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Psychiatric Hospital—not what she thought

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Skywatcher

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My young college daughter, started cutting again, was contemplating downing some pills and chose 911 instead. She stayed in the ER alone all night and chose to be moved to a mental hospital. I find it odd that the ER gave her the choice but didn’t explain what she was getting herself into, including no way out by choice. The good part is getting her depression meds regulated. The rest is bad. They put her in a pic u adult unit. High level psychiatric adults in there. She has to wear scrubs because she is a cutter. The nurses accused her of stirring up the men. My daughter is a cute lesbian barely legal girl. Not a flirt. (She talked to them). One patient continued to beg for dates and was stalking her. Her meds got messed up. Her toiletry bucket got messed with because they didn’t give her a locker right away. When she slept in the overflow room a male patient was peeking in at night. Her anxiety and depression have gone up to an 8 since adding a stronger dose of her Effexor xr and abilify combo. She doesn’t feel safe.

I talked to her case manager. She explained why she was put in there (she had cut?). However, she took my concerns seriously and she is moving to the depression unit in the morning. If we had understood all of this, I would have either done extensive out patient or found her a spot in a recommended private facility no matter what the cost. She told them about her pot use and they have labeled her an addict. I don’t think of pot as a dangerous drug. My h uses it to feel normal. I think my daughter is wired like him.

My anxiety is through the roof and I keep crying and almost cancelling work. My therapist did a 40 minute phone with me on a day that she doesn’t see clients. She never does that! But she was trying to help calm down, plan self care and had me talk through my day’s plans.

I’m really still having trouble processing this and keep having to fight away panic and wouldn’t mind some advice or hearing your experiences.
 
They're shit places to be. That's the truth. Public mental health facilities don't seem to have come very far in the last 50 years, and they're scary places to be.

This isn't the appropriate time for my horror stories, but I've got a lot of them. Like...a lot.

Here's the thing - in the moment? Yeah, you want to be anywhere else. And you get better at working the system so that you get to be somewhere else quicker. Transfers to nicer facilities get easier etc.

Right now? She's alive. She doesn't feel safe. But she's likely as safe as it's possible for her to be right now.

So, support her with the transfer. To another unit, another facility, whatever is available that's better.

But as hellish as it is? If it was this or a completed suicide? This is still better. This was still the right choice. It's motivation to get hella good at those distress tolerance skills asap. But if it comes to the crunch, it will be the right decision next time as well, if that's the only safe place to go.
 
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I thought about that. If they released her today and she went back to school, I might be even more worried than I am now. If she was released into our care and we got her in an out-patient situation, I’d feel much better. We’ve gone through this with her before. She just crashed hard this time because she started drinking with friends and it basically erased the antidepressants in her system. This mostly also started because her pdoc agreed to stop the 2 mg of abilify. And she was just taking her Effexor when she got around to it each day. I also wonder if she had some sort of trauma happen recently. I have a ptsd fear of my daughters reliving my freshmen year bad choices and rape.

Thank you for the support. You are right. I need to NOT hear a bunch of nightmare stories at this time.
 
Huge kudos to your daughter for calling 911.

It sounds like you are being really supportive. I would look into those private facilities you mention. If the depression unit has similar issues, and you think transferring her to private would be better, are you able to do that? I don't know what the discharge rules are over there.

How often do you get to talk to her?

My experience in the psych ward did break me in a lot of ways, but at the same time I know overall that my admission saved my life.

I'm glad your T made the time for you. Do you have a next appointment arranged for yourself?
 
I have my regular Monday appointment. I also asked if we could schedule Tuesday (she’s off the rest of that week).

The facility told me that she can request that the doctor sign a release. If he disagrees it goes to court. Court cases are running 2-3 weeks behind, so she would be stuck in the facility until then. The case worker said that she thinks she could possibly get out on Monday or Tuesday. But I’m not holding my breath.

I can call her when ever I want but the phone line doesn’t always work. My daughter can also freely call me. One of us can visit her on Sunday, Tuesday, Thursday.
 
You can do some research into behavioral health centers in your area, make part of your release to your care request stronger by having identified a PHP (partial hospitalization) program she can 'step down' into. That's a higher level of care than intensive outpatient, but is still not inpatient - so, she'd be living with you. Honestly, that's the pathway this hospital she's currently in would be putting her on, and a solid 8-10 weeks in PHP to IOP will provide her with a tremendous amount of support.

Your therapist - if they work with any adolescents or young adults - will likely be able to give you some suggestions about nearby options.

You could also look into residential inpatient, if you aren't sure that starting in the. home would be best for her. You'd want to be looking at a place that has a step-down system built in.
We’ve gone through this with her before.
Was her previous PHP or IOP experience overall, positive? How long did she do it for?
 
You can do some research into behavioral health centers in your area, make part of your release to your care request stronger by having identified a PHP (partial hospitalization) program she can 'step down' into. That's a higher level of care than intensive outpatient, but is still not inpatient - so, she'd be living with you. Honestly, that's the pathway this hospital she's currently in would be putting her on, and a solid 8-10 weeks in PHP to IOP will provide her with a tremendous amount of support.

Your therapist - if they work with any adolescents or young adults - will likely be able to give you some suggestions about nearby options.

You could also look into residential inpatient, if you aren't sure that starting in the. home would be best for her. You'd want to be looking at a place that has a step-down system built in.

Was her previous PHP or IOP experience overall, positive? How long did she do it for?
Her previous experience was seeing a therapist every other week and a psychiatrist. She wasn’t suicidal, though she did take a bunch of Advil once. She has a very good relationship with her t. They had been terminated since May because she was doing great. This recent stuff came on from college drinking and her Abilify being taken off.

The place she is at said that we shouldn’t request to release her because she will probably be getting out on Monday or Tuesday. Their recommendation was a therapist, psychiatrist and addiction class at her college campus. No long term hospitalization. (This is her first time hospitalization). Depending how she is right now, everyone is in the hopes that she can finish the semester with a bunch of added support in place and then take an intensive treatment during the break. The case worker is hoping that her time at the hospital will have scared her into stopping the substance use and taking her meds correctly, never to return.
 
Their recommendation was a therapist, psychiatrist and addiction class at her college campus. No long term hospitalization. (This is her first time hospitalization). Depending how she is right now, everyone is in the hopes that she can finish the semester with a bunch of added support in place and then take an intensive treatment during the break.
IMO… f*ck that.

No better time than the pandemic to take a quarter/semester off for medical reasons with no questions asked, and no hit to aid packages.

That’s assuming she even needs a medical reason to drop without taking a hit. November, I’d think so, but schools vary. I always took winter quarter -or whichever semester had the best snow- off (my “summer” break) because snowboarding (and trauma anniversaries), and doubled down as I fell in love with the summer programs, and the crazy ass networking/conferences/low ratios/intensive classes/etc. that make up the part of the year 90% of the student body leaves.

She’s had the oh-hell-no-get-me-the-f*ck-outta-here nightmare experience. Rather than make killing herself sound better than calling 911 the next time? GET that private facility, PHP/IOP, equine therapy, water therapy, circus/yoga, all the bells and whistles… to get her a BADASS foundation of support to not only see her through the rest of her time in university, and in the years to come in her life… but also knowing that kind of support is there if she ever needs it again, in the future.
 
@Friday She wants so badly to go back to school. What are your thoughts on her finishing 1st semester so that she can at least receive credit for those? After Thanksgiving, she only has a few weeks left. Her grades are B’s, C’s and one D. She might end up with a bad gpa after finals after missing a week. I don’t know how any of this works. She has non-subsidized loans and had already paid it off with her savings from work. Her grandparents paid the rest with a college savings plan, and we paid a small bit. She told me that if she fails out she is never going back to college. I told her about other options that involve less school. Plus she loves working. She loves to clean, do inventory, take care of animals. I fear some of her friend group around here being a bad influence to her, at least at college her friend group was working towards career paths. I guess the school will tell us her options once she is released.
 
What are your thoughts on her finishing 1st semester so that she can at least receive credit for those?
Let her choose…. But present her with the options.

Whatever she chooses MAY be a mistake. But it’s her mistake to make.

(Even if she’s unduly influenced by what “everyone” wants, and people pleasing, pressure to succeed/do right/measure up/not disrespect, etc. It’s a lesson to be learned in DGAF what others opinions are. Hopefully not one that costs her her life in 6mo, 6 weeks, 6 years. But still… her lesson.)

It’s gutting, as a parent; to let a child choose. But, in my experience at least, it’s less gutting when there’s no “I would have…” attached. Because they KNOW exactly the limits of what I’m willing to make happen, AND be proud of, rather than disappointed in.

It’s wacky, right? My kid is 19. I was 17 when I enlisted, a fully emancipated adult with a wildly different life than my son has. It’s a very strange position to be in… as a parent… of an adult. Albeit a YOUNG adult. Where all the influence is voluntary. On their part.
 
Omg. More problems. Morning nurses didn’t wake my d up for meds. Then they wrote on her chart that she refused. Then when she woke up and asked for her meds they refused and said it was too late. (Thyroid—which we know isn’t late). And her Effexor xr…. They tell me they can’t give it till the pharmacy brings it. I said, she brought it, just give her 2 (it’s the same dose).

I told the nurse that Effexor is supposed to be given at the same time each day. How is she supposed to get better?
 
told the nurse that Effexor is supposed to be given at the same time each day. How is she supposed to get better?
This must be so frustrating for you. I'm really sorry to hear it. If it helps to know - It's good to give Effexor XR at the same time each day, but as long as it gets onboard sometime today? It's going to be alright. Your daughter might start to have a headache from the dose being late, and the headache can be pretty painful. But it sounds like the nurses have requested the dose from the pharmacy. Ugh, it's just shitty all around.

FWIW, I'm with @Friday on the school. stuff...

What are your thoughts on her finishing 1st semester so that she can at least receive credit for those? After Thanksgiving, she only has a few weeks left. Her grades are B’s, C’s and one D. She might end up with a bad gpa after finals after missing a week. I don’t know how any of this works.
You might be able to get the info on this from the school's website, if you dig around into their grading policies and payment policies.

Something that might be an option - at my school, the student can decide all the way up until one week before finals if they'd like to withdraw from grading and instead receive a pass/fail, or a complete/incomplete. Those are two different things but essentially the same, in that it gives the student room to finish the coursework and receive the credits, without having the final grade factor into their GPA.

Another thing you want to look into is whether she can take a medical leave at this point in the quarter. This would mean that she'd not receive the credits, but also not be withdrawing from school; she'd simply be pushing 'pause' on school entirely. She'd also not damage any longer-term scholarships or loans.

The "worst" thing a student can do is simply drop out. I don't mean "worst" in any judgmental way - more that it's the route that always feels easiest (because navigating school bureaucracy is a pain in the ass) but is the biggest waste, since there's no option to re-enroll without re-applying, and any paperwork that's already in the system (financial aid applications, acceptance, scholarship, level placement, etc.) gets thrown out.

She's been assigned an advisor to manage her course planning, and the advisor will be able to talk her through the options. Unfortunately, the advisor probably isn't allowed to talk with you about those options, because of FERPA laws (if she's over 18). But, if her advisor hasn't been informed about your daughter being in a hospital because of an emergency (it doesn't need to be more specific than that), it'd be good to let the advisor. know, as that will give the advisor the power to inform all her current instructors, and will save a lot of stress further down the line.

COVID is still making school weird. In that regard - a medical leave, which yeah will lose her this semester's credits, but in the big picture, isn't going to have much impact on her actual education - isn't really a bad call. Holidays and grading are both major stressors. If you have good options for a PHP to IOP, and she can live at home, and really do the full program (usually 8-10 weeks), it'll stand the best chance of giving her a foundation that will withstand the pressures of college and later, the pressures of life.
 
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