Hello,
My son is having a psychotic episode. He is neither violent nor suicidal. We took his to ER, but they ran some basic tests, a therapist interview him, spoke with the Dr and released him without giving him any medications. He is undiagnosed and unmedicated.
We live in Illinois. What would be the fastest way for him to see a psychiatrist without commit him to a facility?
Thank you in advance
contact your local NAMI chapter - ask to speak to a volunteer who is facilitating the support group for family members if the closest NAMI won’t help you, call others. services available can vary from state to state, county to county,
I think the quickest way may be to go to your sons general practitioner. They can assess him and you can provide written or in person notes .
Typically a referral from a GP gets you priority in scheduling with psychiatrist - assuming the GP has some connection to psychiatrists within their medical group.
Thank you both for the quick answer. I really appreciate your help.
We managed to schedule a tele-call for tomorrow, but I will also call NAMI and his GP.
My son has been talking non-stop to himself for the last few hours. Is there any way to help him calm down and get some sleep?
I am so sorry the ER let you down. My son finds sleep impossible during an episode of psychosis. It’s 9 hours later, has he fallen asleep yet?
Committing him to a facility is what the ER should have done. If he is actively psychotic I think it was malpractice not to have. The stay is typically less than 2 weeks. The patient is stabilized and then released on meds.
What about urgent care? They should at least be able to prescribe a tranquilizer which should help to calm him.
Has he eaten or drunk anything? If not he needs to be seen by the ER. They should have sectioned him, and a GP consult will come up as a non-emergency if he needs acute treatment. (He does, I hate to have to point it out but 9 hrs of nonstop talking would wear most people out, he should be sectioned, as that is the only way he will get the emergent help he needs.)
Aside from what others have already recommended about NAMI, he may need labs done to rule out other causes of his psychosis. Do you know if he has been or is currently using THC or CBD containing drugs/edibles? This is a significant indicator that his psychosis may not only be an actual episode of decompensation but that he also HAS schizophrenia. By the sounds of things, HAS HE BEEN DIAGNOSED WITH SCHIZOPHRENIA OR NOT?
That initial diagnosis is always done with prior lab values and an involuntary hospital stay as they have to do a multitude of tests and scans to rule out other possible illnesses. (Notably, severe Celiac’s disease and atrophy of the gut with malnutrition and flattened villi can induce psychosis and other neurological/psychological symptoms that are misdiagnosed as SZ.) A longer term of clinical observation and stabilization is necessary to exclude other possible forms of illness. A Therapist cannot and does not have the credentials to diagnose mental illness. I do not know WHY they referred you for a telehealth visit when he is obviously in distress/unable to speak/ advocate that something is clearly wrong.
I would ask for a record of his lab values to see what tests they did and did not run. (Again, without any ill will or wish to sound rude, Is your child a minor or is he an adult? This changes how much information and how many tests/results they are willing to release to you.) If he is a minor, that may explain why they did not commit him outright to see what he would do under long-term observation. Getting a diagnosis of schizophrenia at a young age is almost impossible unless he did something catastrophic to you or himself.
If he is resistant to treatment or masking his symptoms (My brother would refuse to answer questions and go comatose before any and all people he thought would or could section him.)
You will never get the diagnosis you need without a period of hospitalization. The medical staff need time to do due diligence. Record what he is saying and ,if you can, take a discreet video of what he is actually like whilst not under medical observation. It sounds as though the Therapist may have outright asked him whether or not he needs in patient treatment. If/when he refuses, there is nothing else to be done unless you prove he is unable/unwilling to consent. Anosognosia is a clinical term for an inability to perceive your own illness, this almost always leads to failed medical compliance and a failure to receive proper diagnosis and treatment. IT MEANS HE CAN BE SECTIONED AND HE MUST BE SECTIONED TO RECIEVE A PROPER DIAGNOSIS. This is non-negotiable. You will have to indicate to a social worker and the nursing staff (most likely outside his presence.) That you believe he has undiagnosed schizophrenia. Take the video with you and bring the audio recording to the Counselor or Therapist. I am sorry that they were so unhelpful at the Hospital. I hope you receive the help you need.
He managed to get full 12 hours of sleep last night and eats a little, but today is another hard day. Tomorrow is the call with the doctor we found online. All in-preson doctors we found so far are available in mid-May.
My son has not been diagnosed with anything yet. The urine drug test they did was negative.
I am very reluctant to commit him to a hospital as it can do more damage than good. I read reviews of all nearby behavior centers and their reviews were mostly bad.
The whole experience is very overwhelming, but we try to stay positive.
I am grateful to all of you who replied so far.
Best of luck. Record whether he can eat, bathe, or drink at all. Again, civil commitment is awful but people can die when they are acutely mentally ill. See the case of Lisa McPherson.
Scientology’s involvement did not help, but more to the point she was unable to feed or clean herself for days. Nothing about her mental condition (she had been admitted to an ER for treatment under a 5150) indicated she could feed, clothe, or advocate for herself but religious status and poor caretakers on the part of the Church of Scientology made her a bygone statistic in deaths directly attributable to untreated mental illness. Out patient care is insufficient for some patients and please don’t feel ashamed or guilty if it is determined he needs that level of help. Denial will only make his illness worse. If not moreso than never being seen at all. With a diagnosis there are more outpatient services at hand so that he can be cared for, especially in the event that you become incapacitated.
I sincerely hope that that is not the case but it happens. My parents were my brothers primary housing but my father had a health issue of his own that means he will never be able to care for him again without a risk of reoccurrence. If you have any family connections I would make them aware of the diagnosis and set up some parameters and things to watch out for. While not every patient is harmful to others.
People need to be made aware of his condition so they can call for help or provide supervision to children or others who cannot take care of their own physical safety against an adult. The other worst case is that your son does something he will regret against someone who trusts him. They will regret it immensely in a period of lucidity. This has destroyed more than one relationship for my family member and I have to get rid of my ideal of what my sibling used to be like when we were kids. Compassion is it’s own form of abuse when it makes people deny necessary care.
\My son was able to get a diagnosis without a hospitalization. He met with a psychiatrist who specializes in severe mental illness for one year. We bribed him to get him to see a psychiatrist. Using Dr Amador’s LEAP method of communication from his book “I’m not Sick, I Don’t Need Help” we found out that he wanted to have a vacation in Colorado more than anything . We told him we would pay the expenses of the trip if he would see a psychiatrist for one year. The teachers in our Family to Family class had recommended the psychiatrist we asked him to see.
I’m glad it worked for you.
We tried bribery. He loves arts and music and we live in an area with a good classical music conservatory that holds concerts. While my brother was more than willing to have the reward he was not compliant with treatment despite his visits and he continued a policy of dishonesty with us. We tried for years and the unwillingness/lies is what made most of our relationship fall apart. I’ve already rehashed my story with others on the forum but now is the first time in forever he has NO choice about what Tx he does or doesn’t receive.
I don’t like having to do this at all and I miss the good memories and times that we had growing up together but the person I knew and admired is gone. I’m afraid because in some ways I know it’s made me cold and isolated than I should be at times. (Dishonesty never helps make relationships I’ve learned.) He needs help and if being distant is what helps him get it, it is unfortunately what I have to do.
I am curious if the dishonesty comes from the patient trying to hide something, or it more a defensive/coping mechanism.
To be completely honest, it is a bit of both. So far as I can tell, he’s been in some truly awful states over the years but then gets mad at us to the point of exploding (he is VERY easily upset) even when we do the adult thing and change to subject or acknowledge where is coming from. Honesty in communications is important.
I will never know what it is like to have schizophrenia and delusions, but the experience is probably annoying, terrifying, and occasionally fun if they enhance parts of life that he likes. (Even if it means being horribly abused or at risk of being taken advantage of in any and every sense possible.) Being unable to control that state is something I can only empathize with on a peripheral level, having never experienced the markers of his condition myself. That being said, he still refuses treatment and ignores what things he does hear to the point of being non-functional. Then no matter how he FEELS about things more practical realities take over.
An inability to bathe got him saddled with horrible rare infections that almost no one gets anymore. Among other issues, he refuses vaccinations and has had more strange illnesses as a result of that than anyone else I know. He doesn’t have an immune condition, but I would honestly like to see someone put in the research to see if there are any epidemiological changes to the immune systems of schizophrenic patients (aside from what ones we can generally attribute to stress.).
Nutrition or a lack thereof already plays a pivotal role in basic human health and the poor nutrition of many SZ patients that comes as a byproduct of their disordered minds means they are more likely to be susceptible to these issues than the general population. Whether the change is perceptual, coming from the brain in a psychological way, or neurological is such a specific and interdependent question that I don’t think there is a clear answer.
in my town it there is no fast route to see a psychiatrist. The Er doesn’t care if patient is psychotic. Its ok to be psychotic in this country and go unmedicated. Do not know how old your loved one is but contact local psychiatrist and behavioral health centers for direction. Also local NAMI can help. Its not easy to get one in a facility without client permission unless they are a minor.