Category: mental illness

What hallucinations are like, from those who know

What hallucinations are like, from those who know

If you care for a child experiencing hallucinations but don’t know what it’s like, these first-hand accounts may help you better understand and support your child.


This writer is taking medications, which help, but do not fully eliminate the hallucinations.

hallucinations 1“The reason my thoughts inaccurately capture existence is because my understanding of existence is different insofar that I have to daily navigate through illusory experiences.

How hallucinations look/sound

“They look like I am looking into another dimension, their bodies fade into the background, but they sound real.  I can tell that it is from another dimension but cannot distinguish it from other normal people’s realities because my reality is all I know.

“In general I find my experience with hallucinations unfavourable because they make other people in this reality quite distant.  Learning complicated tasks is a hundred-fold more complicated for me to manage than regular people.  I literally am disadvantaged by the hallucinations in the academic sphere, but seem to thrive with the hallucinations in other ways such as long distance walking and jogging.  People should NOT interact with me when I am hallucinating because when I am hallucinating, it means I am being overpowered by another dimension and can’t understand what is going on anyway.

hallucinations 2“If family members and friends are concerned about my wellbeing they should encourage me in a positive way to do different projects on my own like reading books about subjects that interest me or go on long excursions like long distance walking and jogging.  Heavy exercise seems to alleviate paranoia and negative thought patterns like being suicidal or angry with others.”

–By Anonymous 1, who lives with schizoaffective disorder


This writer responded to questions I asked.

1. How would you describe visual/auditory hallucinations to someone who has never experienced these? What do you see/hear?

I often see people’s faces and gestures twist up and look and act angry. I hear my name a lot. I see people hiding and running to avoid me catching them and [people] watching me.

2. How do they look or sound? 

Angry, abnormal colored skin, and strange upsetting body language.

3. Can you tell when you are hallucinating while it is occurring?

Sometimes…I don’t always notice right away but there have been times when I knew it wasn’t real.

4. Do you like or dislike hallucinating?

I do, because I feel like God is reaching out to me to protect people from evil.

5. How should someone interact with you if you’re hallucinating?

Calmly, if the situation has highly intense feelings and reactions I could go into a panic attack lasting 1-3 days.

surreal leaves6. What should loved ones do or not do if you’re hallucinating but they are concerned about your welfare?

 

DON’T :

-> Never raise your voice or let yourself become agitated

-> Try to take control of the situation

-> Take anything personally

DO:

-> Hand me things I can hold in my hand for centering (leaves, rocks)

-> Remind me of the people who care about me

-> Be honest with me if I ask how realistic it was

–By Anonymous 2, who lives with schizoaffective disorder


This is a first-hand account drawn from the SARDAA newsletter (Schizophrenia and Related Disorders Alliance of America).

Somewhere around the age of 17 or 18, I noticed that I was not feeling quite right mentally.  Things were confusing, not making any sense, and I started losing my sense of connectedness.  I started drinking to cope and became an alcoholic when I entered college.

hallucination leaf dressAnyway, I got sober by entering treatment and Alcoholics Anonymous about a year later.  I was exhilarated, although things still didn’t seem to be quite right.  I felt lost.  About 14 months into my new life, I decided to find some meaning to my existence.  While on a trip with an acquaintance I noticed things were really quite different.  The leaves in the wind seemed to be talking to me.  Cloud formations had special meanings.  Television and radio shows were talking about my life.  And I thought I could read peoples’ minds and communicate with them without speaking.  I thought I had found what great spiritual leaders termed “being spiritual.”  I truly thought I had been blessed by God and that I had a direct pipeline to Him.  I felt happy and scared at the same time.  I was in a different world.

About one week later I decided to travel out to the West Coast to really find myself, given this new-found power.  While traveling, it seemed like God’s voice entered into my thoughts and told me to do something if I wanted real peace and power in my life.  That being, to run my car off the road and leave the rest to Him.  I did this only to find no peace, but a totaled car and a trip to the state mental hospital.

Since that time, I’ve been dealing with a disease called schizophrenia.  It has been an uphill struggle.  At the time of this writing, I believe I’ve found a way to pull myself out of psychosis and feel connected like before the alcoholism and schizophrenia.  Today I feel peace, own a thriving business and have a wonderful relationship with my wife.  We’re in the process of planning a family.  This has been accomplished by the philosophy of Schizophrenia Alliance, Alcoholics Anonymous, and a few special people in my life.


Readers, what does your child experience?

Do any readers have a child (of any age) who can describe what they’re experiencing when their mental health is poor?  Please share in the comments section, or if you wish to stay completely anonymous, please contact me and I will add your child’s story without any identifying information.

School Shootings, Guns, and Child Mental Illness

School Shootings, Guns, and Child Mental Illness

Up until recently, news of devastating school shootings swerved to public fights about gun control.  I had hoped past shootings would stimulate discussion of mental health treatment (see Guns and Mental Illness: the Debate from a Parent’s Perspective,” written 5 years ago in 2013). After this recent shooting in Florida, it now is.  But be careful what you wish for.  Mental illness is on the radar, but the subject swerved off into mental illness as a significant lethal threat to the public.  (I think this is compounded by a morbid fascination with psychopaths. The lurid TV series “Criminal Minds” plays to this–the entire plot line equates mental illness with psychopathy, torture, and murder.)  Damn it.

Look at the raw numbers below.  Shouldn’t the other deaths caused by children’s mental illness be on the table too?

Deaths by school shootings in elementary, middle, and high schools in the U.S.:

2000-2018 – Deaths by school shootings:  110 children*

2000-2018 – Foiled attempts at school shootings:  19 schools*

Child deaths by suicide in the U.S.:

2014-2015 – Between the ages 10-24:  17,304**

2013 – Suicide by firearm between the ages 10-19:  876***

*(Wikipedia, based on contemporaneous news reports)
**National Institute for Mental Health (latest available numerical data)
***Centers for Disease Control and Prevention (latest available numerical data)

Effective advocacy for preventing suicide (via mental health treatment) requires effective ‘marketing.’

Parkland, Florida, image from metro.co.uk

I wonder about the marketing aspect–the campaign that tells a gripping story that motivates others to act.  Let’s compare:  School shootings are public tragedies, with images of ambulances filmed from helicopters, and wrenching quotes from the anguished.  But suicides happen alone; they are private self-inflicted tragedies.  No helicopters, no candlelight vigils.  People keep their distance.  Money doesn’t pour in to support the victim’s family or increase the availability and use of treatment.  And then there is this awful irony:  if vulnerable children hear the news of a peer’s suicide, it risks suicide contagion.

Maybe the activism of the student survivors in Florida are symbolically opening a door.

Dublin, Ireland, in 2014, irishtimes.com

Maybe there’s a way if victim’s families and friends are willing to tell their anguished stories, too.  I don’t know how it feels to be you–my child made suicide attempts but didn’t succeed (insert deep sigh of gratitude here).  How do you feel about telling your stories to cameras in a large group?  Could you carry signs with photos of your precious lost ones?  or bombard the Twitter-verse to get to the hearts of the public?

Be prepared for the next round of horror, and be prepared to go public.

Our mental health professionals have been warning the public and lawmakers about the magnitude of child suicide for years–the psychiatrists and psychologists and all the other caregivers.  But they use facts, which don’t count in the public eye, whereas personal stories do.

Your comments are encouraged.

–Margaret

Marijuana is uniquely dangerous for troubled teens

Marijuana is uniquely dangerous for troubled teens

Marijuana’s effect on adolescents is more serious than many realize, especially for those with behavioral disorders.  This is no exaggeration; marijuana can lead to psychosis and long-term cognitive impairment for your troubled child.  Numerous recent research studies show that marijuana has a more damaging effect on the young brain than is generally understood. The THC in marijuana is psychoactive, which means it can affect your child’s unbalanced brain chemistry more than the general population. Serious depression, anxiety, paranoia, and psychosis can be triggered in children with latent psychiatric vulnerabilities. (Additional marijuana research going back to 2004 is at the end of this article).

Just because marijuana is plant-based does not mean it is safe.  It has dangerous side-effects like any other psychoactive drug.

Marijuana legalization has deeply concerned pediatric psychiatrists and other specialists in child, adolescent, and young adult mental health treatment.  Up until the their early 20’s, young people’s brains undergo radical changes as part of normal development.  Neurons are “pruned” to reduce their number (yes indeed, one can have too much gray matter to function as an adult). Pruning occurs rapidly in teenagers–think about it, in addition to puberty, a lot of nonsensical teenage behavior can be explained by this.  The THC in marijuana, the part responsible for the high, interferes with the normal pruning process.

When marijuana is ‘medicinal,’ a doctor determines a safe dose.  When it is ‘recreational,’ there is no such limit… teen users don’t realize there should be.

Let’s talk about a safe “dose,” which is different for each person.

THC is known to relieve anxiety in smaller doses and increase it in larger; this is due to its bi-phasic effects, meaning it can have two opposite effects in high doses. Furthermore, some people are genetically predisposed to experience anxiety with cannabis as a result of brain chemistry.”
–What are the Side-Effects of High THC Cannabis. Bailey Rahn, 2016

Recent evidence that marijuana leads teenagers to harder drugs

“The study of the lives of more than 5,000 teenagers produced the first resounding evidence that cannabis is a gate way to cocaine, amphetamines, hallucinogens and heroin.” Read the full story

“Teenagers who regularly smoke cannabis are 26 times more likely to turn to other drugs by the age of 21.  It also discovered that teenage cannabis smokers are 37 times more likely to be hooked on nicotine and three times more likely to be problem drinkers than non-users of the drug.”
–Steve Doughty and Ben Spencer, Daily Mail, London UK, June 7, 2017

Now let’s talk about long-term.  Our troubled children are already slipping behind their peers in important ways, which can include school; emotional maturity (certainly); and physical health (such as gut and digestive problems).   Marijuana will add to your teen’s problems by causing lethargy, impaired memory, and cognitive delays.

We can’t pretend or assume marijuana is safe anymore, regardless of its legality or medicinal uses.

I found this research result extremely worrisome:

“Increasing levels of cannabis use at ages 14-21 resulted in lower levels of  degree attainment by age 25, lower-income at age 25, higher levels of welfare dependence, higher unemployment, lower levels of relationship satisfaction, and lower levels of life satisfaction.”
–Cannabis use and later life outcomes.  Fergusson DM, Boden JM, Addiction;  Pp: 969-76;  Vol: 103(6), June 2008

I worked with adolescents in residential care and in the juvenile justice system who regularly used marijuana when they could.  A young man on my caseload grew noticeably depressed after he started smoking regularly, and his anxiety, irritability, and paranoia increased.  He said that smoking helped him feel better, but he couldn’t observe what I and other social workers observed over time. Smoking marijuana, ironically, was temporarily relieving him of its own side-effects.

A clarification about the two substances in marijuana – The plant Cannabis sativa has two chemicals of interest:

  1. Cannabidiol (CBD) = Medical marijuana:  the molecule is safe for a variety of treatments, such as relief of pain and nausea, and it is approved by the American Medical Association;
  2. Tetrahydrocannabinol (THC) = psychoactive “high”:  in those who are vulnerable it, triggers psychotic symptoms, paranoia, depression, anxiety, and memory loss.

Your troubled child’s future is already at-risk, why worsen it with marijuana use?

All children need the same warnings that we give about alcohol and street drugs to include marijuana.  Whether you live in a jurisdiction where marijuana is legal or not, teens can and will find it.  It may not be possible to completely prevent your troubled child from using, but your caring persistence can reduce or end its use.

marijuana infographic

Please share this information with other parents.  

–Margaret

What will happen in your troubled child’s future?

What will happen in your troubled child’s future?

Are you scared for your child’s future? Is he or she is falling behind? On a scale of 1 to 5, where 1 is “Normal” and 5 is “Worst Case Scenario”, what will your child’s future adulthood look like?

This chart depicts a spectrum of outcomes of mentally ill children when they become adults.  No matter how ill your child is, if he or she gets support and treatment early, their future adult life could end up in the NORMAL column, and out of the RED column.  A network of family, friends, and professional staff can keep them from the worst-case scenario in the far right column, and move them in the direction of normalcy.

“Wellbeing” is possibly the most important.

This is a checklist of childhood problems that lead to poor future outcomes as adults.  Jump on them one by one.

  • Friend problems:  they have inappropriate friends, or no friends, or they mistreat friends (and siblings).
  • Behavior problems:  they do or say disturbing things (swearing, hurting, breaking, manipulating, sinking in depression, attempting suicide…). Everyone is stressed.
  • School problems:  disruptive behavior; poor grades (or a sudden drop in good grades); bullying or being bullied.
  • Health problems:  physical health problems become mental health problems, and vice versa:
    • trouble with sleep
    • digestive system and gut problems
    • poor diet and lack of exercise
    • epilepsy or neurological disorders
    • hormones during puberty
    • substance abuse.
Age 16, starting mental health treatment

We designate legal adulthood between the ages 18 and 21.  That’s too young.  Many normal healthy young people at this age are immature and irresponsible, but your son or daughter may lag well behind them.  Your child may need support and rescuing well into the 20’s or early 30’s–this is not unusual.

You’ll survive the marathon of tough years by pacing yourself, finding support for yourself, and protecting your mental health.

There is reason for hope.  Your child may take many horrible directions in their teens and 20’s, and you may feel hopeless about their future, or helpless as you witness their life nosedive.  If you can hang on and marshal support, your child will find a circuitous path to recovery.  It will have sharp turns and back steps and falls, but they’ll find it… and enter stable adulthood.

Age 20, after consistent mental health treatment

Some parents and families have seen the worst.  They’ve endured violence due to their child’s addiction; sat in court when their son or daughter was convicted of a crime; or they waited in the Emergency Room when their son or daughter was admitted for psychiatric care.  They also lived to see their child achieve the sanity to finish their education, support themselves, develop good relationships, and get that future you always wanted for them.

How two parents handled a “worst case scenario” and supported their child’s wellbeing:

These are true stories of mothers who stuck by their very ill adult children and provided what little they could to bring a bit of wellbeing.  These mothers found some peace by simply doing what they could.  Their child still had hope.

One had a grown son with schizophrenia and a heroin addiction who lived in squalor in supported housing.  He spent all of his disability assistance money on heroin and nothing else.  Her efforts to help him met with verbal abuse and threats of violence, and she feared for her safety.  What could she do, witness his slow suicide by starvation or overdose?  She arranged to visit him once a week in the parking lot, and brought 2 sacks of groceries in the trunk of her car.  He was to come out and get the groceries while she stood at a safe distance.  This worked.  He was still verbally abusive when he got the groceries, but he got food and she stayed safe.  Did he have wellbeing?  Was his life humane?

He lived indoors
He had enough food and clothing
He had encounters with social services and police, which led to some health care
A support system was available if he was ready for help.

One had a son addicted to methamphetamine who was lost to the streets. One day, she discovered a nest of old clothes and rags in an overgrown area behind her garage, and instinctively knew it was from her son.  “Good,” she thought, “He’s alive; I can keep him safe.”  She rarely saw him come and go, but she replaced the rags with clean blankets and a sleeping bag, and put out food for him, and provided a tent.  She couldn’t free her son from addiction, but she could keep him safe from the streets and its desperate people, and fed and sheltered in a way he accepted.

Like in the previous story, her son had a modicum of safety and support, and ongoing monitoring if he was ready for help.

 

–Margaret

Please share your story.

12 Ways Dogs Reduce Depression & Anxiety

12 Ways Dogs Reduce Depression & Anxiety

Most people know that dogs are good for one’s wellbeing, but these creatures literally improve one’s physical and mental health.

Dogs are medicine.

1. They lower our blood pressure

Research has proven time and time again that dogs significantly lower heart rates and blood pressure, before and after performing strenuous tasks. Blood pressure drops when one pets a dog. Petting dogs have also been known to ease pain and improve one’s immune system. It is like a dog’s mere presence is beneficial for pet owners.

2. They offer a soothing presence

Pets, particularly dogs, offer a soothing presence when one is performing tasks that take up a lot of mental energy. This goes a long way in helping speed up recovery of mental conditions.  It is well-known that some children will only respond to animals due to trauma or autism or intense anxiety.

3. They offer unconditional love and acceptance

Dogs are incapable of criticizing, judging or voicing their opinions. They snuggle up next to you even if you smell like poop.  Two reports describe the medical benefits of pets.  According to a 2013 white paper from the American Heart Association “…owning a pet, particularly a dog or a cat, is associated with decreased cardiovascular risk factors.”  The November 2015 Current Gerontology and Geriatrics Research published research showing “pet therapy programs have been shown to be effective in helping improve socialization abilities, lower blood pressure, and combat loneliness.”

There are other great therapy pets : “Benefits have been seen in owners of pets ranging from dogs, cats, birds, and fish to goats, chimps, and snakes.”  Be sure the right animal is matched to the owner.

4. Dogs alter our behavior

You or your child could come home annoyed at a million little problems that happened during the day, and maybe even taking anger out on someone. But imagine that before this happens, a smiling, tail-wagging dog walks up for attention.

Imagine, you or your child kneels and pets her, she licks your face and you smile. Just like that, your behavior is altered and chances that someone will become a casualty of frustration are now much better. People calm down in the presence of a dog, and don’t anger easily or use curse words.  Dogs make us slow our minds and our speech.

5. Dogs promote touch

There is no disputing the healing power of touch. An article published on Huffington Post cites that a 45-minute massage can reduce the levels of cortisol, a stress hormone, and build white blood cells which optimize one’s immune system. Hugging floods human bodies with oxytocin, a hormone that lowers heart rates, blood pressure and stress levels.

A study conducted at the University of Virginia showed that holding hands reduces stress-related activity in the hypothalamus region of the brain, which makes up part of the emotional center. It shouldn’t come as a surprise that stroking a dog can boost dopamine and serotonin levels while lowering heart rate and blood pressure.

6. Dogs distract us

It’s not a problem but a benefit! Dogs take us out of our heads and plunge us into another reality – one that involves affection, food, water… and scratching doggie butt for as long as we allow it. Distraction is sometimes the only thing you or your child needs when you have lost mental or emotional control. It is tough to ponder feeling awful when your dog is breathing in your face.

7. Dogs make us responsible

Owning a dog comes with responsibility and research has shown that responsibility promotes mental health. Psychologists assert that applying our skills to a job and taking ownership of a task helps build our self-esteem, which is why dogs are the most common therapy animals. When your child nurtures a happy healthy dog, it reinforces confidence and a sense of competence. This is especially important for troubled children who are often overtaken by their own thoughts and emotions.  Finally, pet care helps kids and teenagers learn independence and brings structure to their day.

Dogs pull a depressed or anxious child (or parent) out of their troubled head.

8. Dogs increase social interaction

Staying connected to other people or creatures is good for our depression. Starting a conversation is particularly scary for people suffering from depression. That isn’t true with dogs. They are natural social magnets that help pet owners connect with other people and maintain positive social contact.  Walk a dog, and people come up to meet the dog.

9. Dogs help one get into physical shape

Other than grooming, dogs need physical stimulation. This means taking walks and going out to a park to play. In the process of tossing a Frisbee or hiking with your pup, you get to exercise and enjoy nature simultaneously.

The energy boost consequently boosts your mood or blow off some steam.  Blood flow and oxygen to the brain is good for depression. When outside with a dog, your skin synthesizes vitamin D from the sun, which helps fight symptoms of depression.

10. Dogs are great listeners

The most effective way to release stress is to talk about it with someone. But what if you don’t have the courage to approach a friend? What if the idea of talking about your innermost worries makes you anxious?  Pet owners, particularly those who own a dog, will share their wishes and thoughts with a caring partner, with the guarantee that they won’t be disclosed to someone else. Even better, you can talk about your worries knowing that you won’t be judged

11. Dogs provide sensory stress relief

Movement and touch are some of the most effective ways to manage stress. Dogs offer the need for touch such as in grooming, petting and exercising them. Such tasks also help with sensory stress relief, which is particularly important for people suffering from depression.

12. Dogs help you find meaning and joy in life

Taking care of a dog can help lift morale and increase a sense of self-worth, optimism, and fulfillment.  If you’ve adopted a shelter dog, it’s also fulfilling to know you (and your child) provided a home to a dog that may have otherwise been euthanized.

Take care of your dog and your dog will take care of you.

Conclusion

The physical and mental health benefits of owning a dog for children, teenagers, and even the elderly are proven by research.

Note: Owning a dog is not a miracle cure for a family and child coping with anxiety and depression. Dogs are for those who appreciate and love domestic animals, and those who invest money and time to keep their dog healthy and happy.

By Andy McNaby

Founded by animal lovers, we provide honest reviews of pet products. We review products hands-on and we test products side-by-side, so you know you’re getting good honest reviews.

Outlook for schizoaffective disorder and schizophrenia

Outlook for schizoaffective disorder and schizophrenia

How Schizoaffective Disorder compares to other disorders

There is little information about schizoaffective disorder in children, which usually starts around puberty.  As a parent, you know how seriously it affects your child, but how does it compare to depression and bipolar (manic and depressive states) and schizophrenia?  What is the course of schizoaffective disorder, and how can you help your child’s future?

Schizoaffective disorder is not as serious as schizophrenia,
but more serious than bipolar/depression.

Research conducted in Britain* studied young people who received typical treatment for schizoaffective disorder, schizophrenia, and bipolar/depression who were between the ages of 17 and 30 (average age was 22).  Over a 10 year period, those with schizoaffective disorder improved slightly, better than those with schizophrenia.

Outlook for schizoaffective disorderBehavioral functioning over time for schizoaffective disorder, schizophrenia and affective disorders (depression, bipolar) at four consecutive follow-ups.  (This scale goes from 2 (good) to 6 (poor). A “1” would be the level of a person with no symptoms and who is considered normal.)
*M. Harrow, L. Grossman, Herbener, E. Davies; The British Journal of PsychiatryNov 2000, 177 (5) 421-426

Behavioral functioning is measured by how well a person does in five areas:Russian brain diagram

  1. Work and social functioning
  2. Adjustment to typical life situations
  3. Capacity for self-care
  4. Appearance of major symptoms
  5. Number of relapses and re-hospitalizations.

Your child will struggle with these, but there’s good news according to a recent landmark study:
Family support improves a patient’s outcome.

Life with a schizoaffective teen,” tells my story, and what steps I discovered which worked to improve my daughter’s functioning and behavior.  This article also provides insights into how children with schizoaffective disorder think.

A new treatment program was developed that altered some well-established practices.  A set of schizophrenia patients received the following support and were later compared with those who had the usual medication approach.

  1. Dosages of antipsychotic medication were kept as low as possible
  2. Help with work or school such as assistance in deciding which classes or opportunities are most appropriate, given a person’s symptoms;
  3. Education for family members to increase their understanding of the disorder;
    (“Efforts to engage and collaborate with family members are often successful during an acute psychotic episode, whether it is the first episode or a relapse, and are strongly recommended.
    Family Involvement Strongly Recommended by the American Psychiatric Association)
  4. One-on-one talk therapy in which the person with the diagnosis learns tools to build social relationships, reduce substance use and help manage the symptoms.”

Patients who went through this for of treatment made greater strides in recovery over the first two years of treatment than patients who got the usual drug-focused care.  More here.
New Approach Advised to Treat Schizophrenia, Benedict Carey, New York Times, Oct. 20, 2015

“..if you look at the people who did the best—those we caught earliest after their first break with reality—their improvement by the end was easily noticeable by friends and family.”

beautifulbrainThe longer psychotic symptoms stay in an extreme phase,” in which patients become afraid and deeply suspicious,” the more likely the person will be vulnerable to recurring psychosis, and the more difficulty they will have coming out of it and adjusting to normal life.

How to help your child

Be very realistic about what your child can handle in school.  They may be extremely intelligent–but maybe can’t handle too much homework; or class disruptions; or lack of empathy from the teacher.  A parent or school counselor should help your child find low-stress classes or activities, and consider limiting the number of classes per day.  They can only hold it together for so long!  I found it helped my schizoaffective child to take later classes, starting at 10 or 11 am.

Get the whole family on board to make his or her life easier.  Your child might be stressful and a source of irritation for everyone, but family members can help reduce this by taking on the chores your troubled child would ordinarily do; avoid pressuring them about something, or anything; and allow your child to say oddball things without confronting them about how irrational they are or arguing with them.

DIY talk therapy – Here are some ways to guide your child out of their troubled states.

Anxiety

  •  psychosisSchizoaffective kids may express anxiety in a tangled web of seemingly unrelated things, and spike them with paranoia about what they mean. Listen carefully, and conduct a gentle interview to explore what truly is bothering them.  It may be as simple as the room being too cold.
  • Give them plenty of time (if you can). A venting session is sometimes all they need.
  • Diplomatically redirect a negative monologue with a comment about something else more positive. This is where it’s useful to hand them a cat or call over a dog, offer tea or juice, or briefly check email.  The point is to break the spell.

Run-on obsessive thoughts

  • Voices and thoughts can be angry, mean, and relentless. Your child may not tell you this is happening, or may simply assume you already know what’s in their head.  Ask him or her if thoughts or voices are pestering them.  If so, show indignation at how wrong it is for them to mistreat your child, “that’s not right that this is happening to you; this is so unfair to you; you deserve better; I want to help if I can…”
  • Encourage your child to ignore the voices/thoughts and they may go away, or encourage them to tell the voices/thoughts to leave them alone. “I refuse to listen to you anymore!”  “Quit pestering me!”   “Back off and leave me alone, you jerk!”  Negative thoughts and voices are just bullies.

Help your child stand up to thought/voice bullies the same as
as you would help any child dealing with a bully.  Seriously, this works.

Life with a schizoaffective teen,” tells my story, and what I discovered that worked to improve my daughter’s functioning and behavior.  It also provides insight into how people with this disorder think.

Take care and have hope.  You can do this.

Margaret

What to know about psychiatric residential treatment

What to know about psychiatric residential treatment

residential centerHave you been searching for psychiatric residential treatment for your child?  Do all the programs sound wonderful?  Ads include quotes from happy parents, and lovely photos and fabulous-sounding activities.  But what’s behind the ads?  Residential treatment programs are diverse, but there are important elements they should all have.  Here’s how to avoid low quality residential treatment.

Psychiatric residential treatment is serious stuff–it’s difficult to do–especially when troubled children and teens are put together in one facility.

Should you ask other parents for their opinion of a program?  In my experience with a child in psychiatric residential care, and as a former employee of one, word-of-mouth is not a reliable way to assess quality or success rate.  There are too many variables: children’s disorders are different; acuity is different; parents’ attitudes and expectations are different; length of time in the facility is different; what happens once a child returns home is different…  It’s most helpful to ask questions of intake staff and doctors or psychologists on staff.  Quality psychiatric residential care facilities have important things in common.

What to ask about the staff:

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  • What is the training and licensure of staff?  Are there therapists with MSW degrees, registered nurses, psychiatrists and psychiatric nurse practitioners, and is a medical professional available on site 24/7?
  • There should be a high staff to patient ratio, and a physically comfortable environment with lots of emotional support.
  • Do the staff seem mature to you?  Do they support each other, are they a team? There is often heavy staff turnover at residential treatment centers because the work is emotionally draining, so staff cohesion is as important as the qualities of each individual.
  • Safety is paramount.  What are the safety and security plans in the facility?  Staff must be able to safely manage anything that can go wrong with troubled kids.  They should be trained in NCI (Nonviolent Crisis Intervention), “training that focuses on prevention and offers proven strategies for safely defusing anxious, hostile, or violent behavior at the earliest possible stage.”

What to ask about programs:

  • Does the program specifically identify parent/family involvement as part of treatment?  Does it emphasize parent partnership with staff?  Ask.  Whether you live close or far from the center, even out-of-state, you should be regularly included in conversations with staff about your child’s treatment.  You should also be included in a therapy session with your child periodically; some facilities can connect with you over Skype.  Your child’s success in psychiatric care depends on their family’s direct involvement.
  • The program should coach you in specific parenting approaches that work for child’s behavioral needs.  While your child is learning new things and working on their own changes, you must know what to establish back home when they return.
  • You should be informed why your child is getting the treatment or behavioral modifications he/she is receiving.
  • Last and most important: when your child leaves, there should be a discharge meeting and a discharge plan.  What this means:  all staff who worked with your child get together with you and discuss what treatment should continue once they go home.  Medication management and therapy is identified in advance, appropriate school accommodations are discussed, changes in the home environment are discussed if needed…  You should never leave without knowing what comes next in the months following care.

Body health is brain health, and vice versa.

  • residential programsMental health treatment will include medication and therapy, but must also include positive activities and an educational program.  The whole body needs care:  exercise, social activities, therapeutic activities (art, music, gardening), healthy food, restful sleep, etc.

Is your child emotionally safe as well as physically safe?

  • You should be able to visit the unit or cottage where your child will live, see their bedroom, and see how the other children interact with staff and how staff interact with each other.

What to ask about the business itself:

  • Can you take a tour ahead of time?  Can your child or teen visit too if appropriate?
  • Are emergency services nearby (hospital, law enforcement) that can arrive quickly?
  • Does the facility have a business license in their state?  Do they have grievance procedures?  Is the center accredited as a treatment facility, and by whom?  In the U.S., the main accreditation authority for healthcare facilities is The Joint Commission.

Psychiatric residential treatment works miracles, but it doesn’t work for all children.  Some need to go into treatment more than once to benefit. Some fall apart a few weeks or months after discharge.  These are common.  What’s important is that staff observations and advice help you and your child with insight and skills for managing his or her unique symptoms, and for communicating effectively.

Good luck.

 

What was your experience when your child was in residential care?  Please share your comment so others can learn.