View Full Version : 14 year old in psychotic episode what to do...
raisingthree
05-05-2009, 19:59
My friends son is 14 and has had behavourial issues his whole life ADHD/ODD which he has been medicated for.
He went to live with his father about 9 weeks ago and his father has now decided that he cant care for him, due to the fact he is only there one week per month due to work committments and the stepmother can't handle his behaviour.
He has threatened to harm others and himself.
Tonight he has phoned his mother and absolutely abused her, calling her discusting names I cannot repeat because he does not want to live with her and has now been told to leave his father's residence.
He is threatening now to run away, to self harm, to harm his mother and family and has absolutely gone into an episode.
What to do??? - being 14 he is no longer able to be under a peadatrician's care for mental health. This advice was given by a peadatrician.
Does anyone know if he can be scheduled or what to do in this situation.
JabberJaw
05-05-2009, 20:02
Ring mental health in the area the child is in for assesment, they can put him in under the mental health act.
I'm not sure how it works in your state but in Vic we have Crisis Assessment Teams which you can call and they come out to households & assess people. They can then either recommend help or take people in to a psych ward if they feel it is needed. I'm sure there would be something similar available in your state. I had to use this service for my ex husband and I found them to be very helpful.
mumof2brats
05-05-2009, 20:30
he must really be confused right about now ,knowing that know one wants him due to his behavior.
i really hope he gets help,for his own safety and other around him.
Why doesn't he want to live with his mother?
Has he had any other episodes before?
Is he seeing a counsellor/psychiatrist?
What is his relationship with his mother and father?
Has he ever lived through abuse?
raisingthree
05-05-2009, 21:24
Why doesn't he want to live with his mother?
He says he hates it with her because she won't let him have any freedom - as far as she has told me (and I've known her quite a while) its just normal rules for a 14 year old boy.
Has he had any other episodes before?
Once or twice - usually at school when he goes but this one is worse because he is threatening others.
Is he seeing a counsellor/psychiatrist?
A counsellor has seen him in the past but hasn't helped much. He has a gift of telling them what they want to hear.
What is his relationship with his mother and father?
Mother and father separated when very young, both have new partners and other children.
Has he ever lived through abuse?
No - as far as I am aware. The other children of the relationship are absolutely fine also. The pead he has been seeing for the last few years had him on medication and when my friend rang him he said to take him to the hospital for a mental health assessment. You can imagine as a mother tha she feels extremely cruel in doing that and is very confused. She has two other children and is pregnant also.
He chose to live with his father and now his father doesn't want him:no: which would be hard but he doesn't want to go back and live with his mother because of rules such as "no drinking" etc. (reasonable rules for a child of his age). She just doesn't know what to do.
I don't know, it just seems that what he is doing is a cry for help:no:.
TripleTime
05-05-2009, 23:09
Take him to the GP. But make a long appointment, it will be a fight to get him there. Under the current metal health thingy a GP can admit them to hospital for monitoring.
:hugs::hugs:For your friend. A horrid and scary time for both her and her son.
I agree its sounds like he is acting out.
I'm not sure about the advice re his age. Here in Tas he would still be eliable to be managed by a Paed, Paediatric Psychiatrist, and by Adolescent Mental Health Services. Im sure its the same in NSW.
There are numbers here:
http://www.chw.edu.au/healthykids/nsw_child_and_adolescent_mental_health_services.pd f
http://www.community.nsw.gov.au/docswr/_assets/main/documents/parmh.pdf
There should be a mental health crisis line she can call. If he is being violent and out of control then she can call the police if necessary to help her to get him to hospital for review (that's if the mental health crisis team can't do this).
There will be two outcomes: If he is found by either the Mental Health Crisis Team or Doctor to be at risk to himself or to others then he may be detained in a mental health ward for 24hours during which time he will be assessed by a Psychaitrist and either a plan for discharge made or a plan for onging care either still under an order (meaning he is kept confined to the unit with no choice), or voluntary (meaning he agrees to the care).
If would prepare her for the fact that is it highly likely he will be found NOT to have a treatable psychiatric condition and quite possibly NOT to meet the conditions to be held under the Mental Health Act..or at least not for more then 24hours.
Mad (as in psychotic) behaviour is quite different from Bad behaviour. ADD/ODD are not psychotic conditions.
If he is threatening to harm himself or others in the heat of the moment then they may find grounds to detain him or often they can convince the young person to stay voluntarly for at least 24hour cool down. Though sometimes these are "threats" with no real planning made out of frustration and in distress.
If he has calmed down then their other option is to take him to the GP tomorrow and seek a mental health assessment and referral for counselling/ treatment. Preferably by an Adolescent Mental Health Team.
Its sounds harsh but the Children's Services (DOCS) can also sometimes be of great support, espescially if his father refuses to have him live with him and she feels unsafe having him live with her and the other children.
Your friend and his father along with their partners need to sit down with him and decide upon a plan. Hopefully they can find a counsellor or social worker to help guide and support them. He and they need to know where he is going to be living and under what conditions. He needs clear guidelines about what is and what isnt acceptible behaviour at home and what the consequences may be if he can't meet these requirements.
Likewise your friend if she is going to take him home needs to find a support/counsellor who can help support and guide her in setting up rules and guidelines with him. The Adolecent Mental Health Team should be able to help with this. There are also parent support groups that they can refer her to.
I can understand she feels that she is being mean to him by dragging him off for a review but obviously things have come to a head and she (the whole family) need help to sort it.
She needs to view it as being "cruel to be kind"
She is actually showing that she cares by getting help. He probably does have a chronic depressive illness, it often goes hand in hand with ADD/ODD, and may be helped with medication.
She needs to see be reassured that having rules (like no drinking) is totally appropriate. And it would be good if his father and his partner could get together and agree on similar rules so that wherever he lives he is getting consistant messages.
He needs a clear message that violent behaviour and threatening behaviour will not be tolerated and she needs to be clear that she will call the police and have him removed if he is threatening towards her or the other children. And his father needs to have a similar stance.
As tough as it sounds he is now 14 and needs to be given responsibility for his behaviour. Just because he has ADD/ODD he needs to know there is no excuse for violence and hurting(or threatening) people,and that there are legal consequences. She needs to be prepared that this may mean following through with charging him if he hurts anyone or damages property.
He needs to know that his parents love him and care about him, but it is up to him to do his part. This may mean agreeing to take medication and or go to counselling sessions.
As afwul as it sounds she needs to be prepared that he may well choose not to stay with either of his parents for a while.
She and his Dad need to assure him that there love for him is unconditional, it is his behaviour that is unacceptable and that thy believe that he has it in him to work together on helping him feel better about himself and control his behaviour.
Above all she will need your support as someone to vent to and a shoulder to cry on, and reasurance that she is a great Mum in seeking help for her son. Things will be very rough for her for a while, but hopefully he will mature with time and things will settle.
Sorry this is so long winded and a bit disjointed. I have been tryping between settling a 9mth old reluctant to go to bed.
Am :fingerscrossed: the crisis has settled for the night..that he has gone to bed and that they can calmly approach things tomorrow.
BreithCuidiu
09-05-2009, 12:17
I am unsure what area your friend's child is in, but she could phone the Prince of Wales Adolescent Services for advice about who to go in her area. Their number is 02 9382 4737.
Psychosis is when somebody loses touch with reality, they may believe things that are not true, and will continue to believe these even when the evidence shows the thing to be false. They may see, hear, feel, taste things that arent there.
The earliest that psychosis is recognised and treatment sought, the better chance of recovery and long term better mental health.
If this boy is experiencing psychosis it it really important to get him appropriate help asap. If a child had a physical illness and had to go to hospital for an operation (which would cause pain) the parent wouldnt feel like they were being cruel because they are acting on behalf of the childs long term health. i believe it should be same here, the child needs help, mum cant diagnose or treat him, you need a psychiatrist or mental health specialist who can work out what is happening and how to help the boy.
if the pediatrician cant help he should know who to refer the family too. in victoria, there is the early psychosis prevention & intervention centre (EPPIC) who work with adolescents and young adults. on their website, they have some info if you are interested www.eppic.org.au In your state, there will be service available.
It sounds like the pediatrician is a bit out of his depth and now is the time for you to get more professional help.
take care,
k
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