welcome to beyond my crisis i'm your co host ron rosner and i'm vivian jaspar and right now we need to examine what parents should do when they think their child or teenager is having a mental health crisis what does it look like and how to handle the situation ongoing today we have with us here dr stacy place who is a public health professor at cooney college welcome to our show dr pluto thank you very much for joining us and educating our viewers on a subject that i think is very infrequently dealt with in the form that we're in right now thank you for having me here we would like to cover what is something that a person parent should look at the constitutes first of all a mental health crisis what does that look like well first let me say that mental health issues are becoming more and more prevalent among teens about twenty percent of teenagers meet the standard for clinical depression about twenty to twenty five percent having society disorders  statistic no for a parent one of the indicators that i'm a parent what do i start having to look for there are lots of things you can look for the most obvious ones are if your child is talking about not wanting to be here anymore or wanting to kill themselves take that seriously if they're talking about wanting to hurt other people there are a lot of other things that can happen that constitute a mental health crisis that aren't so obvious but the meeting is to use your parental instinct you know if you come across your child and they're crying uncontrollably and they're hysterical and they're talking about that they're no good in they're a bad person you know don't write that off this t v drama ok so engage in a conversation with them but we as parents are not going to fall into that drama where here to kind of guide them through it and have an understanding and the end you standing is that it's not drama that it's important to take it seriously there are lots of other things you can look for if your teen seems to have delusions if they think there's someone out to get them if they're talking very quickly with for speech if if they seem to be falling apart and there's many forms this could take the main thing is as a parent if you're looking at your teenager and you think i'm not comfortable leaving the room right now because my teen might hurt themselves or someone else or i'm not comfortable leaving my child alone you may be in the midst of a mental psychiatric a mental health crisis and at that of the best actions to take the best actions are to get help so one of the things every parent can do is know in advance of any crisis where the help can come from so in new jersey for example and this is true for every state every county has a specific hospital designated that will do mental health screening for adolescents every county has something called a family support organization you can  through the state's department of health that will list organizations that have resources that you can learn about in advance so the first thing is knowing where to go so once you know that if your child if you think they're having a crisis you you can do one of two things if you feel that you can safely transport them to an adolescent psychiatric emergency department you should do so how is this any different opinion on the age of your child or is it any different it's not really any different mental health problems can strike at any age they may manifest themselves differently in younger children versus older children if you don't feel there is an immediate danger to the child or that you have to get the child help rate that second you can make an appointment hopefully for the next day with the child's pediatrician but again if you have any doubt at all if you are feeling uneasy that your child may be hurt or really hurting and that you can't let this go take them to get screened right there's a stigma behind mental health practitioners how do we counter balance that the first thing is to and this is true the stigma is there it's terrible because it's a huge barrier for people getting help ok let's break the barriers so the first thing to do is to talk about is to be willing to broach the subject with your child gently to talk about it with other people so if for example you feel your teens in a crisis situation and you take them to the other listen say yet your department fine try to talk to a trusted friend about it because you're going to need someone to talk to when you should trust it so i think one of the important things for you and your teen or your adolescent is that there's trust as confidentiality so how do you what do you do to establish confidentiality well with a friend or family member you pick someone that you feel that way with to begin with but what made surprised people is as you start talking to others about what your family's going through you'll find a lot of your friends and family have gone through similar things with their children but they never talked about it because of the stigma because of the shame and a lot of just want to go holistic what's your what's your scope on my scope and that is it depends if your child is having a psychiatric emergency in which you're afraid they're going to be immediately hurt a mind from this program might not be enough you know i would trust professionals take your child to the psychiatric emergency department let them get screened follow the advice of the professionals people children don't have to be on medication forever but if being on medication for a few months is going to allow your child to become stable and return to wholeness and then maybe transition to a more holistic way the medications worth it so thank so red for a short time they could take the medication know possibly be off of it and possibly not it's important to recognize that their mental health problems are job the same as any other physical health problem there biological problems based on a chemical imbalance in the brain but we can't diagnose the chemical well we don't know if you doubt but so let's say you do end up taking your child teenager perhaps to a mental health facility because you feel that you just don't feel safe leaving them alone as you mentioned and let's say they do require or highly recommend a stay what does a stay look like what's the length of time do they give options or is it become mandatory what we talk about this is really quite old by the way a stay is called to the psychiatric emergency room what will happen first is your child going to physical health screen because sometimes physical health problems like very low blood sugar can mask or it is a mental health crisis so they'll be checked out physically to make sure there's nothing physical they'll also do with alcohol and drug screen after they're medically cleared they'll be transferred over to the psyche to a psychiatric screen which is typically a psychiatric social worker the social worker will make the determination whether or not your child needs to have a short inpatient stay at a behavioral health facility which is what we used to call that which is what we now call psychiatric hospitals it's usually mandatory at that point you know if a health professional is saying to your child is at risk of hurting themselves or so what will happen is typically the hospital if you don't have insurance will work with you to get something through the children's health insurance program which is in all fifty states through medicaid if you qualify there are a number of programs to help pay for children stays i n the hospitals who work with you but once you go in for care it's determined that your child needs in patient care they cannot refuse to get you to a facility they're not legally allowed to discharge you if they can't do it safely is there some other tips that you can provide parents that once they put him into a stay i don't know how long is it typically so typically it's a forty seven day stay for a short term inpatient behavioral health stay and the first thing i want to say is it's probably one your child the help they need a lot times parents don't realize that their children have a mental health problem until it manifests in a critical way but once it manifests that's the starting point for getting help a lot of people have visions of mental health hospitals as something from one fell out of the cuckoo's nest shelling in the hall a lot of those down there not like that the adolescent units are really nice units colorful strange that actually some children describe them as kind of a really boring summer camp if you know about the worst part of it so what will happen is your child will be taken typically by ambulance and you won't be allowed to take them yourself for safety reasons to from the emergency room to the inpatient place you'll typically be allowed to go with them and sit with them through admissions to the in patient behavioral health unit once you've admitted though you're not allowed to go in with them and that's the most heart wrenching moment for parents watching your child walk through their doors so what tips do you have for parents to make their help their kids at that moment help themselves and help their family that's at home kind of what's going on in the uncles saying if they need medication will be given medication they're on an inpatient stay so if they have a bad reaction to the medication they're at a hospital the best possible place to do this and that's what you say to your family and that's the secret they'll be in croup therapy every day they'll be an individual therapy what you can do to help your child is several things every one of these places you drop of clothing and a hairbrush and sometimes personal hygiene it's important to take the strings out of all the clothing for safety they'll make you do that to them their own clothing so they can be comfortable in their own clothing bring them some flip flops or some shoes or slippers issues with that laces sometimes you'll be allowed to bring some paperback books no hardcover books every one of these places is visitation the best thing you can do for your and do that some places want now you because it is your child and you make child may be in a place where they refuse to see you which is their right don't be discouraged keep showing up your child needs to know that you love them and you're there for them even when your child is turning down don't you know be positive feel really plain about a situation like oh my god it makes missing work so i can see you or anything negative that yeah tell them that you're glad they're in a place where they're going to get help that you will do everything in your power to help them get help after they leave that you're sorry that they're in this place but that this is the chance for things to get better and that you're glad to be there with them make it really clear that you're supporting them through this and like you said see nothing negative but also keep it light but we ca sugar coat the whole thing i mean they're going to have to do some hard deep in themselves to get transformed but it's not going to happen in this forty seven days right so that's just the beginning stable and that's the thing to understand well what does happen afterwards mean what can you help our audience understand that after that short stay of four to seven days what's next does this go on indefinitely is it for a minimum of several months the ongoing thing there are no what happens so there's no answer because every child is different and there's a wide range of mental health issues but what generally happens is your child will be an inpatient facility for forty seven days you at that time that's your time that you have when you know your child safe for you to work really hard to think about what do you want to discharge discharge planning it's no use agree to these places they're great at getting your kid stable but you have to think about what's next one of the great options there's lots of great options one of the things you can do is have your child transmission to a partial hospitalization program for a few weeks so i went out patient visits are quite a few times a week well and it's more than that an intensive outpatient program is instead of going to school every day your child goes from what's a nine to five or a nine to four goes to a therapy center and there they'll get group therapy the individual therapy to start doing their schoolwork that center will be in touch with your child's school bus and school work those centers all have tutors and teachers that come in to work with the kids and you just need to be there for a few weeks and the state pays for this because it's part of you know no child left behind education in the state does not pay for the intensive  outpatient programs those you have to explore ways of paying with the hospital and with the program ok it depends on your insurance if you don't have insurance depending on your income level their state programs this is where parents need to do their homework  the next step after that so your child may need to be there anywhere from three to eight weeks a lot of kids after that remember your child's mental health crisis didn't just happen it was a long time coming and you may have not seen it and it but you know about it now it's you know is the time to move forward when you just give us a couple of signals that people should just watch out for because so many people are caught up in their survival the day to day let's go to work drop the kids off do the homework cooking and what do we check you know do child is emotional things if your child withdrawing from usual activities do they seem sad all the time are they sleeping a lot are they not sleeping enough do they seem really anxious are they withdrawing from friends  you suspect that they're engaging in self harm do you suspect that they're thinking about killing themselves and it's important to to child about it really hard to do calmly but important to do it nonjudgmental  hey you know have you ever thought about killing yourself and then like stop talking and listen because a lot of times as parents i think we want to talk and talk and some of the kids listen don't lecture but listen don't lecture but listen and if your child says they've thought about it get help that may not mean you have to run to the adolescent psychiatric emergency room you may be able to prevent things getting that far right but if you do know it but get it still get them help find you can go through your pediatrician every  couple things it depends again this is where you have to get your gut as a parent there's no absolute checklist i can give you you keep the lines of communication open if you think something's really wrong take them to a counsellor and leave the room you know a lot of times your child may be relieved they have someone to talk to but they're not going to say in front of you they may not want to say what's going on in front of mom or dad they might be embarrassed they might feel awkward so get them to a professional and then go sit outside and let them for physical and sexual abuse of children if a child discloses to a teacher or a police officer or even a girl scout leader a health care professional mental health professional that they've been physically or sexually abused that that professional is mandated to report the abuse to the authorities to the police to the police or to to children and family services european p c c yet they're obligated to report it to some authority and who exactly they're obligated to report to varies by state and very right so you know you numerated one mandated reporter with another mandated reporting if there is a serious concern that the child is going to hurt themselves or somebody else they can mandate that the child go to an adolescent psychiatric emergency room get further screening and the child can be involuntarily committed for a few days to do further screening to find out what's going on child should you just take the precaution of removing your guns from home and maybe giving it to a friend to hold on to well they're already locked well hopefully hopefully even if they're not all are smart so first question alters if you have weapons in your house sometimes if your child is thinking about cutting themselves or hurting themselves lock up all your knives it might be inconvenient to have to go to your locker room to get a knife every time you want to kind of that is about even rice is yours you know it's impractical how can you lock every sharp object away they could find they could sharpen a stick outside the back yard if they wanted to do harm it's not it's impractical as it sounds you do the best you can if you are at the point where you think your child is going to harm yourself you should be talking to profess you know not just guessing what you should be hiding and you are the professional will say to you you know your child's talking about killing themselves with medication you may have to let inconvenience when worse it is when we have to lock up the nation's very important thing when do you need to assert yourself above what a professional saying where you don't feel right the professionals you don't feel is doing all the right things how do you steer this or drive this ship you do it well you educate yourself and there are wonderful web states the national institute of mental health has a good one most state health departments have one you educate yourself before you go in you figure out what you want for your child you talk to the professional about it if you think the professional is really wrong you go to another professional i know but sometimes i'm concerned or someone is concerned that they may say the wrong thing and just like mandated reporter you say the wrong thing even as a joke they may take this out of proportion that usually doesn't happen with their does not pay now professor especially children's mental health professionals are there to help your child but of course you have to be the ultimate decider what can really be helpful and i can't say this enough is getting someone you can call get in touch with other families who are going through the same thing find out what they're doing go to those meetings and i know that everyone's busy you know we're working we're not trying to take care of a mentally ill kid but we could do a search on google and find  with results yet we can talk to someone on the phone and then there are what sometimes this predation trumps being too busy because you don't want the alternative what happens if you decide your busy schedule which of course is a real thing or not making up that you don't have to do all the things to work and take care of your household but if you don't pay the proper amount of attention to this crisis and how to live beyond do it because people think the crazes is the immediate need for the sa but right now we have to project out what's getting beyond that immediate crisis to mitigate and this could be a year or years of work and sometimes a parent will lose their opportunity or an income because to be ok with less income improve family and that's the main thing is you know when your child's in crisis your focus is on the child not to blame the child at all but to help the child and to keep in mind that someone having a mental illness is no different than someone having diabetes and we wouldn't blame some we wouldn't blame a child if they had diabetes you know we shouldn't blame a child if they have a mental illness the object is to get them the help they need so they quickly reiterate you know if there's an intense crisis your child may spend a short amount of time in a patient hospitalization that will get them stable that's just the beginning they may transfer from their two week intensive outpatient hospitalization for a few weeks that will help get them ready to get back to school ready to function the day to day life when they go back to school this is really critical you have to tell the school if your child has an individualized education plan what are you paying an i e d you're going to want that modified you're going to want to figure out what you kid needs and put it in there if your child is not you have to request in writing that your school's child study team meet to evaluate your child and provide them with what they need now none of this will question any money because that the schools are leaving home schooling  homeschooling your local public school pool is legally obligated to provide you with the services your child needs to get the education they're entitled to after for them after they committed intensive outpatient hospitalization they may be an afterschool program for several weeks or they're back in school and then they're going to the four times a week after school to therapy to further work on their issue and then ask you that they may transition to  with a therapist once a week now where you said three to four times a week does that mean the parent then drives them to a meeting several times a week or do they pick up service how would that work every place is different many of the places that offer after school therapeutic programs will pick your child up from school out that's even better yet let's just say the parent so your child will be picked up from school but you will have to pick your child up they most of these places do not offer a service where at five thirty they drive your child home but at least it's half the battle so it's help for the parents who are working right so you're working your child has taken from school to the afterschool program you pick them up from the after school program and then you come home you know in addition to  having therapy most of these programs have a family therapy component as well and you want to participate in that doc to put to this is an extremely important from a sion that this is why we wanted to give you are a damn sight attention our entire episode because this is life changing not just for the child the teenager in crisis and living beyond that crazes but it doesn't compass the whole family so to make sure the parents become that child's advocate in school outside of school in their psychiatric care and of course to be communicating with the siblings of appropriate age and what's going on with that child in question it's all about responding we as parents have to be responsible for the ability to respond so it's about responding and remember you don't have to respond alone there are there's a lot of support in the community for parents going through this and many more people tha you think are struggling with helping a child that has a mental health issue thank you thank you so much has been fantastic information and i know there's many many people who now know what to do god forbid this happens to their family