Category: mental illness

How to work with police once you’ve called 911.

How to work with police once you’ve called 911.

 

Q: Should I call 911?  I’ve been told I should call the police or mental health hotline when there’s a crisis, but how do I know when it’s a real crisis?


A:  If your child is doing something dangerous to him or herself, or others (including a pet), or property, and if you can’t manage it or stop it, call.  “Dangerous” means threatening, harmful, or abusive.  Emergency 911 dispatchers, police, and mental health crisis workers all encourage anyone to call, anytime.  You will not bother them.  I once visited a 911 facility and got a chance to ask to speak with the staff and this was their message.  They described the many ways they can respond when a child or teen “blows out,” runs, or becomes suicidal.

 


Once you call the police:

Advice from the Federation of Families for Children’s Mental Health (www.ffcmh.org).

  

1.   Remain as calm as you possibly can.

 

2.   Provide only facts as quickly and clearly as possible.

EXAMPLE:  I am calling from [address].  My 13-year-old son is threatening to cut his sister.  He has [diagnosis] and may be off his medication and under the influence of alcohol.  There are 4 of us in the house: my mother, my son and daughter, and myself.

 

3.   Identify weapons in the vicinity or in your child’s possession and alert the dispatcher

 

4.   Be specific about what type of police assistance you are asking for.

EXAMPLE:  We want to protect ourselves and get my son to the emergency room for a psychiatric evaluation, but cannot do that by ourselves.  Please send help.

 

5.   Answer any questions the dispatcher asks.  Do not take offense when you are asked to repeat information.  This is done to double-check details and better assist you.

 

6.   Offer information to the dispatcher about how an officer can help your child calm down.

 

7.   Tell the dispatcher any addition information you can about what might cause you child’s behavior to become more dangerous—suggest actions the officer should avoid.

EXAMPLE:  Please don’t tell him to stand still.  He cannot hold his body still until he calms.  If you can get him to walk with you, he can listen and respond better.  He is terrified of being handcuffed.  Please tell him what he needs to do to avoid being handcuffed.

 

REMEMBER:  Your primary role in this situation is to be a good communicator.  Your ability to remain calm and provide factual details is critical the outcome of this situation.” 

– – – – – – –

 

What is your local police force like?  Call the non-emergency line and check, ask questions about how police typically respond to situations where a child or teenager is diagnosed with a mental disorder and out of control.

 

In many parents’ experiences, including mine, the police were very helpful.  Others have had poor experiences.  Some said their child calmed down and appeared normal once the police arrived, and they felt the police assumed they were exaggerating.  Some said the police only aggravated the crisis, and in a very few cases, the encounter lead to tragedy.

In 2007, I attended the national conference of the Federation of Families in Washington DC, and learned from the President of the National Association of Chiefs of Police, Ronald C. Ruecker, that the NACP has made a commitment to promote police training in crisis response to children with mental disorders, including information about the disorders and their manifestations.

What to do when you’re blamed for your child’s behavior

What to do when you’re blamed for your child’s behavior

  

Our sick kids deserve compassion too
Our sick kids deserve compassion too

I have yet to meet one family with a troubled child that has not felt blamed or judged by close people in their lives:  best friends, family members, a religious community, co-workers, even medical and mental health providers.  Nothing could be more wrong or more hurtful to the family’s well being.  Blame adds emotional burdens on top of what they already face, and can undermine an already shaky hope and faith. 

 

Parents like us are aware that many people are not comfortable around a child with bizarre or extreme behaviors, like our child.  We understand this.  After all, who else knows more about the stress they create?  But it is unacceptable to be blamed or judged by others on our parenting, our character, our child, and/or presumed to be abusing our child.  This is simply not true for the overwhelming majority of families with troubled children.

 

These are some things that have helped caregivers cope with, and overcome, the debilitating effect of judgment and blame.

 

First, resist defending yourself; it will only attract more unwanted attention and disagreement.  You don’t have the time or emotional energy to teach someone who resists and challenges everything you say with countless questions and misinformation.  Avoid people like this (even friends and family!).

 

Second, actively seek out supportive people who take the time to listen, just listen.  You need as large as possible a network of compassionate people around you.  Stop and think about this, you have many around you already.  They may be waiting in the wings, at a polite distance so as not to interfere or add to your stress.  If you think you can trust someone, ask them to be your friend.  You will be surprised at how many people are out there who have a loved one with a mental or emotional disorder, and how many are willing to help because they completely understand what you’re going through.

 

Third, politely and assertively say thanks but no thanks.  If judgmental people ask why you haven’t contacted them or returned calls, tell the truth, also without blame or judgment.  “Our situation is not good, but we are getting the best professional help, and we have been pulling back to take care of ourselves.  Thanks for showing interest, and thanks for your understanding and for giving us space.”  No apologies.

 

There is a curious phenomenon where craziness seems to attract “crazy” people.  You must block them from your life.  They might be obsessed with a religious, medical, or philosophical belief and want to make your child’s life their cause.  If this happens to you, don’t hesitate to end contact with anyone that wants to entangle themselves in your lives without your permission.  You are never responsible for meeting another’s needs or fitting their beliefs!

 

I once had a co-worker who had strong feelings about “natural” health care, who offered a steady stream of articles and comments about what could help my child.  I had to firmly insist that if she could find one piece of research proving that her preferred treatments helped even one person with schizophrenia, then I would listen.  This ended the unsolicited advice. 

 

Fourth, be prepared to grieve lost connections.

 

A single mother with a 16-year-old daughter sought help in a support group:  “Can someone help me?  I need someone to call my sister or mother and tell them that I and [my daughter] are not criminals or sickos.  They’ve stopped calling, they refuse to have us over or visit for Thanksgiving and Christmas, and I just want someone else to tell them that she’s fine now because she’s taking meds, and that her behavior is not her fault or my fault.”

 

Let go of those who blame, and move forward with your priorities.  Very often, they eventually turn around and make an effort to understand.  Many really do change and apologize for their insensitivity. I’ve experienced this and observed this, but it is not your job to make this happen.

 

Your criteria for friendship will change.  You will find out who your real friends are, and they may not be family members or current friends.  Real friends let you talk about feelings without judgment or advice, they are always around to listen, they help out with little things:  go out for coffee; call to check in on you; or watch your other kids in a crisis.  They may be people you never felt close to before but who have reached out to you with compassion.  Accept their help.  Don’t be too private or too proud to accept the offer of support.  Someday, after you have turned your family’s life around, find another family who needs your support.  Make a promise to help others in need, and to give back to the universe.

Get your power back and reduce your child’s tantrums

Get your power back and reduce your child’s tantrums

If you have lost control of your troubled child and your household (most of us have), you know how hard it is to get things back on track–especially for following house rules. Each time you try to enforce a rule, it’s ignored, or your child throws a huge tantrum that you give in rather than spend more precious energy.  Who wants to invite another backlash?  Who wouldn’t give up and just try to get by and muddle through?

A powerful tantrum is a good thing; it’s evidence that you are regaining authority.

This seems counterintuitive, but the more your child fights back, and the more power they lose and the more you recover your authority. Fighting back harder and harder against rules and boundaries, then having an over-the-top tantrum, is a normal psychological response that psychologists call an “extinction burst.”  It means the original behavior goes extinct so to speak..  We all do this to some degree. It has been measured through behavioral observations of people of all ages and has nothing to do with troubled behavior.  The term “extinction burst” is even used by dog and horse trainers to describe a behavioral change in training. 

It goes like this: parents set a rule and start firmly enforcing it, and one of two things happen: 1) a huge tantrum, or 2) things are OK for a little while, and then tantrums start up again.  If you can hold the line, psychological studies show that when massive tantrums fade, the extinction burst peaks.  They give up their own power and change their behavior.  Look at this diagram:  The vertical scale indicates level of bad behavior.  When a rule is firmly enforced (intervention), the tantrum peaks then it falls off quickly.

If you can stick it out through that huge tantrum, you will see fewer tantrums over time.  It works, but one must be like a rock and have support when The Big One happens. But be prepared, you might need to face several extinction bursts.  Little by little, simple rules will be followed, or they’ll be followed most of the time (you will always be tested).  But by this point, enforcement becomes easier.

Plan for major tantrums ahead of time and recruit help for holding a firm protective wall.

For explosive and aggressive children, it can be scary or dangerous to be on the receiving end because you know about the potential for violence and harm.  Prepare family members and others, and explain how the tantrum will be handled and how everyone will be kept safe.

Rules for house rules:

  1. Few
  2. Fair
  3. Strictly Enforced

Run a tight ship at home, but only have a few hard-and-fast rules, maybe 2 or 3, to save your energy.  Holding fast on enforcement is draining.  Pick the rules carefully because they need to make sense and feel fair to everyone, and they need to be about safety and family wellbeing, examples: we will eat every dinner together as a family; curfew is 8 pm; if there is any outburst, the person must stay in their room for 15 minutes…

You may be surprised how relieved everyone will be after living through chaos for so long!  They will be thankful someone is finally in charge instead of the troubled child.  When I put on my armor and set about getting my power back, it was exhausting and very stressful, but consistent order brought a sense of security and safety. Use common sense and be flexible, set aside some rules temporarily if your child is in crisis or the family is too stressed at the moment.  Be very strict on only a few critical things, for example:  have zero tolerance for violence against others and alcohol and drug use.

You earn more respect when you are in control and better protect everyone’s peace of mind. 

You are the king or queen of your home, it is not a democracy.  Make reasonable and fair rules, enforce the rules with an iron hand at first, and then relax bit by bit, and live in a peaceable kingdom (with problems you can handle).

 –Margaret
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Your troubled child’s recovery and how you help them achieve it

Your troubled child’s recovery and how you help them achieve it

What recovery looks like – A person with a mental or emotional disorder who is in “recovery” can look and act like anyone else.  They have:

  • stable relationships
  • a steady job or in school
  • a place to live
  • a proper diet
  • cleanliness
  • regular mental health check-ins.
Their mind is unstable. It’s like they stand on a beach ball that can topple them at any moment.

Recovery is maintained when your child can pay attention to themselves and notice if their symptoms are starting up, and then take action to stop the symptoms.  You teach them what to look for, and how to do a personal check-in.  It’s just as if they are monitoring any other problem in order to stay healthy such as: blood sugar, body temperature weight gain or loss, digestive system function (gut microbes).  In mental disorders, their signs and symptoms are not steady.  Anything can lead them from “OK” to “out of control” in an instant, and problems can last minutes to weeks to months.

What your child will need to sustain recovery as an adult:

INSIGHT  +  STABILITY  +  RESILIENCE

INSIGHT– self awareness

Insight allows a child to recognize they have a problem, and choose to act to avoid the problem.  If insight is not possible, they need a toolbox of options that help them to respond appropriately, instead of reacting to chaotic messages in their brain. Knowing and admitting they have a problem, or knowing techniques for avoiding problems, are very powerful skills they need as adults.

STABILITY – fewer falls or softer falls

Your child is like a boat that’s easier to tip over than most other boats; any little wave will capsize them, and everyday life is full of waves, big and small.  Your job is to notice when the troubled child is starting to capsize and show them how to right the boat, or if that doesn’t work, how to use the lifesaver.  Eventually, your child will learn how to sense when trouble is coming on, avoid the thing that causes problems, and ask others for help.

  • Sense it.
  • Avoid it.
  • Ask for Help.
Life throws punches. Vulnerable brains need to be more wary and resilient than the average person.

RESILIENCE – bounce back when they fall

Troubled children have a much harder time bouncing back from problems.  They have extreme responses to simple disappointments like breaking a toy, or poor grades, or something as serious as the parents’ divorce.  Some even fall apart in joyous times because the emotional energy is too much!  You must be acutely aware of this–they will not get back on track by themselves.  Don’t worry that helping them will spoil them or “enable” them.  Eventually they will learn from you how you do it.

“…We are all born with an innate capacity for resilience, by which we are able to develop social competence, problem-solving skills, a critical consciousness, autonomy, and a sense of purpose.”

     “Several research studies followed individuals over the course of a lifespan and consistently documented that between half and two-thirds of children growing up in families with mentally ill, alcoholic, abusive, or criminally involved parents, or in poverty-stricken or war-torn communities, do overcome the odds and turn a life trajectory of risk into one that manifests “resilience,” the term used to describe a set of qualities that foster a process of successful adaptation and transformation despite risk and adversity…”   http://www.athealth.com

–Margaret

 

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Mental illness is more deadly than cancer for teens, young adults

Mental illness is more deadly than cancer for teens, young adults

Why isn’t everyone more upset?

A disease is killing our children and it’s more deadly than cancer and leukemia!  Did you know it was mental illness?

Out of curiosity, I did some research on child mortality rates from various causes because I wanted to know how death from mental illnesses compared with other fatal illnesses of childhood and adolescence. The results were astonishing, unexpected, and disturbing.

Look at the highest bars in this graph. They are 3-4 times the height of average cancer and diabetes rates in children. There are gaps in the available data, but this simple comparison is disturbing.

* The starting point for the mortality rates of medical illnesses was the website for the Center for Disease Control and Prevention www.cdcp.gov  in Atlanta; the starting point for the mental illnesses was the website for the National Institute for Mental Health, www.nimh.gov.

** The suicide data was from those with depression, bipolar disorder, schizophrenia, and psychotic disorders-unspecified.  (Suicide from other mental health causes, such as borderline personality disorder and co-morbid substance abuse is also prevalent, but I could not find data for children to young adult age ranges.)

On suicide:

  • It’s often normal for children and young people to think about suicide, but just in their imagination. They might consider it during some painful time in their lives, but there are no plans made or steps taken.  When the difficult times are over, they don’t think about it any more.
  • Young people with early onset mental illness can’t endure much stress; thoughts of suicide recur over time, starting as early as age 6 or 7.  These children are vulnerable to repeated intrusive suicidal thoughts because they live with a combination biological, psychological, and social/relationship causes (called “biopsychosocial”).  More about this is explained here: “Use the “S” Word: Talk with your Child about Suicide.”
  • There are ‘fast’ and ‘slow’ suicides in young people.
    • The ‘fast’ ones are 1) direct self-harm that has been planned, or 2) spur-of-the-moment suicide due to an extreme emotional reaction to a single intolerable event (examples: a boyfriend/girlfriend or best friend dies; a teen has a serious fight with a parent and (without planning) wants to ‘get back’).
    • The ‘slow’ suicides result from a persistent pattern of harmful behaviors that eventually lead to death.  Young people struggling with anorexia can die by heart failure or other causes due to their weakened body.  Others abuse substances and/or participate in extremely risky activities that expose them to multiple lethal situations:  overdose, criminal environments, disease.

This graph screams out for a changes in attitude, policy, and investment in children’s mental health treatment and suicide prevention.  I had no idea that death rates from mental illness could be 3 to 4 times higher than most cancers and leukemia.  It is imperative that young people with mental health issues receive as aggressive and sensitive treatment as is expected and demanded of medical systems that treat cancer in children.

 

Parents: talk about this. Talk to your child; share it on social media; and talk to mental health organizations about what you can do.

The data on mortality rates for mental illnesses was difficult to find, and it required searches in many different medical journals and websites.  I chose to use the data on cancer, leukemia, and diabetes because the mortality rates from these are high and because deaths from all other causes were insignificant by comparison (motor vehicle accidents are the one exception).  In this graph, the death rates for cancer and leukemia are averages for the different forms of each, and in the medical journals they were presented together.

I welcome additions or corrections of this data from any other sources, and encourage readers to investigate this for themselves.

–Margaret

 

Parent to Parent Guidance

Parent to Parent Guidance

Margaret Puckette is a Certified Parent Support Provider, and partners with parents for successfully raising their troubled child, teen, or young adult. She believes parents and families need realistic practical guidance for home and school life, not just information about disorders. Margaret has mentored families for over 20 years. She is an author & speaker, and believes mentally healthy families raise mentally healthy children.

You Can Handle This.

You Can Handle This.

You are not alone. It's no one's fault. Behavior disorders are disabilities! Troubled children need a very different parenting approach than 'normal' kids.

Care for yourself first, then set new goals:
1. Physical and emotional safety for all
2. Acceptance of the way things are
3. Family balance, meet the needs of all
4. One step at a time, one day at a time

Practical Guide for Parents

Practical Guide for Parents

A guide with practical steps for reducing stress at home and successfully raising a troubled child. You use the same proven techniques as mental health and other professionals. It starts by taking care of your wellbeing first, then taking an entirely different approach to parenting.
Amazon $14.99, Kindle $5.99