Musings from an Orthodox Jewish work at home mom of twins with Autism Spectrum Disorders.

Psych Admission?

To those parents who have been there and done that—–  how did you know it was time for a psych admission? What do they do that’s helpful? serious question. We’ve never admitted Fred (yet) — we’ve gotten beaten, kicked, punched, bitten—- but USUALLY (pre corona) on 4 strong medications he’s done in 10-15 minutes. Now with no structure he’s up to 45 minutes to an hour of hell making his sister cry, us cry, my husband scream at me to call the police, me trying to calm my husband down—- but I just don’t know how the hell a psych admission would help him or would it be more of the same— well let’s try this med, let’s try that med……. do these places actually ever take a kid OFF all meds and start fresh based on data they take? HOW does a psych admission work? One of us would have to stay with him and one of us would have to stay with his sister— for a week? Two weeks? How do parents WORK while this is going on?  We’ve been  living off savings this summer but hubby goes back to work soon.

I was getting dressed after my shower tonight and I made the mistake of looking at myself in the mirror— you know in the movies where you see domestic violence victims seeing their bruises in the mirror?  Yeah.

Comments on: "Psych Admission?" (1)

  1. Melanie said:

    Hello,
    I have read your posts for years now, but have never commented. Honestly, your voice about the daily struggles is such a help to me, a single mom raising one neuro-typical kiddo and another ASD and more alphabet-soup diagnoses who has symptoms and severity swinging somewhere between your twins… life is hard all of the time. I love hearing from you and knowing I am not the only one living a difficult life. Please, do not be quiet for the comfort of others! I get it, and I do not think we should be silenced because our stories make people uncomfortable. We do not live in the days where those who are different need to be shamefully hidden. So don’t hide.
    My son is 15. When he was 7 his behavior changed and he seemed to be more withdrawn cognitively and emotionally, but also more aggressive physically. Eventually I realized he was experiencing a pretty severe depression, but without the ability to communicate as typical kids do. Unfortunately, that process of realization took me over a year and it also came to light that he was being abused during this time by adults in the public school who were meant to be there for his support. At that junction, his primary care doctor wrote him out on medical leave – permanently. He cannot return to public schools because of the PTSD related to these in-school incidents (we have tried private school since then, but the PTSD is such that any school-like/institution-like environment causes him panic). He became suicidal during this time, and the exhaustion of trying to keep him safe, protect his sister from the emotional damage of seeing him in rage and distraught all-the-time, and neglecting my own self-care because there was not ten minutes for me to look away from him to wee and shower, nevermind sleep! – this coupled with the pediatrician saying to me, if you cannot look away to wee, then it is time for him to be inpatient. If you cannot leave him to sleep the night unsupervised, then it is time for him to be inpatient. If his self-injurious behaviors are frequent enough and long-lasting enough that you know your eyes are not enough to keep him safe, then it is time for him to be inpatient – this led to the decision to admit him to a pediatric neuropsychiatric hospital. Scariest decision of my life, and so necessary. He was inpatient for so long before step down to a day program and discharged to ongoing outpatient care. I think between inpatient, full-day program, and partial-day program (all levels of hospitalization), he spent just more than three months before discharge to ongoing outpatient mental health support. I was basically a zombie during this time, having to be on-call anytime they needed me to come in or give feedback on his behaviors or care. Visitation was so incredibly limited in the first two weeks, that was the hardest, but they needed to see him at his worst. He was taken off all meds to be able to see what was going on first-hand and invent a plan. Ultimately, there was a decent observation done with appropriate data to back it up, and documentation of what was or was not helpful, medicinally. However, he did not benefit from their behavioral health program, because he was too low functioning for their high-functioning unit and too high-functioning for their low-functioning unit, and also in a traumatic episode from the recent school abuse. The suicidal tendencies passed and a plan was implemented that did help tremendously with his self-injurious behaviors, and still helps all these years later. However, he and I were also traumatized by the abrupt change in environment and no-contact during those first weeks.
    These kids are challenging! Who knows what is right when making decisions for them, we just do the best we can with the information we have – sometimes realizing later that perhaps it wasn’t actually the best decision. We’re only human. I suggest to you, discuss with his team of professionals where he would go inpatient, and what they might suggest in preparation for the most successful outcome for all of you. Jot down a list of what YOUR priorities for outcome would be for his stay, is the focus med management, behavioral, reduce aggressive episodes from X amount of time to X amount of time… This will help you remember why you are all going through this. Keep your mind on the goals! I would also suggest you be firm about seeing the facility and understanding the expectations of everyone, as well as the rhythms and models they utilize, for your own sanity. For your son, there will be no really effective way to prepare him, unfortunately. However, they do need to see him at his worst in order to help him achieve his best, or help him at least reach something better than what he is living right now. I couldn’t take the opportunity to do these things because my son was actively trying to take his life – his tiny, eight-year-old life, because of the pain he was in. I so wish I had, because the unknown and the abrupt change in going from being hands on literally 20 hours of the day and sleeping with one eye open the other four hours, to having no contact at all… it was a horrendous experience for me. Years later, when he could communicate, he talked – still talks – about this experience for him. It was the same for him as it was for me, he didn’t understand but couldn’t communicate. He was locked in a safe bedroom at night and they would only come when he banged a lot on the door – but he couldn’t communicate so they simply helped him back to bed. He has extreme separation anxiety and cannot be alone, so I can only imagine how awful this must have been for him. He didn’t understand the program, there wasn’t enough attempt to communicate with him in a way he understood, at first. It took some time for everyone to understand his unique needs. He understands now, years later, that it was a necessary change, but it was somewhat traumatizing, too.
    I hadn’t meant to type so much! I hope this is somewhat helpful, I am rooting for you and your family and sending you all some well-wishes and calm vibes for the experiences you are living during these crazy time.

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