The process for getting a mentally ill child into treatment is so long and drawn out. There’s no mercy because they are children, no greater compassion. the process is exhausting, especially for the caregivers. We’ve been through this process now three times in six months. Every hospitalization has been so exhausting on us as a family. Every stay has been for over 2 weeks, there’s a stillness to the household, we try to stay light and cheery, but there is an emptiness that we can’t deny. We miss her when she’s away and we just want her home. The boys understand the process, but there is a frustration that comes with it. It’s hard for them to understand why they can’t just fix her. I wish it was that easy too.
So this is how the process works.
Child is in great distress and can’t be calmed
Take her to the Emergency room at the children’s hospital
whisper to the administration desk that your child is having a mental issue and needs to be evaluated.
All staffs eyes try to get a peek at the child with the wild hair and big eyes that’s trying to hide behind you.
They look you up and down as if trying to access your part in it.
What have you done to this child, to make her this way.
You are then sent to the unit. It is an area most people wouldn’t even know exists, its lock and key, guarded by security. Beyond those doors is a different place. You enter, give sympathetic glances to the other caregivers awaiting evaluation. Your possessions are taken away from you and stored away, the distressed child is made to change into hospital attire and sit. If it’s a particularly busy day they sit in the hallway until a room opens up. Children are brought in on stretchers from school with school administrators because they’ve run wild, some with their arms tied down. Some kids wait for hours until a caregiver can get to them because they are working. It always strikes me at how young some of these children are. It wakes me up to the fact that mental illness doesn’t discriminate. Age doesn’t matter.
It always strikes me that there are very little tears here. Once in this place the children for the most part do as they’re told. As if something beyond those doors changes them, and suddenly there is a calmness, maybe it’s a feeling of safety or fear. The loud ones are the ones put away into rooms first and farther away you hear them but don’t see them. Security stays closer to that end of the hallway.
then you wait, trying to keep your distressed child distracted. Carmelo comes and we switch off since the presence of the both of us seems to agitate her. Most of the time she wants me.
the ratio to psychiatrists to mental health patients is always low, it takes hours for an evaluation. Then a recommendation is made, if you’ve gotten to this point of being in the unit in the emergency room odds are an inpatient stay is going to come out of it. The question is where and for how long? There are two types of inpatient stays short-term and long-term care. The short-term stay is normally three days to try to get a child stabilized. It is then determined after those three days if the child needs further evaluation then they would move to an extended inpatient situation. Ranee has always needed extended inpatient care. You have little choice as to where your child goes, it comes down to bed space and a facilities willingness to take on your child’s crisis. A facility is a rotating door, as soon as a child moves out of inpatient care one comes in. If no bed opens up the child has to stay on the emergency unit until a bed opens up somewhere.
The first facility Ranee was sent to after her initial mental break was an hour and a half away from us. She was put with other children ranging in age from six to twelve. With limited visiting we would faithfully make the trip everyday, a three-hour round trip drive for a one hour visit but that one hour was everything to me. The distance didn’t matter I would have driven to the moon to see my daughter, but it was exhausting. For both Carmelo and I we had a deep need to see her everyday, to reassure her that we where here for her and to see for ourselves if she was making any progress.
Babies aren’t allowed on the mental health unit for their own safety because there are children with unpredictable actions and moods, so Charlene was in the care of friends daily. The boys being older, hang at friends houses or just hang with each other at home waiting for us to return with the daily report of her condition. I’m so grateful for those families that show love to my other children, they would check in on the boys and make sure they had food. But those where hard days, not just on us but Alexander and Christopher. That first stay was the hardest on all of us, but with each institutionalization it got easier. Ranee got to the point where she didn’t want us to come everyday. She was getting comfortable and familiar with the routine, when she is unstable she feels safe within those walls. She understands the purpose of her being there is to get relief and that’s what she craves.
It’s not like being physically ill, where you can just go to the doctor they access your illness, mend what’s broken and send you away with a prescription. The mind is broken in a sense, and it can’t just be pieced back together it’s hard to diagnose what’s broken or where. In Ranees case, there are a lot of factors other issues developmentally that can be related to brain processing. It takes trust in the doctors that they’ve done this before. As a parent that’s difficult, to relinquish control and to admit that you don’t have the answers. You live with this child you should know best what they need but you don’t.
Then there’s the medication issue. This was a big one for me and Carmelo I have to admit I resisted at first. I’ve never been a medication person really, if there’s another, natural alternative I’ll go that route. I wanted to believe that they could just cure her, that if we just loved her more prayed more and reassured her of our love we could fix this. Maybe she just needed a detox of sorts, to get away from television and electronics, talk her through it with some group therapy and some one on one attention. But after three days of inpatient twenty-four hour surveillance it was evident she needed more than what we where giving. Love alone wasn’t going to do it. She needed medication. She needed and wanted relief.
The doctors say we have to treat the symptoms to get her to a point where she can work on what’s triggering these episodes. I resent the medication sometimes because the side effects don’t fully allow her to be everything that a nine-year old should be. Her body gets weak, she can’t cool down quickly so she can’t play outside for long, her body aches. But I can’t deny that it’s working, we are seeing progress and my Ranee my beautiful child is starting to emerge again. Medication is a gamble they don’t know exactly what’s going to work or even why or how it works. The first medication seemed to be working but she developed an uncontrollable twitching of her mouth and her body ached so bad she could barely walk. During the process of weaning her off of that one and starting another she ended up back in the hospital. During that second inpatient stay she greeted me very excited, “mama do you notice anything different about me?” before I could even remark she said “socks, mama look I’m wearing socks”
For a child with sensory issues that has struggled so hard to have fabrics touch her skin, that stupid little ridge on the socks was our nemesis for so long. My Ranee is wearing socks, that is major progress, the medication is working on many different levels.