Allegations of Abuse

Children with bipolar illness can, and often do have episodes of aggressive outbursts or hypersexual behavior that are symptomatic of the illness.  Fortunately, these symptoms usually respond to proper medical treatment. Due to the child's sometimes alarming behavior, teachers, babysitters, social workers, well-meaning acquaintances and other adults who are not familiar with the disorder may suspect the child has been the victim of abuse.  Therefore, they may feel compelled to report parents to authorities for investigation. The parents may have done nothing at all to cause the child's behavior and may have been trying to stop the behaviors for months or years.

The Balanced Mind Parent Network has received increasing reports that parents (especially mothers) of children diagnosed with bipolar disorder have been accused by social workers or teachers of fabricating the child's symptoms and thereby harming the child (Factitious Disorder by Proxy or Munchausen's Syndrome by Proxy). This happens because the symptoms of  bipolar disorder, and how it can lead to unfounded allegations of child abuse has been slow to reach the community and the courts. As a result, some families have been unnecessarily torn apart by abuse allegations.

A child with bipolar disorder may express his or her overwhelming feelings at school, or may express them only at home. The target of the child's outburst is often a family member, most frequently the parent to whom the child feels closest. The episodes of aggression are usually not of a predatory nature but are triggered by a hyperaroused stress-response system (part of the physiology of people with the disorder) and a feeling of being attacked or frustrated. A child or teen with impulsive aggression needs medical treatment to gain self-control, and should be referred to a doctor.

Hypersexual behavior occurs in nearly 25% of prepubertal children with mania and 70% of adolescents with mania, as reported in the work of Barbara Geller, M.D. and colleagues (see B. Geller article) . A child with hypersexual behavior due to mania needs medical treatment to gain self control, and should be referred to a doctor.

If the child's outbursts include physical assault, the parent may need to physically restrain the child to prevent injury to family members, a family pet or someone else. At times, such use of restraint has resulted in criminal charges against the parent that can lead to loss of custody by the parent of all of their children.

Poor judgment and delusional thinking can cause a child to feel out of control.  In some cases, the child may even call 911 to report a parent who has not in fact been abusive. Altered thought patterns are not unusual in children with bipolar disorder, and the child may not understand the dire consequences of a false report. The family's local child protective services agency may become involved and threaten to remove, or actually remove, the child and perhaps other children from the home.

Every instance of child abuse and allegation of child abuse, even those with little or no evidence apart from the child's statements, must be investigated. These investigations are usually performed by a social worker and may lead to a judicial hearing to determine if the child should be placed in protective custody. A social worker representing a state agency may come to your home to look for signs of a harmful environment for the child. These investigators are influenced by the appearance of your home, its orderliness, the availability of nutritious food, and their perception of how well you meet your child's fundamental needs in a nurturing way. If you are concerned that your child's behaviors might prompt an investigation of your family, be sure you protect your rights as a parent in the following ways: Have your doctors, psychiatrists and therapists keep written records of your child's problem behaviors. Keep a well-organized notebook that details your child's medical history and treatment, school accommodations, and other significant information. Write and date letters or memos to your treatment team documenting behaviors that concern you — for example, sexually provocative and other manic behaviors such as not sleeping, giddiness and risk-taking activities. Keep copies should you need to defend yourself against abuse allegations.

Families faced with unfounded charges of child abuse are advised to obtain the services of a local attorney with expertise in this area to represent their interests. (See Finding an Attorney or Advocate). Because your parental rights are being challenged, you may qualify for a court-appointed attorney. The legal interests of the child and the parent are different, and therefore, if you are charged with child abuse, you should seek an attorney to represent your own interests regarding retaining custody of your child. Your rights as a custodial parent are in jeopardy, and good legal representation is extremely important. Accusations of Munchausen's by Proxy are extremely serious and it is important that any parent (usually the mother) accused of Munchausen's Syndrome by Proxy obtain representation by a competent criminal law attorney. These allegations can result in the loss of custody of every child in the home, before any charges are filed, and it is very difficult for an innocent parent to clear her name. The National Child Abuse Defense & Resource Center is an advocacy organization for parents falsely accused of child abuse, including Munchausen's Syndrome by Proxy. The book Munchausen's Syndrome by Proxy Reconsidered, by Eric G. Mart, Ph.D., is an excellent handbook for parents and attorneys involved in these cases.

Any attorney who represents you needs to be well informed about bipolar disorder. It will be crucial for your attorney to establish that a child with bipolar disorder is not explosive as a result of bad parenting or insufficient parental controls, but rather as a result of mood swings caused by a brain disorder. Children with bipolar disorder are often less in control of their behavior at home, where they feel safest. An expert witness may be extremely useful at a custody or abuse hearing. Your attorney may be able to locate such an expert by contacting the psychiatric department of medical centers at major universities. Attorneys have access to national services providing expert witnesses, but early-onset bipolar disorder may be too new and specialized an area to be included in the listings. The expert should be someone such as a professor of child psychiatry from a university school of medicine or a child psychiatrist who has recognized national credentials in the field of early-onset bipolar disorder. In addition to a nationally recognized "outside" expert, a child psychiatrist who has evaluated your child may be able to provide helpful testimony.

Disclaimer: Families with legal problems are urged to hire a capable local attorney licensed to practice in the state in which the family resides. The Child &Adolescent Bipolar Foundation (The Balanced Mind Parent Network) is unable to provide you with legal advice and The Balanced Mind Parent Network’s attorneys are unable to represent you. The information on this web page is not a substitute for legal advice. It is intended to be general in nature. The laws of each state are different. The law is always changing. The information here may not reflect the latest legal developments. NO WARRANTY OF ANY KIND, EXPRESS OR IMPLIED, IS GIVEN AS TO THE ACCURACY OF THIS INFORMATION.

Last updated: February 3, 2010

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