Category: parenting

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.

Helping your troubled teen after they turn 18

Helping your troubled teen after they turn 18

Most young people aren’t ready for adulthood by 18 years of age, but your troubled teen is especially unprepared. By 18, their legal status instantly changes to “adult” and they are free to fail at life’s countless tests. Your hands are tied and you can’t keep your son or daughter safe from themselves any more.

Pace yourself for a marathon

Your job as parent is far from over.  Not surprisingly, parenting an 18+ year old will feel the same as when they were 17 years 11 months old.  They’ve been behind their peers for a long time–emotionally or socially or academically. You’ve done everything possible to get them ready for adulthood, but they simply aren’t!  For troubled teens, the teen years last into the mid-20’s or longer. And this is really scary; suicide rates across all age groups are highest for people aged 16-24.  It’s the period of greatest stress, whether the person is suicidal or not.

Many people with disorders aren’t able to take full responsibility for themselves until their early 30’s.

Over the past 16 years, I’ve asked this question of people with mental health disorders, their parents and siblings and children, and their friends:  “At what age did (you, your loved one) make the conscious choice to take responsibility for themselves: treatment, income or job, living on their own, choosing to associate with healthy people. I asked dozens and dozens of people. Their answer? Every single one told me they or their loved one didn’t turn things around until they were between the ages of 29 – 34.

True story: a co-worker once shared about his bipolar disorder and his years of substance abuse and hardships. I would never had guessed this grounded stable person had a troubled past. I asked when he turned his life around; it was 30. I asked what motivated him.  His answer? “I couldn’t avoid it anymore. I ran out of excuses. I hit rock bottom too many times.”

The questions to ponder are how much to sacrifice and how much to let go.  There needs to be a balance.

Parents have a tendency to rescue their adult son or daughter when a crisis befalls because  it’s so hard for the child to recover from set-backs.  But rescuing too much makes them more dependent on the parents (or adult siblings).  Pressuring a troubled teen to be an “adult” when they are not ready may lead to their dependence on others who might make their lives worse.  Or they’ll cope with drugs or alcohol, or risky choices, or give up.

I know of a couple in their 70’s who’d rescued their troubled 34-year-old daughter her entire life, and faced cutting her off because they couldn’t manage anymore.  They were heartbroken to let her go, painfully afraid she would become homeless or suicidal, and deeply regretful they unwittingly undermined her capacity for independence.  Don’t let this happen to you.

The first challenge is deciding where they’ll live.

As with any troubled teen, they must become independent eventually.  It may be a tough call for you:  bear the stress if they live with you? or worry when they leave your protection, possibly forever?  Ironically, your adult child must be better than ‘normal’ young people at managing life because they have so much more to worry about.  Besides the usual adult responsibilities, add self-monitoring for mental and emotional stability, taking meds or obtaining therapy, and disciplining themselves to stick with dozens of choices that support their well-being (diet, exercise, healthy friendships, education or work, financial stability…).

If your troubled teen of 18 must live at home full or part-time, change your rules and expectations. Rules can include a requirement for ongoing mental health care. Your troubled teen must transition to becoming your guest who stays at your invitation and a renter who contributes to the household and follows the landlord’s rules.  You’ll need discipline to step back and respect their privacy and (reasonable) choices and activities.  This may not be easy to achieve–you’ll make many compromises.

In the eyes of the law, you are not responsible for them anymore.

You really aren’t.  In fact, you have the right to banish your 18-year-old from your home and change the locks on the doors.  The parents who do this are usually in fear for their physical and emotional safety–not because they don’t care.  If this describes you, it’s understandable and forgivable if you feel forced into this step.  But know this, things change.  Your adult child will change; banishment is not forever.

There’s good news. Adults have more options for support.

Ironically, your troubled teen, by 18, will have more access to services than ever, and you’ll both get the support you’ve desperately needed.

  • In the U.S., people with mental health problems are protected from job/housing/educational discrimination by laws that protect the disabled.
  • insurers are required to provide mental health care on par with all other treatments and services.
  • Mental health advocacy groups support adults by offering support groups, referrals to safe housing or appropriate job opportunities, social connections with safe accepting peers, and legal and legislative advocacy.
  • Educational institutions have special departments solely for supporting students with disabilities, and that includes troubled young adults.

 

This is what your troubled teen needs to function after 18. This list is based on long-term monitoring of 1000’s of others with mental health challenges who did well in life:

  1. Constant support from family and friends
  2. A job or continuing education
  3. Ongoing mental health care
  4. A safe living situation

Adjust your expectations for how quickly they’ll progress.

Parents with ‘normal’ 18 year olds gradually revise their relationship with them, becoming a mentor and peer rather than a parent.  You can’t do that yet; your challenge is to flow between the role of parent, disciplinarian, social worker, and therapist until they are ready.

You can do this.  Stay patient.  Keep a bridge built.  They’ll eventually grow up.

–Margaret

 

Please rate this post and comment.  Your thoughts and experiences will help others who read this article.

Calming room ideas to prevent tantrums, for kids with autism or other disorders

Calming room ideas to prevent tantrums, for kids with autism or other disorders

calmroom1

This article was provided by Ryan Novas on behalf of National Autism Resources.

For those with an autistic child, it is a parent’s nightmare to face a tantrum with no way to calm them down.  That is why it is important to have a calming room or area set aside for your child that helps ease distress before a tantrum starts, or to send them to in order to ease the distress. Here are three versions of a calming room you can create to help when your child is about to have a tantrum.

The HUG room

calmroom6The hug room is popular for calming any child down, especially one on the spectrum. The hug room needs to have calming items that provide a sense of security and warmth, and a cocoon-like hug.  In this room, provide a weighted blanket or snug embracing vest (in case your child won’t lay down). Both of these are like bear hugs, which can be comforting and calming for children with autism.  Another great item to have in this space is a crash pad (used by many therapists and parents in combination with a weighted blanket), or a large or stuffed animal or pillow that the child can hold on to or hug.  You want to make sure the animal or pillow does not have parts that can be ripped off and chewed on or cause damage in another way.  You’ll also want all other items to be soft and safe to throw to protect the room or others in case your child does have a full-blown tantrum.

The SOOTHING SOUNDS & SCENTS room

calmroom4One thing that can work very well for some children, especially with tantrums brought on by overstimulation, is a room with soothing sensory experiences. In this room, block or mute outside sounds–TVs, stereos, and people walking or talking near the room so it’s as quiet as possible.  Once your child is in the soothing sounds room, you’ll need to have a place for them to relax or lay down.  You can use a bed, a crash mat, or something else they can fall asleep on or even just sit on with their eyes closed.  Silence or a soft gentle background ‘hum’  or soothing sound helps, such as  from meditation CDs, music or birds or flowing water.

calmroom3You can also try products like the Twilight Turtle which has soothing sounds and even includes a light show of constellations (also perfect for the 3rd room, below).  Noise blocking earmuffs and headphones make great additions for this room if your child needs to be removed from all noises.  These also provide a kind if ‘hug.’  You can combine them with a scent or scented toy or stuffed animals to calm your child.  Think about little pillows stuffed with lavender flowers, or an air freshener they like.

The VISUALLY CALMING room

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  • For a visually calming room, remove overly bright colors and small points like those from a static night-light that plugs into the wall.  Instead, find something like the Tranquil Turtle above or even liquid motion lamps or light projectors with calming colors and patterns. You can also try adding black out curtains on the windows to block bright sunlight–the point is to make light easy on their eyes. Darkness may help the lights do a better job.

calmroom2

The most important thing when creating a calming room is to make sure it meets the needs of your child. Include features that are most effective for him or her. Don’t forget to exclude or remove anything that is easily thrown or could hurt your child or others or cause damage to your house.

 

Addendum:  I’ve seen these other things used to calm people to prevent overstimulation or impatience.  The first two were in a psychiatric unit for calming recovering mental patients.

  1. A bubbling aquarium, or a virtual aquarium on a computer monitor
  2. An image of a fire or rippling surface of water, available as a CD or as special lighting
  3. A mobile or motion toy powered by a solar cell
  4. A clock with a pendulum

 

Have you discovered something that works for your child?  Please share.

How to help your child cope with anxiety

How to help your child cope with anxiety

anxiety2We all get anxious, but it becomes a “disorder” when it prevents a person from normal functioning. Anxiety and panic are very real, whether triggered by life in general or certain things such as phobias. Take it serious–it’s not something an extremely anxious child can “get over”.  Willpower alone does not work.

Anxiety disorders are also one of the most common psychiatric conditions in children and adolescents, but often go undetected and untreated. Early, effective treatment can reduce the negative impacts on academic and social functioning.

Excessive worry or anxiety about multiple issues, which lingers six months or more, can indicate an anxiety disorder. 

anxiety3Anxiety is often expressed in physical symptoms:

  • Anxious mood: excessive worry, anticipating the worst
  • Tension: startles or cries easily, restlessness, trembling
  • Phobias: fear of the dark, fear of strangers, fear of being alone, fear of animals, etc.
  • Insomnia: difficulty falling asleep or staying asleep, nightmares
  • Intellectual difficulties: poor concentration, memory impairment
  • Depression: decreased interest in activities, inability to feel happy
  • Somatic complaints (muscular): muscle aches or pains, teeth grinding
  • Somatic complaints (sensory): ringing in the ears, blurred vision
  • Cardiovascular symptoms: tachycardia, palpitations, chest pain, feeling faint
  • Respiratory symptoms: chest pressure, choking sensation, shortness of breath
  • Gastrointestinal symptoms: difficulty swallowing, nausea or vomiting, constipation, weight loss, abdominal fullness
  • Genitourinary symptoms: frequent or urgent urination, painful menstruation
  • Autonomic symptoms: dry mouth, flushing, pallor, sweating
  • Physical behavior: fidgeting, tremors, pacing
  • Other: risk of abusing alcohol in adolescence, cutting and other self-injury (not suicidal)

Cutting

Physical pain reduces psychological pain by shocking a person’s attention into the here-and-now.  Like a glass of water thrown into someone’s face when they are upset, the shock overrides inner turmoil, and releases adrenalin and endorphins.  It’s stimulating, even energizing.  According to statistics from research, cutting becomes addictive after about 14 episodes.

anxiety6True story: Laurel, age 14, cut herself regularly on her fingers, preferring to cut under her fingernails.  She hid the cuts and scabs with nail polish.  Her father eventually learned about this and asked her why: “I feel more calm because the sting feels good and distracts me.” A therapist recommended that Laurel draw “cuts” on herself with a red pen instead of a knife, and also wear a rubber band on her wrist or fingers and snap it when she wanted to feel a sting.

It is common for cutters to hide their scars or scabs under clothing if they think you will try to stop them, or they will cut in a place you won’t see unless they are unclothed.  They may also make an excuse about an injury if you do see visible cuts.  You can look for unexplained blood on clothing.  Don’t be afraid to ask if they are cutting; many young people have freely ‘confessed’ when asked.

Treatment for anxiety

anxiety5anxiety4A child or teen will often be diagnosed with more than one type of anxiety disorder, in addition to a psychiatric disorder–30% of all anxiety cases include a diagnosis of depression and attention-deficit/hyperactivity disorder.

Cognitive behavioral therapy (CBT), in combination with antidepressant medications “have consistently shown efficacy for anxiety disorders in children and adolescents.” Many anti-anxiety medications on the market are addictive, so a doctor or psychiatrist will be very cautious about prescribing them except on an as-needed basis. Treatment must also include parent involvement, especially if the parents are also anxious. In the case of cutting, allow your child to cause themselves pain that is harmless, for example:  hold tightly onto ice as long as they can, smell vinegar, taste hot pepper.  These may sound strange, but they are effective techniques used in Dialectical Behavior Therapy (DBT) to help an anxious person tolerate stress.  You find out more about CBT and DBT here:  Therapy types explained – DBT, CBT, CPS, and others

How you can help

  • Validate or affirm your child’s feelings. If he or she is worried, fearful, upset, or distraught, don’t insist they should not have their feelings, regardless of the reason. You can let your child know that feelings are normal and it’s OK to have a little fear at times.
  • Reduce their dependence on you. Help them learn to cope by offering less reassurance, which can undermine their commitment and skills for coping. Messages that “everything will turn out OK” teaches them that you will help them through all fears, but they need to learn that they can get through fear on their own.
  • Avoid helping too much. If you try to protect your child from all harm, it prevents them from becoming independent and keeps them socially immature; traits they need to learn in their teens. Learning and maturing require that kids handle challenges on their own by confronting small anxiety hurdles along the way.
  • Model how to cope*. A parent’s anxiety greatly aggravates their child’s anxiety.  If you are anxious, tell your child how you plan to cope with it. For example, “Sometimes I feel nervous when I have to climb a ladder, but I just need to take a deep breath, be careful, and do it. If I get too nervous, I can always climb back down, and try it again later.”

* Charles H. Elliott, Ph.D. “Anxiety: Three Messages to Avoid Giving Kids”

anxiety1Escape plans

If your child is in a situation where they are experiencing severe distress, always have an escape plan or an “out” so your child can leave the situation as quickly as possible. Prepare yourself ahead of time so you won’t feel inconvenienced when it happens, and accept this as part of their treatment needs.

  • This reduces anticipatory anxiety when they are exposed to stress, and teaches them how they can manage themselves on their own. This is also a teachable moment when you reinforce self-calming skills.
  • This builds trust in you and a willingness to listen to your guidance. (When I did this consistently, my child grew more comfortable in similar stressful situations.)

Don’t forget to take care of YOU and your foundation

Keep your energy in balance so you can maintain your family's foundation. Too much spent on your child affects everything else your family needs to survive.

 

 

 

If you’ve found ways to reduce your child’s anxiety, share them in the Comments section for others to consider.

–Margaret

Guns and Mental Illness: the Debate from a Parent’s Perspective

Guns and Mental Illness: the Debate from a Parent’s Perspective

Shortly after the tragic massacre of children in Connecticut, I wrote the following Letter to the Editor to the Oregonian, Portland’s main newspaper:

normal-murderer“Tragic shootings always raise the question, “Why?”, and the response often jumps to guns. Yet guns are tangential to the problem. Those of us with a mentally ill person in our families can answer “why.” We’ve witnessed the behaviors leading to a mental health crisis. There are always signs, but many don’t interpret or take them seriously until it’s too late.

“If you have a loved one at risk of harming themselves or others, but aren’t sure if it’s serious or real, trust your gut. Look for behavior changes that are abrupt or steadily worsen over time. Listen for statements that seem out of character Pay attention to significant overreactions to events or ideas. Never be afraid to ask directly, “Are you OK?” Don’t hesitate to seek help from mental health advocacy or support groups. Whatever the cause, mental illness is treatable; there is hope, and people who can help.”

gun in knotsA couple of weeks later, a reporter from the Oregonian contacted me to help with a story on mental illness in children.  She said she wanted this important longstanding issue brought back into the national discussion.

Perhaps we have finally reached a turning point?

 

gun deaths per 100,000

Sandra Spencer, Executive Director for the National Federation of Families for Children’s Mental Health, met at the White House with Vice President Biden’s task force on gun control to ensure that the issue goes beyond just gun control.  The following is an excerpt:

“We must deal with the real issue that children do have mental health challenges and parents don’t have support or access to services without fear of losing their children to public scrutiny, bullying, discrimination and even institutionalization. …These children, youth, and families need to know where to go, which treatment is best, and how to access community support.

“The isolation parents feel because of their children’s behavior, due to mental illness, keeps them from reaching out or even knowing who to trust for help.  There should be national outrage at the number of young people who die each year by suicide and drug abuse, or the number of children with a mental health diagnosis that go untreated, and the lengths parents go to just trying to keep their children safe and out of trouble.  This has to change in our nation before we can adequately address the need for an improved children’s mental health care system”

brain-green backgroundThe issue of gun control is important to work through, but not at the expense of mental health and the millions who continue to struggle—the families and their loved ones.  Not again.

 

Your comments are strongly encouraged.  What do other parents think?

–Margaret

Is my teen ‘normal’ crazy or seriously troubled?

Is my teen ‘normal’ crazy or seriously troubled?

photo8A high percentage of teenagers go through a rebellious or crazy phase that is normal for their age and brain development.  The difference between normal teen crazy and truly troubled behavior is when the teenager falls behind his or her peers in multiple key areas.  At a bare minimum, a normal teen should be able to do the following:

  • Attend school and do most school work if they want to;
  • Have and keep a friend or friends their own age who also attend school;
  • Have a maturity level roughly the same as his or her peers;
  • Exercise self-control when he or she wants to;
  • Have basic survival instincts and avoid doing serious harm to themselves, others, or property.

photo5It is normal for teens to be inconsistent, irrational, insensitive to others, self-centered, and childish.  Screaming or swearing is normal–regard this the same as a toddler temper tantrum.  It is a phase that crazy teens grow out of unless something else is holding them back.

This is your challenge:  even teens with mental disorders have challenging  teenage behaviors like those listed above.  How do you tell which is which so you can get help?  Look for pervasive patterns of social and behavioral problems that stand out against their peers, are persistent, and occur most settings.  The patterns repeat and you fear they will become increasingly worse.  It is clear the troubled teen cannot control themselves if they wanted to.

photo2

Some signs of abnormal unsafe* behavior

*Unsafe” means:  there’s a danger of harm to themselves or others, property loss or damage, running away, seeking experiences with significant risk (or easily lured into them), abusing substances, and physical or emotional abuse of others.

  • If a troubled teenager does something unsafe to themselves or others, it is not an experiment, but is impulsive, intentional, and planned.
  • They have a history of intentional unsafe activities.
  • They have or seek the means to do unsafe activities.
  • They talk about or threaten unsafe behavior.
  • There are others who believe there is something abnormal or unsafe about your child.  (e.g., your child’s friend comes forward, their teacher calls, other parents keep their children from your child, or someone checks to see if you’re aware of the nature of his or her behaviors).


photo7How psychologists measure the severity of a child’s behavior 

“Normal” is defined with textual descriptions of behaviors, and these are placed on a spectrum from normal to abnormal (“severe emotional disturbance”).  Below are a few examples of a range of behaviors in different settings.  These descriptions are generalizations and should not be used to predict your child’s treatment needs, but they do offer insight into severity and the need for mental health treatment.

School behaviors

Not serious – This child has occasional problems with a teacher or classmate that are eventually worked out, and usually don’t happen again.

Mildly serious – This child often disobeys school rules but doesn’t harm anyone or property.  Compared to their classmates, they are troublesome or concerning, but not unusually badly behaved.  They are intelligent, but don’t work hard enough to have better grades.

Serious – This child disobeys rules repeatedly, or skips school, or is known to disobey rules outside of school.  They stand out in the crowd as having chronic behavior problems compared to other students and their grades are always poor.

Very serious – This child cannot be in school or they are dangerous in school.  They cannot follow rules or function, even in a special classroom, or they may threaten or hurt others or damage property.  It is feared they will have a difficult future, perhaps ending up in jail or having lifetime problems.

photo6Home behaviors

Not serious – This child is well-behaved most of the time but has occasional problems, which are usually worked out.

Mildly serious – This child has to be watched and reminded often, and needs pushing to follow rules or do chores or homework.  They don’t seem to learn their lessons and are endlessly frustrating.  They can be defiant or manipulative, but their actions aren’t serious enough to merit a strong response.

Serious – This child does not want to follow rules, even reasonable rules.  They take no responsibility for their behavior, which can damage to the home or property, or cause harm to themselves or others.  They bring everyone down.

Very serious – The stress caused by this child means the family cannot manage normally at home even if they work together.  Running away, damaging property, threats of suicide or violence to others, and other behaviors require daily sacrifices from all.  Police are commonly called.

photo9Relationship behaviors

Not serious – The child has and keeps friends their own age, and has healthy friendships with people of different ages, such as with a grandparent or younger neighbor.

Mildly serious – This immature child will argue, tease, bully or harass others, and most schoolmates avoid them. They are quick to have temper tantrums and childish responses to stress that make them “high maintenance.”

Serious – The child has no friends their age, or risky friends, and is manipulative or threatening. They can have violent tendencies, poor judgment, and take dangerous risks with themselves and others.  They don’t care about others’ feelings., and take anger out on others.

Very serious – The child’s behavior is so aggressive verbally or physically that they are almost always overwhelming to be around.  The behaviors are repeated and deliberate, and can lead to verbal or physical violence against others or themselves.

photo1If your child’s behavior falls along the spectrum encompassing Serious to Very Serious behavior, get good mental health treatment for them now and spare them a difficult future.

Pay attention to your gut feelings.

If you’ve been searching for answers and selected this article to read, your suspicions are probably true.  Most parents have good intuition about their child.  If you’re looking for ways to “fix” or change your child… all I can say is that this approach will probably not work.  You may need to work on yourself; you may need to change how you relate to your child or picture your situation.  Regardless, seek help.

photo4Early treatment, while your troubled teenager is young, can prevent a lifetime of problems.  Find a professional who will take time to get to know your child and you and the situation, and who will listen to what you have to say–a teacher, doctor, therapist, or psychiatrist.

–Margaret

Your comments are welcome.

 

–Margaret

“You’re under arrest!”: Crime and Troubled Teens

“You’re under arrest!”: Crime and Troubled Teens

You’ve tried everything. Now you watch helplessly as your troubled teenager starts down a path leading to jail, and you wait for that call from the police. There’s been a crime. It finally happened like you thought it would.  But this bad news can be good news. This may be the point when things start to turn around.

“Experts estimate that from 40 percent to 70 percent of youth in the juvenile justice system suffer from some form of mental health disorder or an illness – anything from ADHD to full-blown psychosis. About 15 percent to 25 percent have mental illnesses “severe enough to significantly impair their ability to function.”” (see “Mentally ill minors put in juvenile hall” at end of this post)

Juvenile crime is considered as serious as adult crime, and juvenile “detention” is just like jail for adults. Yet there is one critical distinction between teenage and adult justice: teens are given a second chance for a clean record and an education.  If your jurisdiction is enlightened, they will get treatment for mental illness or addictions. An adult criminal record is forever a barrier and an embarrassment. It comes up when a former convict applies for a job, a loan, a college degree, military service, a rental, or even a volunteer opportunity.

The juvenile justice system is only partially punitive because society recognizes that the teenage brain is the problem that causes much crime, whether or not they have a mental disorder or addiction.  Enlightened juvenile court judges want their rulings to be “rehabilitative” or “restorative” justice. Enlightened agency directors understand the need for additional support services for learning disabilities, addiction, mental illness, and vocational training.

In the system, teen criminals (“adjudicated youth”) are required to participate in consequences and treatment; it’s a “carrot and stick” approach.

  • The carrot:  The teens attend school and receive training for vocations such as car repair or catering.  They participate in positive character-building activities such as training dogs for adoption, building and maintaining hiking trails, or constructing homes for Habitat for Humanity.
  • The stick: Teens have a complete lack of freedom, whether in detention or out on probation, intensive monitoring (including random urinalysis), immediate consequences for behavior violations, and physical labor to pay back victims (community work programs).

When a police officer calls to say your son or daughter has been arrested, use this as an opportunity to help your kid. It’s a perfect teachable moment. Not only do you have their attention, you can hand the problem over to the Law to enforce their behavior and treat their disorders or addictions. Your son or daughter cannot refuse—when held or convicted on criminal charges, your child has no rights to anything except humane treatment and an appearance before a judge. You are off the hook. You can step back and relax… and be the Good Guy for once.

How to work with the juvenile justice system:

  • Be an active partner with the court. Cooperate fully with the judge, court counselor or therapist, and any attorney, case worker, or probation officer involved.
  • Show up for everything:  visitation, family therapy, court hearings, and parenting classes even if you don’t think you need them.
  • Stand shoulder-to-shoulder with staff.  If your teen has a probation officer, do what they tell you, even if it means tattling on your kid.
  • Be cooperative with staff, and they will work harder for you and your son or daughter. Support the programs required for your teen, and support your teen when they struggle. Your involvement will someday impress on your child that you’re on their side and care.
  • Change your ways.  If you’ve been too harsh with your teen in the past, go easy on them now and let him or her see your good side. If you’ve been too easy on them or too protective, demonstrate backbone. Show you know what’s best for them and that you will remain in charge once they are released.
  • Stick with your child.  If your teenager becomes a Frequent Flyer in the system, it doesn’t mean they are lost.  Remember, they have that uncontrollable teenaged brain and need more time and lessons for it to reach maturity.

Once they come home on probation you need to set strict limits on their activities, and work with the probation officer or social worker to enforce them. These are harsh at first, but should be negotiated later when behavior improves, with consultation with the juvenile justice staff.

Remove risks:

  • Don’t allow them to stay out late ever. Set an early curfew, and report them to their probation officer if they are late.  When they get angry about this, explain that you are bound by the law and that they should discuss their concerns with the officer.
  • Not negotiable: ban drugs and alcohol, especially marijuana. (“Marijuana is uniquely dangerous for troubled teens”.)  Hide prescription drugs and alcohol if you use them. You have the right to search their room and belongings.  If pertinent, hide weapons, matches, or other means of harm to themselves or others.
  • Stop or limit contact with risky friends. This may mean monitoring visits, monitoring cell phone use and internet access, or blocking access entirely if used for crime.
  • Limit access to money to prevent drug/alcohol purchases or escape plans. Get receipts if necessary.
  • Reduce free time. Busy them with as many activities as you can–a job is the ideal.
  • Build your own network of other concerned parents to track your kid… in other words, to spy on them.  Besides other parents, I even contacted businesses where my teen was known to hang out, such as a mall and cafe.  See  “Gang up on your kids: Parent networks for tracking at-risk children.”

Three Goals:
     1)   stay at home
     2)  stay in school
3)  stay out of trouble

Three House Rules:
     1)  continue mental health treatment
     2)  no violence when upset
     3)  clean body, clean clothes

Build their esteem as you would for any troubled child. Guide them to their strengths. Give your teenager something to do that they good at, and allow them ample opportunity to shine. More at  The good things about bad kids.

Extreme measures. I know of three cases where parents took drastic steps to help their son or daughter stay out of trouble, and these worked!

True story – a single father was worried about his son’s gang involvement, especially since the son was still on probation for a crime, and additional charges would draw lengthy prison time. Dad sold the family home and bought another one in a neighborhood ‘run’ by an opposing gang. The son was terrified to leave the house except for his new school, a long way from his gang brothers. This son graduated high school and left the area for college… alive, uninjured, and with a clean record.

True story – After a couple of years trying to keep their daughter out of trouble, parents started looking for work in a smaller town.  They wanted to find a safer place with fewer risks and more eyes. After she completed her mandated one year probation, the family moved.  She was upset to leave her friends, but they were the problem friends. Her crime sprees ended.

True story – a single mother was on the edge of sanity and financial ruin trying to manage the world her son created.  While visiting a juvenile justice counselor with her son, the counselor made an off-hand comment about handing him over to foster care so that she could get her job back and sleep at night.  With a heavy heart, she went forward and obtained a “voluntary placement” for him (temporary state custody), and he went to a foster home.  After two years, he was ready to come home and she was ready and empowered to support him.

A note of caution:  You may have seen ads for outdoor programs or “boot camps” for at-risk teens. Some of these programs are extremely inappropriate for troubled youth, even traumatizing. Or some may not allow teens with a criminal history. Get advice about therapeutic programs for your at-risk teenager from a counselor or social worker, not just from the program itself.  Your teen’s providers often know which ones are appropriate.

The people in the Juvenile Justice System

In my personal experience, 99% of employees in juvenile justice are there because they care about teens, they like teens and “get it” about them, and they believe in the power of what they do. My co-workers have many success stories among their cases. Some former delinquents come back to work for the juvenile justice system and use their hard-won experience to help the next generation.  Ironically, it’s the one job where a criminal record helps!

If you are concerned about what your child will experience in the juvenile justice system, just call and ask.  You may be surprised.

Challenges, risks, and potentially serious problems

  • A troubled young person in detention or incarceration is exposed to others with criminal behavior. They may bully or be bullied or both.  They may meet fellow inmates to sell drugs to when they get out, or learn who can supply them with drugs. Depression is common, and presents as anger or self-destructive behavior, such as getting in trouble on purpose.
  • Not all juvenile departments provide mental health treatment, or treatment is inadequate.  And sadly, there are still places where staff and citizens don’t believe in the mental health “excuse” for bad behavior.  You may need to be an assertive advocate for treatment.  Work with your child’s public defender, who is provided by the court, and give them evidence of mental health problems in  medical records.  Your child will need to sign a waiver for the attorney to have the records.
  • Some states have Mandatory Minimums–pray it’s not yours. Certain crimes lead to long prison sentences regardless of the circumstances of the crime or the mental illness of your child. My state of Oregon will incarcerate anyone over age 15 for seven years if they commit one of these crimes. This made sense to the voters who put it into law, but the reality is a worst-case scenario for how NOT to rehabilitate youth.  No one I’ve ever met in our state, from judges to prosecuting attorneys to sheriffs to probation officers, thinks it’s a good idea–the outcomes have been horrible for reasons too lengthy to go into here.
  • Each county and state has a different culture and attitude towards juvenile delinquents. Some are exceptionally harsh, or they neglect the kids’ legitimate needs; some are reluctant to treat kids like individuals with different needs and strengths; some get that right balance of punishment and rehabilitation. It depends on the judges, the county, and the state. Each is different.

Is your child at risk from criminal involvement or charged in a crime?  Please comment so other parents who read it can learn from your experience.  Thank you.

How am I doing?  Please rate this article above, thank you.

–Margaret


Mentally ill minors put in juvenile hall (excerpt)
Daily Bulletin, Mediha Fejzagic DiMartino, June 12, 2010

“Juvenile halls have become catch-all basins for severely mentally ill youth.  Designed as secure holding facilities for minors who are going through the court system, juvenile detention centers now double as a default placement option for youth diagnosed with schizophrenia, bipolar disorder or major depression.   “There is no place for them in [our system],” said a county juvenile court judge in California.  “We can’t just arrest our way out of the problem. Juvenile hall is not a place to house mentally ill.”

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.
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