Family and Caregiver Schizophrenia Discussion Forum

Hearing Monday to hospitalize my son


#1

I have been absent in the forum lately, as we have been navigating our recent guardianship (December 9th), getting all of my son’s records and having access to his hospitalizations, previous evaluations, etc., because we were unafforded that information through him refusing it to us, and HIPPA. Currently, we are working with our County Attorney on an involuntary hospitalization of my son. He was hospitalized in Jul’16 during what we now understand to be possibly his second break psychosis (sophomore year college). This was police initiated, but I flew there at the request of some of his friends, and initiated the call to the police. His first break was in the year prior (self-described activities to a therapist he saw when he had insight and sought counseling at school without our knowledge). He is now gravely disabled by this illness, has never taken medication (refuses), and he has no insight into his illness what-so-ever. We petitioned the court for guardianship in December, were able to get all of his records, and last week, he had 3 nights during a week where he was out of hand and the third night, we called the County Sheriff and told him he can no longer stay in our home. This behavior is not unusual. Although it had been escalating, he is manageable 75% of the time, and scary 25% of the time. We stated we were fearful of our own safety, and his (he was punching walls, smashed his guitar…and in the nights prior, he was banging his head on the wall, destroyed various electronics in his room…in the most recent prior incident, he put 30 dents in our refrigerator). We are 1.5 hrs from any ER, so by the time they could get him in the vehicle he made it to the ER, he was mellow. The ER doc said he was certainly mentally ill, but he did not meet the criteria and wanted us to take him home. I refused, insisted on a CRT evaluation, and although he was completely delusional, grandiose, and visibly mentally ill, they too said he didn’t meet the criteria. I disagreed and I refused to take him home and made them aware that I had been working with the County Attorney for the last three weeks on our need to hospitalize our son. He cannot take care of himself, and is gravely disabled and because of that, he is an eminent danger to himself. I insisted the CRT therapist return to his ER room with me and that they listened to me tell my son that he had three choices: He gets on medication with his doctor, He voluntarily admits himself, or we were pursuing an involuntary commitment and so, he was not coming home with me. He declined to do either of the first two, and said he doesn’t want to come home anyway. I then questioned where he would go in the company of the CRT staff, “Doesn’t matter”. Where will you sleep, “under a tree”, how will you eat, “I don’t need food,” and as it was snowing and blowing outside, the questions continued, his answers were equally bizarre, and I walked out of the ER and told them all he was there problem. I also told them that if they let him leave the ER he would be dead. Well, today, he is in psychiatric detention and has not unraveled. I was wishing he would unravel, but he can pull it together like this. I think we have enough. His psychiatrist will be in the hearing, and I will be testifying about my 6 months with him (he has been living with us since discharge in July), of which 100% is delusional. As I said above, the hard part is that 75% is manageable due his core behaviors kind and gentle. 25% of the time he is destructive, sometimes violent, suicidal, and completely unpredictable. His psychiatrist’s testimony is if he was left to his own devices, he would be dead, and the public defender told me Thursday that it was likely he will be admitted.

Either way, I am nervous and stressed about having to testify against my son. I have visited him twice in psychiatric detention, and he is mad. He believes I am part of the evil ploy to steal his life. He believes he is there because I called the sheriff. What is so hard is I am who he will be discharged to, and what I have done to this relationship ?? I suppose, all I can do is honestly represent my life with him. Although I believe he will be admitted, I am nervous that there is a possibility that he won’t be. If he is admitted, I am simultaneously having our attorney who filed the guardianship/conservatorship amend that petition to include medication within our authority.

I am wondering if anyone has any additional suggestions? The psychiatrist said, although he will be admitted with their typical 90 day time-frame, he will likely get on medication, gain some insight, and be discharged within the month because the bed availability is so poor where he is going.

If anyone has anything to share, advice on additional ways/areas for us to push related to services during/after his hospitalization, etc., I welcome them. This is all so new to us…and it is completely awful to have to take this action. I feel blind.


#2

It sounds like you’re doing everything possible.

I would take some solace in knowing that a living son who hates you is better than a dead son who doesn’t.
If nothing else, you’ll know you tried everything you could.

And, they say, that once well, most people forgive you for everything you did to get them help.

My son is on his third involuntary in 6 months. First time he stopped taking his meds because he lost insight. Second time, he stopped taking his meds soon as he got out the first time so they put him on injections. This time, either the injection they used only worked short term for him or they didn’t give him a high enough dosage.

My son has never been violent or threatened to harm himself when he’s went in on involuntaries. However, they see that he is too sick to protect himself from harm and is too sick to consent to treatment. But, each time, he’s initiated it by either asking to go to the hospital or to see the crisis staff.

I seem to have really good luck with it compared to most people here, which makes me wonder if he’s really that much sicker than everyone else, or if the laws are better here, or if it’s because he’s looking for help instead of me demanding it.


#3

Thank you for this, slw. I needed to hear this.


#4

I keep trying to remind myself that if I make a choice to do something or not do something because I’m worried about whether or not it’ll make him mad, or make him hate me, then the decision is about me and not about him.

I’ve done a lot of that in the past. Maybe he would have been better if I had been braver or less selfish.


#5

Again…so true about worry/fear…that is about me. It is okay to feel those feelings, but when we strip it down, it is about saving a life. Our loved ones, or someone who is in their path during extreme psychosis.

Were the subsequent hospitalizations any easier to implement? One concern I have is about after discharge and if there are any safety nets. Thus, the reason for the medication addition in guardianship.

I turned a corner a little over a month ago in my journey with my son and realized I had been approaching this all wrong. I was approaching it as if treatment or medication was a cure. “If he would just take medication…”, and then it dawned on me that each of the actions we have taken are merely pages in a chapter of a really awful story about this diagnosis he will have for the rest of his life. I started planning the rest of our life together at that point, started to draw boundaries, and had to get honest about what I could and could not do…what I am able, and not able to endure…and it has been a bit easier to see the steps that way.

Thank you for chiming in on this.


#6

The first time, they put him back on the same meds he was prescribed before & refusing to take.
So, of course, within a week, he wasn’t taking them again.

The second time, they put him on injections - this time, I blame a lack of follow up.
He saw his pdoc when he came out, then they scheduled him to come back about 6 weeks later.
In the meantime, I called when he started having breakthrough symptoms before his first shot outside the hospital.
They told me to be patient, he got the shot, and it kind of held him steady, but we didn’t see the improvement we saw before.
I called them when the symptoms got worse, and they still told me to be patient.
Then, they got to see him when he was really, really sick and begging to just go straight to the hospital.

Now, as luck would have it, his Medicaid came through on his second day of this hospital stay, so now he’s eligible for the intensive program our county runs and he will get a new pdoc and new caseworker who have smaller caseloads & can work with him more closely, so I’m cautiously hopeful. Of course, he has to be willing to work with them too.

Your question about easier to implement. For me, they were about the same. He was so sick, there was no question that he needed help. And, when he gets this sick, he doesn’t hide symptoms - he’ll tell them about his delusions because to him they’re 100% true, so why would he lie?


#7

Thank you both for all of what you wrote.

I was unable to hospitalize my family member quickly enough (and it’s really hard where I live, plus very short stays with no long-term results, so easier to forego when nothing has ever improved for long after brief, three weeks at the most, involuntary hospitalization). I should have tried harder and didn’t do it in time (though I was working on it); partially I didn’t rush because there is no treatment until criteria are met and partially because of my own feelings and need to be close to my family member. Anyway, I failed my family member.

So, instead, family member’s most recent psychosis led to much worse after which I could not intervene. The situation was and is beyond what any person with severe psychosis can bear. But hundreds of thousands of people with SMI are experiencing this and by extension a million or so family members.

So, do anything and everything you can. Try as hard as you can, knowing it’s not up to you. Doctors, judges, designated examiners, some sort of consumer advocate for people with mental illness: any of these can prevent involuntary commitment. Don’t worry about any of them. You are focussed on your goal of helping your son stay safe. We all support you.

Stay strong and good luck.


#8

So I talked with the County Attorney today, and one thing he shared was that I changed the game when I left my son in the ER and refused to bring him home, or house him any more.

Truly, it was the hardest thing I have ever done. Someone else in this forum took a similar action and I told myself that we have everything to prove the third part of the law in our state - which is eminent danger to self because they cannot take care of themselves and there well being would deteriorate significantly without someone caring for them…so that is why I am sharing this. I thought, if they could do it…maybe we could too. I told the ER staff and the CRT therapist that he will be dead if they let him walk out the door, his psychiatrist agrees…and it will be on their hands.

Meanwhile, the CRT therapist followed me out of the room and tells me she knows he is mentally ill, but he too has choices (Seriously??). She said, if he leaves here and he escalates, we can have him picked him up. I said, what…??? Leaves here and goes where? Goes to sleep under that snowy tree in a snow bank he was talking about? We don’t live where the ER is. I told her, he can’t even feed himself…and then I turned around and walked out of his room, and out of the revolving ER door.

I swear I felt like I had cement in my shoes and could not take the steps to take the action and leave…it was blowing snow in the depths of the 3rd coldest winter we have had on record, but I did it anyway. I called my husband when I got to my vehicle, and said, “Please tell me I am doing the right thing!!!” I literally thought I was going to vomit…but I knew it was the only way, if there was a way at all.

The good news today is my son was evaluated today (the necessary evaluation before the hearing) and the CRT therapist said he was very mentally ill. She recommended the County Attorney continue on. It is possible that between the CRT testimony from Wednesday and today, and his psychiatrist also testifying, I was told I may not have to get on the stand. The County Attorney believes he has enough to display what he needs.

He did tell me that they will struggle to keep him there for any length of time because of their overpopulated state, but I am hopeful for mandatory medication in a community treatment order paired with medication added to our guardianship powers will assist.

So grateful for all of you in this forum. Your collective experience and all that you have shared has helped me navigate this with my son. I can only hope to do the same for others.


#9

jmarie, I don’t think you intended it but your reference to walking out of a revolving door seems aptly poetic. I hope you find a good outcome for your son.


#10

Thank you, @engineerguy…and yes, aptly poetic!

Wishing you the best outcome as well!


#11

I simply told them that no one wants to do this. It was suggested that We not do dual guardianship because both of us would have to be present and sign all the time. Instead name one and have the other be alternative. Hang in there.

I did have to take the stand and you probably will also. Just describe the history and the most severe episodes. It will be alright and a weight will be lifted from your shoulders. I too hope all goes well with you and your son.


#12

they cannot release him on the street, can they? If you refuse to take him home, should they not make sure they have some kind of housing arrangements for your son?
(I am in Canada so I don’t really know how does it work in the US)


#13

Yes,that is what they said, as he has free will as a 20yo young man, and quite honestly…that is what my son wanted. To his own demise, he thinks he can survive in the wilderness without food. He wasn’t arrested for any crime, he was just behaving poorly at our home, destructive, etc. For the most part he is kind and gentle, but sometimes the mental anguish and agitation is beyond his ability to control. He could have been arrested for disorderly conduct, but we insisted that he shouldn’t be…and instead we insisted he go to the ER for a CRT evaluation because he is mentally ill. My initial goal was simply to get more issues documented, but he has deteriorated significantly in the last month…and I just decided to push harder.

Typically, they would have handled him like any homeless person, and because we were not willing to house him, he was essentially homeless. What I didn’t realize is how much gravity this gave to his issue of being gravely disabled. They would not qualify him as being a danger to himself or others at the time, but knowing his condition would deteriorate further if they turned him loose, and because of him not having a place to be to stay safe, he was considered a danger to himself…and that qualified him (or at least that is what is being presented in court on Monday).

The whole uphill battle and circumstance for those of us that are caregivers for our loved ones trying to get them necessary help is so wrong.


#14

I think you are doing the right thing in trying your best to keep him safe. Winters scare me too!


#15

@jmarie1067 and @Never_to_become. Yes they can release our mi adult children on the street and parents need to make the biggest stink about that. Recently I was told that daughter could be released – given a bus ticket and go wherever. I basically said that she is in no way able to care for herself and become victimized on the street. I said more but you get the picture. Make yourself a rabid advocate and most likely someone will listen. Just remember that folks who work as police officers and mental health care providers are human beings with families of their own. Paint a picture that folks can identify with. I found most folks my daughter has encountered through the legal and mental health system very caring and compassionate. Most of all be very respectful to these folks but communicate with conviction ---- they can help you.


#16

So…my son was involuntarily hospitalized today, which will give us some time to regroup on our life with him. Thank you all for sharing your time and your thoughts with me. I am so very grateful for all of you and your wise words. :heart:


#17

That’s great news!! :smile:


#18

I hope your son gets the help he needs now.


#19

Reading your story and the following dialogue with slw makes my heart go out to you all. No one can truly understand what it is like to have a child with this horrific disease. It is almost beyond description the emotional meat grinder you are subjected to. It is a “club” (for lack of a better word) that you never probably dreamed in your wildest nightmares you would be a member of. Here, at least, you find that you are not alone. Even though everyone’s story is different. To the degree, at any given moment, of their loved one’s perception. My son is 33 and all I can say is that we came through those earlier terrible,devastating, dangerous, even violent years negotiating madness to a livable situation now. Don’t lose hope. The disease can level off some as they age. No, there is no cure. No medicine is going to return their pre schizophrenic brain to them. But you can exist as a family if you are lucky. And you don’t give up hope. Even if it takes 10 years to find that spot. It is absolutely worth it, to be at the spot we are at now. He would have never survived til now if i had given up.


#20

Thank you for sharing, @willysmom. I met with my sons doctor today where he is at in the hospital, and felt hope for the first time in a long time. So much of it comes from the wisdom within this forum…like the story about your son. I know it will require diligence and time, and even then…the outcome may be uncertain or not what we are reaching for. Either way, we are all-in!

Wishing you and all of you a good end to your week.