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Janna
Community Elder

A Recent Experience

My apologies for the length of this post.  I have tried to keep it as succinct as possible.  Thanks in advance if you do read it all.😊

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I thought I would post this story so I can share my experience with the mental health care system.

In May, my son was voluntarily admitted to a private young person’s mental health unit for treatment of his depressive disorder which at that time was severe. The inpatient program is generally for three weeks. At the time of his admission, we were still living with my abusive personality disordered husband. I was at the end stage of planning our exit and was working towards leaving during his absence over a long weekend four weeks into the future.

Upon admission, my son put me down for full disclosure and listed his father for non-disclosure. My son also requested that I do not disclose his admission to his father. I agreed, with no guarantee that I would be able to maintain this for the duration of his stay. Our home was so dysfunctional, and his father so disengaged from reality, that I was able to conceal his absence without any difficulty.

Meanwhile, my son was being treated in the unit under the direction of a new psychiatrist. He was fully aware of the domestic violence and social issues that surrounded my son and appeared to understand the dynamics. He was also aware of the tenuous and harmful relationship that existed between my son and his father and knew that I was planning to leave.

I was called to attend a "Family Meeting" with my son and his psychiatrist in the second week of his stay. During this meeting, the psychiatrist interviewed me at length and concluded that from what my son and I had told him, my husband was clearly suffering from an undiagnosed personality disorder. Given that I was planning to leave one week after my son's discharge he recommended that he remain in the unit until this was over.

The following week I again met with my son, his psychiatrist and a psychologist. The entire session was dedicated to safety planning. The psychiatrist emphasised this and advised me that he was lowering the threshold for notification to the police because of the paranoid delusions my husband had exhibited in recent weeks. He advised me to notify police at the first signs of agitation, amongst many other things. He was more than happy to keep my son in the unit throughout this high conflict and potentially unsafe time. I was greatly relieved that my son was not going to be present during this move and would be in a physically and psychologically safe place.

That weekend I left my husband successfully while he was away and over the following week had to deal with the fallout. The psychiatrist conducted a conference call with me on Wednesday and again emphasized safety and how important caution is during this potentially dangerous time when an escalation of abusive behaviour was likely. He again assured me that the unit would keep my son on a "see as we go basis" until things had settled sufficiently. He scheduled a review meeting for the following Monday to discuss this.

By the Friday of that week, my husband had become quite irrational and was desperately attempting to contact our son. He concluded that I was deliberately blocking his communications and that I had brainwashed our son. He began harassing both of us with a string of phone calls and text messages. My son decided to answer his messages and in the course of communicating told his father where he was and added that he never wanted to see him again. Naturally, this angered my husband and led to him to ring the unit demanding information. They did not disclose anything and did not even confirm my son's existence, which in turn angered him further. He concluded by advising that he intended to visit on the following day.

The staff of the unit contacted the psychiatrist who immediately instructed staff to suspend my son's weekend day leave and remove his phone. This decision seemed reasonable and was to protect my son. The following morning I received a call from the psychiatrist to advise me that he had decided to discharge our son. He justified this decision by saying that he did not want a "flashpoint situation" occurring when my husband arrives and is not permitted entry. He added that this would be stressful and harmful to our son and other inpatients. I was advised to collect my son as soon as possible and also told that hospital security had been notified and placed on stand-by.

My son was very distressed to learn that he was being discharged and began crying. Nursing staff tried to console him, but he was very upset and repeatedly said, "He's won again. He ruins everything".

I arrived to collect my son, and as we were leaving, we were offered a security escort to the car. That clearly indicated the situation was unsafe. On our return trip, we were bombarded with a total of a combination of over 20 calls, SMS's and voicemails from my husband. He threatened to report our son as a missing person to the police, accused me of subterfuge, threatened to track us down, etc. This situation created so much anxiety in my son that he became nauseous and wanted to vomit. Thankfully we arrived home safely and the irrational communications from my husband ceased with a final message that contained veiled threats.

As a result of the abrupt discharge the scheduled psychiatric review was not conducted, no discharge plan was made, and no follow-up was conducted.

I contacted my son's psychologist immediately to advise her of what had happened, and she instantly expressed her disapproval and condemned the actions of the unit. She believed that my son's welfare was jeopardized and that they were in breach of the Children and Young Person's (Care and Protection) Act and did not exercise a basic duty of care. She also questioned what psychological impact this would have on him.

The psychology practice wrote a letter of complaint to the Executive Director of the hospital and the head of the unit. This letter was signed by the Director of the psychology practice, my psychologist, my son's psychologist and his psychiatrist (who was the referring Dr). Although I am unaware of their exact response, I have been told enough to know that the psychiatrist is not a very happy man and that we appear to have burnt our bridges with the unit.

Unless I’m missing something, discharging my son at a time when his father was in a volatile mood is exactly what should NOT have been done due to the risks involved. My husband could not have entered the unit in any case as it is secured with an electronic release door. The way I see it is that the facility did not want to have to deal with my husband and his rage on their property, so they discharged my son and in doing so compromised his safety. He should have been permitted to stay in the unit and deserved to be discharged in a planned and normal manner at a time when the risk to his internal/external safety was low. It also completely contradicts the safety plan that psychiatrist emphasised.

My son was already particularly susceptible to emotional and psychological trauma due to his past chronic exposures to domestic violence and current psychological health. I fail to understand the logic of how a facility that is dedicated specifically to helping individuals with emotional and psychological issues can do something like this and potentially harm someone further.

It appears that my son will no longer be able to use this facility for treatment. That is a real shame because he responded very well to the inpatient treatment and bonded with many staff within the unit. Despite the abrupt end, the rest of his inpatient stay was good and yielded positive outcomes.

He recently expressed a desire to return because of his worsening depression, and I explained that this may not be possible. It broke my heart when my son was abruptly discharged from a place where he felt safe. It now breaks my heart even further to tell him that he is no longer welcome there. How can something like this be good for a young person struggling with severe depression?

I would love to hear comments and opinions. I'm curious to know if I'm just not seeing it from the right perspective.

Janna ❤️

9 REPLIES 9

Re: A Recent Experience

I think it was a good thing to share some of the complexities of dealing with public and private mental health services. People need to know that these people are not gods. 

Yes I can see your idea that the rational situation that a ward with electronic doors and staff would be more protective of your son than many places.

I had a similar experience where I was dumped by a Adoptive Sevices of Dept Health and I was "left with the baby" because they were scared of career, legal and reputation issues.

 

Re: A Recent Experience

It's not really the fact that they didn't protect my son, it's that they chose to boot him out of a unit with no notice, no review, no discharge plan, no follow-up and into a known unsafe environment.  No child (adolescent) deserves to be discharged in this manner, particularly when the primary reason they are in there is for treatment of depression and anxiety.  My son walks a fine line as it is.  He has low self-worth, self-esteem, self-confidence and is highly sensitive to anything and everything.  No person admitted to hospital for psychiatric treatment should be discharged like this, no matter what the circumstances.  It's unethical and just plain wrong.  No wonder he's been on a backward slide ever since ..... not that this is the primary reason ... but I would say it contrbuted.

Janna ❤️

Re: A Recent Experience

Yes I have experienced some of the shortcomings of our systems .. with devastating effect upon my family ... since 1970, in fact.

My position is that all humans should be entitled to equal treatment and opportunities according to need .. it doesnt happen though.

I am interested in the reasons behind the turn around of support in the MHU ... do you have any idea?

Re: A Recent Experience

I haven't wanted to drop this one, but my husband is a well respected medical specialist.  I feel that ultimately it was a case of protecting a fellow colleague.  I honestly can't think of any other reason.  Despite the psychiatrist being independent and assigned to look after my son, I think that he wanted to protect my husband from a situation that could potentially have ended in a very ugly way for him.  At the end of the day the person who was offered protection was my husband and not my son.  This is the only thing I can think of.  The reason about protecting my son and other inpatients doesn't sit well with me because I know that my H could not have got into the unit.  I don't think I'm wrong.

Re: A Recent Experience

I actually wondered whether that was it as you mentioned it in a prior post. A nurse I once worked with told me that doctors always stick together.

There is always a reason ... if they had decided to keep father out they certainly would have been able to.

I am deeply saddened that your son was the one to suffer .. I hope you have the various resources to weather out this next phase. You seem determined and clear .. keep loving your son and dont lose hope for him, even if it is extremely tricky atm.

Re: A Recent Experience

Hi @Janna, thank you for sharing your story.  You've been through an extraordinarily tough time.  Leaving an abusive relationship is difficult under any circumstances but especially so with your concerns for your son.  It sounds as if you've found yourself a safe place to stay and are enjoying some respite from the harassment.  

You may be right in your suspicions but are you certain that your son is not welcome back? The treating Psychiatrist may quite rightly have had some difficult questions to answer within the unit, but does that definitely mean that a future admission is out of the question?

Re: A Recent Experience

Hi Suzanne,

Last week my son was in a very bad place and was considering suicide.  It appeared that an inpatient stay was needed and in fact my son was requesting to go back to the unit.  I spoke with his regular psychiatrist and without saying anything directly, I could tell from his hesitant response and tone that he was very reluctant to make another referral to that unit.  He actually threw the ball into my court and suggested that I ring them to find out what their response would be.  I simply couldn't do that due to my lack of courage.  I don't know why I should be feeling like I've done something wrong, but I do.  I received the same response regarding a re-admission to the unit from both my psychologist and my son's psychologist. In fact, they all went as far as to recommend another unit which is located a long way away.  

I don't believe that a unit can ban a person from admission.  That would be unethical and illegal IMO.  However, I suspect that the psychology practice has taken a stance in which they will no longer recommend or refer any clients to this unit and if this is the case they would naturally not be supportive of another admission.

I also find it very odd that there has been no communications from the unit to myself.  I have worked in the health care system and know only too well how they work.  All complaints are taken very, very seriously and they try their hardest to smooth things over for fear that the complaint escalats to the Health Care Complaints Commission.  Whether the complaint is justified or not should make no difference.  As a matter of courtesy I would have expected some communication that acknowledged the complaint and responded to it appropriately. 

I honestly would have expected a letter of apology of sorts in which they at the very least acknowledged their mistakes and assured me that our son would be welcome back at any time in the future.  Hospital or not, this is a fundamental principle in any business.

Ironically, when my husband was told about the discharge I didn't mince my words and told him that our son had been disharged because he was threatening to come in against our son's wishes.  His reply was "Do you honestly expect me to believe that.  That would be unlawful"!!

I'm loathed to have to make contact with the unit after this experience, but I may consider writing a personal letter to the CEO for clarification about the whole matter.  

Janna 

 

Re: A Recent Experience

As it was the psych practise that complained, rather than you personally, I'm not terribly suprised that you didn't hear back.  It's difficult for organisations to apologise or admit to fault in writing these days.  They are so worried about litigation.  

While it makes sense that you and your son's treating psychs don't want to refer back to a unit that they consider to have done the wrong thing, it shouldn't stop you from pursuing this if you are convinced that it's the right option for your son.  With all the acts of courage you've made over the past little while, contacting the unit yourself should be a breeze 🙂  Seriously, advocating for our kids, even when it means going against the advice of 'experts' is never easy.  But sometimes it needs to be done.

Only you can decide if it's necessary.  No-one else knows your son as well as you do.

Re: A Recent Experience

I'm lucky to not be at the foot of that bridge at the moment.  My son has improved and an inpatient stay is not as acutely needed at the moment.  I'll do whatever I feel is right for my son according to need.  Thanks.

Janna ❤️

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