6 Ways to Prepare For An Emergency
No parent wants to think about hospitalizing their child for psychiatric treatment.
We tell ourselves that our child isn’t that ill, or that hospital treatment represents a failure. Or we are fearful, because our image of an inpatient psychiatric unit comes through the distorted lens of horror movies and TV dramas.
Sometimes, when a child is perilously unstable or every other intervention has failed, hospital treatment is needed. Hospitalization can be the best way to provide safety and stabilize a suffering child, to conduct medical tests, or change medications under expert supervision. A good pediatric psychiatric unit is a lot like a good pediatric medical unit—therapeutic and designed to be safe and comforting for kids.
As parents, we need the guidance of a trusted clinician in this decision, but we also need to trust ourselves. If a crisis feels like an emergency, it probably is an emergency. No one would fault a parent for rushing a child with acute stomach pain to the emergency room. Severe depression or mania can be life-threatening, just like appendicitis.
The best time to plan for hospitalization is before a crisis. It is hard to make good decisions or explore options in a moment of extreme stress.
Here are some ways to prepare before an emergency:
- Make a plan. Talk with your child’s psychiatrist or the physician monitoring his or her care about what to do in a crisis. Get an emergency phone number to reach your child’s doctor, and keep it where you can find it quickly.
- Find out if your child’s doctor has hospital admitting privileges. A physician with admitting privileges can call ahead to admit your child, allowing you to avoid a long wait in an emergency room. If your doctor has admitting privileges, he or she may be able to treat your child during hospitalization.
- Ask your doctor which hospitals he or she would recommend, and which you should avoid. Call your health insurer to find out which hospitals are covered under your policy.
- Call prospective hospitals to find out the age range of children that they treat. Ask if they allow a parent to stay with their child throughout the admission evaluation, until the child is assigned to a room. When can parents visit? How many beds are on the pediatric unit, and how does staff monitor young patients? Does the hospital have instructors who can help your child keep up with schoolwork as he or she recovers?
- Plan where to get emergency help if you fear that your child, you or someone else could get hurt. Many communities offer crisis intervention services, staffed by police and/or social workers who are specially trained to de-escalate a psychiatric emergency. Alert your police or crisis intervention service that a child with mental health needs lives at your address, so that emergency responders will be aware that your child has special needs.
- Ask a friend or relative if they will shelter your other children in an emergency.
Hospitalization is a painful decision, but planning ahead can make it less scary and stressful for everyone.
We had no plan and were unable to reach our daughter’s psychiatrist during a manic crisis when our daughter was 15. We feared that someone would get hurt, and so we took our very scared and angry child to an emergency room. Several months later, she was very depressed and asked to be hospitalized. In-patient treatment was no longer a frightening unknown. It was a safe haven.
Has your child been hospitalized? Is there anything you wish you'd done, or known, prior to his/her hospitalizaton? Please share your suggestions in the comments below.
My son has been hospitalized 11 times since age 8. I was in such a chaotic state the first time, I wish that I had researched what available hospitals there were in the state for my child. I had to learn the hard way, and now when I teach NAMI Basics to parents I pass out a sheet of the hospitals that cater to children under the age of 17. Sometimes in the ER the professional that is seeing your child may only be looking at one hospital for admittance, when they should be looking elsewhere in case there are no available beds.
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Luana Rath
Son-15-BP1/GAD. Lithium, neutontin, trazedone, ability, depakote, ativan-as needed
Tim's been hospitalized 12 times and, for better or for worse, we were hyper-prepared for the last five.
We have his pdoc's service number in everyone's cell phone (even Tim's), and taped inside a kitchen cabinet door.
We have a plan for our other kids - they are allowed to leave the house together, no questions asked, as long as they are together, or our youngest has a safe neighbor she is allowed to go to, no questions asked. We know exactly where they will be when the crisis is over or handled.
Tom always suggests to parents to have a book to read in your car, at all times. Tim always had to be admitted through the emergency room, which could take anywhere from three to a dozen hours. Having something to pass the time with for you helps.
Here in Illinois, we have the SASS program, which will come to your house in a crisis, evaluate your child, and do the legwork of looking for a hospital bed. You can read about the SASS program here: http://www.hfs.illinois.gov/sass/
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Chrisa, 43, Chicago Suburbs, Internet eCommerce Professional
Mom to Tim, 16, Developmental Disability / Schizoaffective Disorder, Clozaril, in RTC
Also mom to Di, 15, RAD; Alex, 20, college sophomore
Married to Tom, 43, SAHD and high school pole vault coach
My daughter has been hospitalized twice in the same facility. One problem we faced was that we were given incorrect information regarding procedures and rules at the beginning of each admittance. So, I'd double check all of your information with the staff once your child is in his/her room & treatment program.
Also demand to be in contact with your child's doctor. These are busy people, and they don't always see the parent as a partner in the treatment plan. You know your child, and you have to be involved. Speak up if you have any concerns or need more information.
If possible, check ahead of time to find which hospitals are available for your needs. If you are on private insurance, determine (as much as possible) what will be covered. Often, even if the hospital is on your plan, individual doctors and technicians who treat your child may not be. The bill can be quite a shock if you don't do your homework, and preparation may help in appealing some insurance decisions.
Although my daughter hated the idea of going back to the hospital, she was the one who made the final decision to go back the second time. So, if you think this is what is needed, rest assured that it is probably the right decision. Someday, your child may thank you.
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Sharon
mom to DD (domestic private adoption at age 2 1/2 yrs), 18, bp1, suspected fas, add, behavior support program in high school, zoloft, risperal, valerian
My daughter has been hospitalized 3 times for her Bipolar Disorder. The first time at the young age of 8, for a short visit as a means to get her meds when we relocated and had the impossible task of trying to find a new Psychiatrist. That was only a less than 2 day stay. Again she was hospitalized at 12 shortly after being diagnosed with Transgender(Gender Identity Disorder). That was just a nightmare. When my than 15 year old son and I went to visit as we left Ashley became upset and started to run to the door, at which point 6 grown adults men and women dragged my daughter down a hallway and into a room the size of a closet which than locked behind them. My son and I could hear Ashley screaming in fear, at which point my son ran down the hall and knocked the door open. As we entered the room they were literally sitting on my daughter one grown man had his knee on her chest complete over killed for the situation. My son was so upset that after the institution called the police on me because I refused to leave without her(how could anyone trust after all of that) the doctor agreed to release her to me, that was less a less than 24hr stay. After that not only did I have to deal with my daughter's mental illness, I now had a 15 year old son(who never had any mental issues, the all american good student, football player,wrestler) with severe panic attacks The third time we went through the ER and she was admitted to the regular hospital for four days(where I was able to stay with her in the room the whole time, even to sleep) regulated on meds and released due to the fact that they could find no beds anywhere but 4 hours away(I could never let her go that far away, how could I ever visit) A single mom with 2 other children at home, and absolutely no help. After my daughters transition from my son to my daughter although not coming as a big surprise to anyone in the family(he had told us all from the age of 2 that he was not suppose to be a boy God made a mistake he was really a girl, never one time in his life playing with boys or boy toys) we were completely abandoned by my entire family. We were an embarrassment to them all I guess, even though my daughter is beautiful and no one can ever believe that she is transgendered and ever lived as a boy. So now here I am lost, confused, scared, alone and definitely not to trusting of the system(especially due to the transgender, placement get so much more complicated). So I'm reaching out here hoping for some support, just people who I can relate to and who can relate to me.
~Toni Ugalde~
Mom to a 19 yr old son, a 7 yr old son and of course my 16 yr old ADHD,Bi-polar, transgendered daughter.(who is currently on Lithium, Abilify, Clonodine and Adderall.(Oh yeah and also receiving hormone blockers) to prevent any testosterone, and preventing her from getting facial hair, an adam's apple and any other secondary characteristics of the male gender. LOL I bet there are some of you out there feeling a whole lot better about your situation right now. See it could always be worse(I would give anything to be dealing with just Bi-polar disorder) Not to minimize mental illness I just would have been content with one or the other the two together are a different kind of insanity altogether.
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~Toni Ugalde~
Hi, Toni --
You have a lot on your plate! No one has the same set of issues, but there are many families with very complicated struggles. You can find support and understanding on the CABF website. Just go to the home page, click on the "Connect" button and scroll down to "Support". There are many support groups, many organized by age, issue or region. You can join a group and talk to other parents who will understand and try to help.
Best wishes,
Jean
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Jean Meister
Hi Toni,
Wow, you've got a lot to deal with. Others may not have the same exact struggles, but they will be able to relate to what you are experiencing. You are not alone! Please do join a support group here, it will give you a chance to correspond with other parents.
Hang in there,
Sharon
mom to DD (domestic private adoption at age 2 1/2 years), 18, bp1, suspected fas, add, behavior support program in high school, zoloft, risperal, valerian
DS 14, gets very stressed by his sister's behavior.
DH, 46, tries, but is very frustrated and avoids interacting with DD as much as possible.