can be blinded by our devotion to those closest to us that sometimes inhibits our abilities to make good decisions.

Sounds like that is the case here. As her friend she is asking if she should speak to her. Not a big deal. If it were me, I would but it sounds like she knows everything you will tell her. They just aren't ready to face up to it yet. They need to do it on their own timetable. Is the younger brother getting therapy? I sure hope so. My own brother was sent away for severe depression when it had just overtaken our family (I was 16 at the time and it was really really hard) so I am sensitive to it.

I loved him but i will never forget the day my parents took him, I felt free and like this huge black shroud of hopelessness was gone. It served him well too, he was gone for 6 months and came back a new person. Today he is a happy, well adjusted successful professional who is married with a daughter on the way. He thanks my parents every day for doing what they did (it was a huge financial sacrifice for them). We were far from wealthy but they did what they felt they needed to do and it was absolutely the right thing.

Good luck OP. I think if you are good enough friends there is nothing wrong with taking her out for lunch or coffee and telling her that you are just really concerned about her, their family, her other son, etc....come from a caring and supportive place.

+1
You aren't a judgmental bitch OP, I totally get where you are coming from. But you can't fix this for your friend, you can only support her and show her that you are there to help support her. Offer your perspective, but don't risk alienating her by being too prescriptive on what she needs to do.

Anonymous wrote:Most consider alcoholism a disease and now obesity is not really a choice, either. It's those bad people who sell us food who make us eat cheeseburgers and french fries.

Mental illness isn't a choice. It doesn't sound like the young man in OP's post has been diagnosed with a mental illness, just that his observable behavior leads those around him to believe he has mental illness.

Is literacy a choice? OP says very explicitly the child has depression and bipolar disorder, it's only the schizophrenia that she says is a maybe.

Most consider alcoholism a disease and now obesity is not really a choice, either. It's those bad people who sell us food who make us eat cheeseburgers and french fries.

Mental illness isn't a choice. It doesn't sound like the young man in OP's post has been diagnosed with a mental illness, just that his observable behavior leads those around him to believe he has mental illness.

You are a nice friend. I was in the situation of your poor friend and I deeply regret not institutionalizing my child sooner.
All my friends were sympathetic. I was also a stiff upper lipper
1. If your friend is getting professional advice she is being told that the family can manage it with drugs etc. This is UNTRUE as she can see from it being 3 years of non success. But that is the advice she will continue to get along with a lot of judgement from the professionals.
2. Keep reassuring her that she is not to blame for the situation, and that the rest of the family needs a normal life.
Suggest she find something in Massachusetts which has good mental health laws and support.
otherwise she will end up like me- her problem child no better and her normal child with a horrible ruined childhood.
3. I got into a spasm of mothering cycle- never give up etc. Its not healthy and she needs support to get off it. We finally went to a marriage counselor and she told us to save our marriage by finding institutional care.