Thinking of Others

Patti and I were fortunate during the holidays because six of our seven children  — that’s right seven —  were able to be with us.  Patti was a widow with four young children when we met. I was recently divorced with three of my own.  Blending two families hasn’t always been easy, but as I watched everyone having a wonderful time, I felt proud — especially of Mike. Two years ago, we were dealing with his fourth serious  breakdown. Now, he is doing great and recently became a peer to peer specialist. I am so proud of him.
Of course, remembering what we were going through, made me think of other families who were in crisis during the holidays. A few days later, I received an email from a NAMI friend.  I asked her if I could post her note on my blog and she agreed after I promised to change the names. What this family is experiencing is all too common. It’s a reminder to all of us that even when our loved ones are well, there are others who still need help and support.
Dear Pete
As you probably know Tom spent most of the summer in jail for taking a sailboat out into the Atlantic Ocean “to sail back to his birthplace.” The Coast Guard picked him up and thankfully handed him over to the local police. We did not bail him out this time or even try to get him out for we told him last spring, when it seemed like he would flee, that he wouldn’t. He was released at the end of July with a misdemeanor and made his way 170 miles back home. I heard something way before dawn and was startled by him outside the window by my desk. This began a difficult time.
We were doing nothing to help him by giving him anything but help.
If we gave him food, shelter, money, a ride, a room, a drop of water, a piece of fruit, a meal, clothing, a shower, we were keeping him away from getting the help he desperately needed. This place, home, could only represent one thing and that was help. We questioned this move every day. We had no choice, the cycle of hospitalizations and running nowhere only to come home which would lead to chaos had to stop.
In October, we managed to get Tom, now actively psychotic, admitted into a local hospital. We were trying to get him into (a  state hospital)  because we knew another short term hospitalization would do nothing to stop this cycle. We were unable to do this and again, upon admission the discharge plan began. I told the social worker on the unit that if they planned to release him in 5-7 days, they might as well not waste the time and resources and let him go right now. He needed longer term so the medication can have a chance to work, that was our only hope.
I was told, “…there is no such thing as long term hospitalization anymore…they don’t do that anymore…”
But I knew there were patients at (the state hospital) for months.
We continued to listen as the days passed “…we don’t do that anymore… they don’t have long term up there anymore…”
And the most disturbing “…I only send the really difficult patients up there…”
Even Tom’s psychiatrist, who I respect said, “…well…..we don’t normally like to transfer….they don’t like it when we do this… …I don’t think we’ve ever transferred someone up to (state hospital) after a 7 day inpatient here…”
I’m confused because during this time I’m talking to the professionals at (state hospital) who are hearing me and they’re ready for him. They want to help and yes, there are patients who have been there for two weeks, two months, four months, a year and more.
Finally, an angel at (state hospital) says, “It’s a shame ya’ gotta get ugly, isn’t it?” She gave me a direct phone number to a doctor who would coordinate the transfer if (local hospital) would make the transfer. I tried to explain to the annoyed staff at (local hospital) that I wasn’t trying to make their jobs difficult. How many fewer admissions there would be if the hospital was not pressured to discharge so soon? The rotating door admissions would certainly decrease, which would save valuable time and resources and would give the patient a chance to recover.
So Tom was transferred to (state hospital) in mid October where he remains today. It has been a difficult time for Tom but he’s hanging in there. Initially, he presented very well and after a month they moved him to the research unit where he managed to escape for 24 hours. They placed him back in the high security unit which was a low point.
Let me back up.
As soon as Tom arrived at (state hospital) I noticed something different. First, it is not a “nice” facility…the hospital is old and dingy.
But the staff, the medical treatment teams are like nothing we’ve experienced in five years at (short term units.” Here, the focus is on the patient, not discharge. It is the first time I spent over an hour with the “medical treatment team” asking me questions and truly interested in the answers- the patterns, the symptoms, the cycles, the compliancy, the running away, the running back home, the diagnosis, the medication, the explanation of his psychotic breaks, and so on. They use this information with the information they get from Tom to give him the best care.
Here, we are not a headache to the staff, we are a welcome and a vital part of recovery. This is a (university connected hospital)  were everyone was working to understand brain disorders like schizophrenia and to hopefully find a cure.
Last week, after over two months, Tom moved up to “2 South.” It is still secure but there are many fresh air breaks and the real perk is the “therapeutic mall.” Here Tom takes classes from 9am-3pm and he learns about his illness, the medications, relapses, symptoms, art and daily living skills. There is a gym and even a band consisting of patients –some who have been there for years.
So (during the holidays), I see  college kids coming home and I find myself wondering where Tom would be if he hadn’t gotten sick. I need to remind myself that today he is better than he’s ever been. He expressed enjoyment in drumming during a music therapy class on Saturday and that is a first in a very long time. A beautiful gift. He is more in the moment and the doc said he was “chipper” on Monday. He asks about family and friends and these are all signs that he’s getting well. Discharge will come eventually when the time is right.

For the first time in a long time, we have hope.
This email raises a question that many in mental health refuse to address. Some people need long term care to fully recover. This care is generally not available in most community settings. But state hospitals are not popular and continue to be closed down.
Where will persons who are severely ill get the help that they need to become stable?
About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.

  • Maria

    I can not help but think of others everyday of my life. I am an individual who knows what it is like to suffer first hand from a psychotic state of mind and experience side effects from psychiatric medications such as severe-parkinsonslike syndrome, weight gain of 80lbs in 6 months and suicidal thoughts.

    I was blessed to find a medical doctor who tests for the underlying causes of mental illness. The manic highs and delusional states of mind I experienced were a result of toxic encephalopathy from long term chemical exposure in the work environment and past exposure to lead. Chelation therapy helped to reverse symptoms and give me my life back.

    Personally I have helped 2 other individuals dx with bipolar disorder discover the cause of their symptoms to be toxic encephalopathy from chemical exposure.

    My symptoms were accurately discribed as mania. Bipolar disorder is nothing more than a stigmatizing label, not a disease, the correct diagnosis was toxic encephalopathy and there was a treatment for it.

    There are many underlying causes of mental illness that are overlooked and left untreated.

    Here is a link to an article on The Role of Infections in Mental Illness:

    20.http://www.nutritional-healing.com.au/content/articles-content.php?heading=The%20Role%20of%20Infections%20in%20Mental%20Illness

    Here is another article of interest:

    Neurotoxicology. 2008 Nov;29(6):1147-9. Epub 2008 Jun 24.

    Toxic causes of mental illness are overlooked.
    Genuis SJ.

    While proper brain function requires the complex interaction of chemicals perpetually occupied in purposeful biochemistry, it is well established that certain toxic substances have the potential to disrupt normal brain physiology and to impair neurological homeostasis. As well as headache, cognitive dysfunction, memory disturbance, and other neurological signs and symptoms, disruption of brain function may also manifest as subtle or overt alteration in thoughts, moods, or behaviors. Over the last four decades, there has been the unprecedented development and release of a swelling repertoire of potentially toxic chemicals which have the capability to inflict brain compromise. Although the ability of xenobiotics to induce clinical illness is well established, the expanding public health problem of widespread toxicant exposure in the general population is a relatively new phenomenon that has spawned escalating concern. The emerging area of clinical care involving the assessment and management of accrued toxic substances such as heavy metals, pesticides, plasticizers and other endocrine disrupting or neurotoxic compounds has not been fully appreciated by the medical community and has yet to be incorporated into the clinical practice of many consultants or primary care practitioners.

  • Maria

    I can not help but think of others everyday of my life. I am an individual who knows what it is like to suffer first hand from a psychotic state of mind and experience side effects from psychiatric medications such as severe-parkinsonslike syndrome, weight gain of 80lbs in 6 months and suicidal thoughts.

    I was blessed to find a medical doctor who tests for the underlying causes of mental illness. The manic highs and delusional states of mind I experienced were a result of toxic encephalopathy from long term chemical exposure in the work environment and past exposure to lead. Chelation therapy helped to reverse symptoms and give me my life back.

    Personally I have helped 2 other individuals dx with bipolar disorder discover the cause of their symptoms to be toxic encephalopathy from chemical exposure.

    My symptoms were accurately discribed as mania. Bipolar disorder is nothing more than a stigmatizing label, not a disease, the correct diagnosis was toxic encephalopathy and there was a treatment for it.

    There are many underlying causes of mental illness that are overlooked and left untreated.

    Here is a link to an article on The Role of Infections in Mental Illness:

    20.http://www.nutritional-healing.com.au/content/articles-content.php?heading=The%20Role%20of%20Infections%20in%20Mental%20Illness

    Here is another article of interest:

    Neurotoxicology. 2008 Nov;29(6):1147-9. Epub 2008 Jun 24.

    Toxic causes of mental illness are overlooked.
    Genuis SJ.

    While proper brain function requires the complex interaction of chemicals perpetually occupied in purposeful biochemistry, it is well established that certain toxic substances have the potential to disrupt normal brain physiology and to impair neurological homeostasis. As well as headache, cognitive dysfunction, memory disturbance, and other neurological signs and symptoms, disruption of brain function may also manifest as subtle or overt alteration in thoughts, moods, or behaviors. Over the last four decades, there has been the unprecedented development and release of a swelling repertoire of potentially toxic chemicals which have the capability to inflict brain compromise. Although the ability of xenobiotics to induce clinical illness is well established, the expanding public health problem of widespread toxicant exposure in the general population is a relatively new phenomenon that has spawned escalating concern. The emerging area of clinical care involving the assessment and management of accrued toxic substances such as heavy metals, pesticides, plasticizers and other endocrine disrupting or neurotoxic compounds has not been fully appreciated by the medical community and has yet to be incorporated into the clinical practice of many consultants or primary care practitioners.

  • Very good letter! I was wondering what State the State Hospital is in that was mentioned. Pennsylvania is good with treatment, also, however there are some “glitches”. When a person “acts out” and/or “misbehaves”, they are not given the opportunity to participate in the treatment groups, and must be “ward restricted”. So, that is a problem, and the person really doesn’t benefit from being there. Nice to hear good comments on a State Hospital, and I am aware of other conditions that trigger a mental health diagnosis. Thanks for all that you do!

  • Very good letter! I was wondering what State the State Hospital is in that was mentioned. Pennsylvania is good with treatment, also, however there are some “glitches”. When a person “acts out” and/or “misbehaves”, they are not given the opportunity to participate in the treatment groups, and must be “ward restricted”. So, that is a problem, and the person really doesn’t benefit from being there. Nice to hear good comments on a State Hospital, and I am aware of other conditions that trigger a mental health diagnosis. Thanks for all that you do!

  • Patty

    If you want to send a relative to a state hospital, check with NAMI first or other people in the know. Some state hospitals are really subpar.

    I was in a state hospital fora few days because of a medication reaction and all the community hospitals were full. Some of the staff were very abusive, honestly, I wonder if they had personality disorders, because they enjoyed having power over the patients and tormenting them. The level of training of staff was much lower than that in community hospitals. The more trained staff (with at least a 2 year nursing degree) NEVER came out of the glass booth except for a brief 5 minute conversation daily. I am in Minnesota, a state that probably puts more funding into public mental health care than most and it was this way. A psychiatrist told me that the people who got fired from the community hospitals often got hired on at the state hospitals. They’ve gone to 16 bed units in the past few years, and I have heard they are a big improvement over the larger state facilities, which there is only one of those left. In that facility, they were allowing women with problems such as severe mania to trade sex for money for chocolate bars. The staff KNEW. Hmmm, good place to put your spouse or other relative when you are trying to protect them from the consequences of full blown mental illness. So check it out, before you put your relative in a state hospital. I still haven’t gotten over the abusiveness of those women, and it’s 5 years later.

  • Candace Jackson

    I have such empathy for Tom’s parents. As a NAMI Family to Family Teacher, support group facilitator and former NAMI CA State Board Member, I see this problem all of the time. In fact, my co-teacher can’t get his own son to be considered for LPS Conservatorship. It’s not that he doesn’t know and understand the mechanics of attaining the conservatorship.

    My co-teacher has tried everything during his son’s inevitable hospital stays to get him recommended for LPS Conservatorship. Every time he thinks he’s getting somewhere they discharge his son. Consequently, he is now living behind the dumpster of the local health food store.

    The problem lies in the fact that this young man is the poster boy for medication. They give him medication in the hospital and of course, he presents beautifully in about 10 days. Because they pick him up on the streets they release him back to the streets. Of course the first thing he does upon release is throw away his meds.

    I feel extremely fortunate in the fact that my son was recommended for LPS Conservatorship while he was in the hospital after his first really big break. I was told at the time that it would be almost impossible to attain. However, my son was in such bad shape that his conservatorship was approved immediately. Thank you God!!!

    Only last Fall did I decide not to renew his conservatorship. He is at a wonderful board and care in Bakersfield. He has THE best care that anyone could get. My son told me that they treat him like family there. He always takes his meds, so that isn’t an issue. He is now so set in his regimen that I felt confident that he would make no rash changes, which he hasn’t. Most people with brain disorder find change extremely stressful. This horrible brain disorder sometimes forces us to lower our expectations. We’ve learned that the hard way.

    I am one of the fortunate parents and for that I am so thankful. Unfortunately, until a cure comes along he is stuck in a rut and is quite stagnate. However, I count my blessings that he is finally stable. For some people like my son, stability is as good as it gets.

    However, for the most part, the system is failing us all over the US. We need to change this from the local level all the way up to the National level. Join NAMI, if you haven’t yet and help us change the system. http://www.NAMI.org

  • Candace Jackson

    I have such empathy for Tom’s parents. As a NAMI Family to Family Teacher, support group facilitator and former NAMI CA State Board Member, I see this problem all of the time. In fact, my co-teacher can’t get his own son to be considered for LPS Conservatorship. It’s not that he doesn’t know and understand the mechanics of attaining the conservatorship.

    My co-teacher has tried everything during his son’s inevitable hospital stays to get him recommended for LPS Conservatorship. Every time he thinks he’s getting somewhere they discharge his son. Consequently, he is now living behind the dumpster of the local health food store.

    The problem lies in the fact that this young man is the poster boy for medication. They give him medication in the hospital and of course, he presents beautifully in about 10 days. Because they pick him up on the streets they release him back to the streets. Of course the first thing he does upon release is throw away his meds.

    I feel extremely fortunate in the fact that my son was recommended for LPS Conservatorship while he was in the hospital after his first really big break. I was told at the time that it would be almost impossible to attain. However, my son was in such bad shape that his conservatorship was approved immediately. Thank you God!!!

    Only last Fall did I decide not to renew his conservatorship. He is at a wonderful board and care in Bakersfield. He has THE best care that anyone could get. My son told me that they treat him like family there. He always takes his meds, so that isn’t an issue. He is now so set in his regimen that I felt confident that he would make no rash changes, which he hasn’t. Most people with brain disorder find change extremely stressful. This horrible brain disorder sometimes forces us to lower our expectations. We’ve learned that the hard way.

    I am one of the fortunate parents and for that I am so thankful. Unfortunately, until a cure comes along he is stuck in a rut and is quite stagnate. However, I count my blessings that he is finally stable. For some people like my son, stability is as good as it gets.

    However, for the most part, the system is failing us all over the US. We need to change this from the local level all the way up to the National level. Join NAMI, if you haven’t yet and help us change the system. http://www.NAMI.org

  • Liz

    I wish I could see the good news but as the letter-writer mentions “home” is problematic. Our son has been here over a year now after a stay of 5 months in jail and my husband and I are his only caretakers. I have gone to my local mental health organizations for advice and always try to follow their lead but am truly frustrated with it all. Regarding peer support specialists, they are widely touted here but actually inaccessible or unavailable. We are constantly met with this question “Does your son want help?” and “Sometimes they have to fall hard!” Double jail time for failing to return to the community corrections facility where he was allowed to leave to seek therapy or work -HA!!!! When you are severely mentally ill, this is CRAZY and we told our kind lawyer such. Our son has fallen hard, we are picking up the pieces though we can not seem to put them back together again nor access anyone locally who can or will try. Yes, I have gotten him on disability and he receives supplemental as well and I am told this is a good thing but he is still really isolated here with us and we are tired. Parents stick by their kids but I do not kid myself that I am helping him toward independence and if we readmit him fear he will only leave again. I spoke with a local judge when I volunteered at a NAMI dinner for the SPMI folks in our community before Christmas and she could offer no help.
    Why would I want to let him wander the street where he could be victimized and I no longer delude myself that there is a system of help which is functional. At least at home he is safe though it is such a struggle.

  • Liz

    I wish I could see the good news but as the letter-writer mentions “home” is problematic. Our son has been here over a year now after a stay of 5 months in jail and my husband and I are his only caretakers. I have gone to my local mental health organizations for advice and always try to follow their lead but am truly frustrated with it all. Regarding peer support specialists, they are widely touted here but actually inaccessible or unavailable. We are constantly met with this question “Does your son want help?” and “Sometimes they have to fall hard!” Double jail time for failing to return to the community corrections facility where he was allowed to leave to seek therapy or work -HA!!!! When you are severely mentally ill, this is CRAZY and we told our kind lawyer such. Our son has fallen hard, we are picking up the pieces though we can not seem to put them back together again nor access anyone locally who can or will try. Yes, I have gotten him on disability and he receives supplemental as well and I am told this is a good thing but he is still really isolated here with us and we are tired. Parents stick by their kids but I do not kid myself that I am helping him toward independence and if we readmit him fear he will only leave again. I spoke with a local judge when I volunteered at a NAMI dinner for the SPMI folks in our community before Christmas and she could offer no help.
    Why would I want to let him wander the street where he could be victimized and I no longer delude myself that there is a system of help which is functional. At least at home he is safe though it is such a struggle.

  • Peggy

    After numerous stays in the local hospitals my son finally made it into a state hospital for a four month stay. What a blessing. He attended classes daily from about 8:00 to 3:00 learning about his illness, how to stay well and various other things. This opportunity to have him on medication for a long enough period for him to see more clearly that he needed it to function made all the difference. It has been 3 years since he left that hospital and has not been hospitalized since. There have been a few scares that it might happen but everything worked out. I do agree that sometimes “stable” is the best I can ask for—he has done really well at times and not so well others, so STABLE is good! I pray for all of those living with mental illness and for their families! God Bless!

  • After numerous stays in the local hospitals my son finally made it into a state hospital for a four month stay. What a blessing. He attended classes daily from about 8:00 to 3:00 learning about his illness, how to stay well and various other things. This opportunity to have him on medication for a long enough period for him to see more clearly that he needed it to function made all the difference. It has been 3 years since he left that hospital and has not been hospitalized since. There have been a few scares that it might happen but everything worked out. I do agree that sometimes “stable” is the best I can ask for—he has done really well at times and not so well others, so STABLE is good! I pray for all of those living with mental illness and for their families! God Bless!

  • Deb

    I recently (4 months ago) experienced a suicidal episode, my first relapse in 5 years. The hospital experience between the two hospitals was night and day. The first focused on a day patient program for those of us who were capable of daily care and lasted for several months.

    The second hospital where I was placed on a 72 hour hold- and all they were focused on was the discharge. Worse yet, my friends, who have always seen me as high functioning, didn’t understand how long it would take me to recover, so I was under a lot of pressure to get a job, find a place to live (I was financially depleted.), have had to live with different friends- some of whom don’t know about my illness and try and juggle getting contract work.

    It’s all working out, and I found a great resource through a peer-run organization, Mental Health America’s “We Can” program. (link below) I took a one-day class on the Wellness Recovery Action Plan. (link below) The program and the plan WRAP, are helping me and my friends prevent further serious episodes and how things will be managed if I am hospitalized.

    We Can of Colorado
    http://www.wecancolorado.org/

    Wellness Recovery Action Plan http://www.mentalhealthrecovery.com/aboutwrap.php

    I hope this is helpful for everyone!

  • Deb

    I recently (4 months ago) experienced a suicidal episode, my first relapse in 5 years. The hospital experience between the two hospitals was night and day. The first focused on a day patient program for those of us who were capable of daily care and lasted for several months.

    The second hospital where I was placed on a 72 hour hold- and all they were focused on was the discharge. Worse yet, my friends, who have always seen me as high functioning, didn’t understand how long it would take me to recover, so I was under a lot of pressure to get a job, find a place to live (I was financially depleted.), have had to live with different friends- some of whom don’t know about my illness and try and juggle getting contract work.

    It’s all working out, and I found a great resource through a peer-run organization, Mental Health America’s “We Can” program. (link below) I took a one-day class on the Wellness Recovery Action Plan. (link below) The program and the plan WRAP, are helping me and my friends prevent further serious episodes and how things will be managed if I am hospitalized.

    We Can of Colorado
    http://www.wecancolorado.org/

    Wellness Recovery Action Plan http://www.mentalhealthrecovery.com/aboutwrap.php

    I hope this is helpful for everyone!

  • Scott Callison

    I was first diagnosed with Bipolar Disorder when I was 24. I’m 33 now and experienced my 4th hospitalization in April 2008. What led up to that was the classic mistake of stopping taking my medication. I went 2 years without pills and figured I had the illness beat, but now I realize that I can’t beat it, I can only understand it. I am on a combination of Geodone and Lamictal now and amholding down a job as a branch manager for a credit union in Florida. I have been with the company for almost 4 years and my future looks bright. The care I received in psych wards of hospitals in Pennsylvania and Florida have been positive ones. I found a psychiatrist that specializes in Bipolar. I consider myself lucky and encourage others with mental disorders (and their family members) to remain hopeful. Thanks, Pete, for starting this blog and tell Steve I say hello.

    • Barb

      Scott, it’s Steve’s mom. His wife is from FL, Daytona Beach. Where are you in the state?

  • Scott Callison

    I was first diagnosed with Bipolar Disorder when I was 24. I’m 33 now and experienced my 4th hospitalization in April 2008. What led up to that was the classic mistake of stopping taking my medication. I went 2 years without pills and figured I had the illness beat, but now I realize that I can’t beat it, I can only understand it. I am on a combination of Geodone and Lamictal now and amholding down a job as a branch manager for a credit union in Florida. I have been with the company for almost 4 years and my future looks bright. The care I received in psych wards of hospitals in Pennsylvania and Florida have been positive ones. I found a psychiatrist that specializes in Bipolar. I consider myself lucky and encourage others with mental disorders (and their family members) to remain hopeful. Thanks, Pete, for starting this blog and tell Steve I say hello.

    • Barb

      Scott, it’s Steve’s mom. His wife is from FL, Daytona Beach. Where are you in the state?

  • This is some valuable information, I just wrapped up my paper for school and think i may need to bookmark or save this for the second class lol. You may have just made me a regular :)

  • This is some valuable information, I just wrapped up my paper for school and think i may need to bookmark or save this for the second class lol. You may have just made me a regular :)

  • Marti C

    Our son told me at 5 am on Christmas Day that it was ‘time’ for him to move out. He is 26, and was diagnosed bipolar 2 1/2 years ago. We had been concerned about his behavior for a few weeks, but each time we thought he might be on his way into another manic episode, he seemed to normalize again, and we hoped he would get through it.

    Christmas Day was the beginning of another roller coaster ride that is finally (Jan 13) slowly winding down. He had to be taken by the police to the county hospital two days after Christmas. They kept him for a few days, then decided he didn’t ‘meet criteria’ (a danger to himself or others) and discharged him.

    This episode was so much worse than in the past that we could not take him back into our house. He had destroyed things, including smashing the windows on his dad’s truck, and stealing things from both our house and the office, where he had been working for over a year.

    He told the doctor he had a friend he could stay with, but didn’t. After two days of driving from place to place, agitated, grandiose (he is ‘Jesus Christ’ when he’s manic), alternating between euphoria and abusive anger, bringing homeless people into our home and office, the police took him back to the county hospital.

    Each of his three episodes have gone like this, there are phases before he gets help:

    Phase 1: He’s on the street, and while to us he’s obviously a danger to himself and others, when the police come, he calms down instantly, and they can’t do anything. Finally, either he does something that is harmful in some way, or we have called so many times they begin to believe us, and they pick him up and take him to the Psych ER. (We have no insurance.)

    Phase 2: The ER doctor has to be convinced that he ‘meets criteria’ by his behavior. Our son, being an adult (even though he is a mentally ill adult, and therefore can’t necessarily make rational decisions), can decide not to sign the paper so that the doctor can ask for our input. If he meets criteria, he is admitted to the inpatient facility at the county hospital.

    Phase 3: If he makes it this far, he has to (again, with a new doctor) meet criteria, and a judge has to sign a commitment paper to send him for long term treatment. All this time, he is delusional, and we know he is not stabilized, but they don’t know him between episodes, and can’t ask for our input until he signs the permission form.

    Phase 4: If all the above steps are completed, and we are all very, very lucky (from our experience, it usually takes more than one admission and discharge cycle before he gets to this point in the process), he is transferred to the state hospital, where he still may be discharged too early, but there is the possibility that he can receive real help and be stabilized on his meds before discharge.

    We are just entering Phase 4 this time around, and now we have to find a way to convince the treatment team at the State Hospital not to discharge him.

    Our son is very smart. He knows what to say, as soon as he starts coming down from the mania, he can convince almost anyone that he can function, but he can’t. He has done drugs (mostly marijuana) since early teens, self medicating, we are sure, but this time, he got into methamphetamines, and says he has been addicted for the last few months, so there’s a new factor.

    He crossed a line with his behavior this time that we aren’t sure how to deal with when he does get out. He’s always lived at home, and hated it because he’s dependent on us. He wants to move out, but since his first episode has had to work for his dad’s roofing company, has only recently paid off his debts for the previous episodes, and had any money left over at the end of the month. If he doesn’t realize and take responsibility for his mental condition, he could end up on the street. We know we can’t do this, he has to, and would appreciate any advice from anyone who might have ideas.

    Thank you.

    • Marti C

      Actually this is a quick follow up. I spoke too soon. Our son thought he was being transferred to the state hospital, but the doctor had only told him that was a possibility. They are planning to discharge him Friday. He is not ready for discharge.

  • Marti C

    Our son told me at 5 am on Christmas Day that it was ‘time’ for him to move out. He is 26, and was diagnosed bipolar 2 1/2 years ago. We had been concerned about his behavior for a few weeks, but each time we thought he might be on his way into another manic episode, he seemed to normalize again, and we hoped he would get through it.

    Christmas Day was the beginning of another roller coaster ride that is finally (Jan 13) slowly winding down. He had to be taken by the police to the county hospital two days after Christmas. They kept him for a few days, then decided he didn’t ‘meet criteria’ (a danger to himself or others) and discharged him.

    This episode was so much worse than in the past that we could not take him back into our house. He had destroyed things, including smashing the windows on his dad’s truck, and stealing things from both our house and the office, where he had been working for over a year.

    He told the doctor he had a friend he could stay with, but didn’t. After two days of driving from place to place, agitated, grandiose (he is ‘Jesus Christ’ when he’s manic), alternating between euphoria and abusive anger, bringing homeless people into our home and office, the police took him back to the county hospital.

    Each of his three episodes have gone like this, there are phases before he gets help:

    Phase 1: He’s on the street, and while to us he’s obviously a danger to himself and others, when the police come, he calms down instantly, and they can’t do anything. Finally, either he does something that is harmful in some way, or we have called so many times they begin to believe us, and they pick him up and take him to the Psych ER. (We have no insurance.)

    Phase 2: The ER doctor has to be convinced that he ‘meets criteria’ by his behavior. Our son, being an adult (even though he is a mentally ill adult, and therefore can’t necessarily make rational decisions), can decide not to sign the paper so that the doctor can ask for our input. If he meets criteria, he is admitted to the inpatient facility at the county hospital.

    Phase 3: If he makes it this far, he has to (again, with a new doctor) meet criteria, and a judge has to sign a commitment paper to send him for long term treatment. All this time, he is delusional, and we know he is not stabilized, but they don’t know him between episodes, and can’t ask for our input until he signs the permission form.

    Phase 4: If all the above steps are completed, and we are all very, very lucky (from our experience, it usually takes more than one admission and discharge cycle before he gets to this point in the process), he is transferred to the state hospital, where he still may be discharged too early, but there is the possibility that he can receive real help and be stabilized on his meds before discharge.

    We are just entering Phase 4 this time around, and now we have to find a way to convince the treatment team at the State Hospital not to discharge him.

    Our son is very smart. He knows what to say, as soon as he starts coming down from the mania, he can convince almost anyone that he can function, but he can’t. He has done drugs (mostly marijuana) since early teens, self medicating, we are sure, but this time, he got into methamphetamines, and says he has been addicted for the last few months, so there’s a new factor.

    He crossed a line with his behavior this time that we aren’t sure how to deal with when he does get out. He’s always lived at home, and hated it because he’s dependent on us. He wants to move out, but since his first episode has had to work for his dad’s roofing company, has only recently paid off his debts for the previous episodes, and had any money left over at the end of the month. If he doesn’t realize and take responsibility for his mental condition, he could end up on the street. We know we can’t do this, he has to, and would appreciate any advice from anyone who might have ideas.

    Thank you.

    • Marti C

      Actually this is a quick follow up. I spoke too soon. Our son thought he was being transferred to the state hospital, but the doctor had only told him that was a possibility. They are planning to discharge him Friday. He is not ready for discharge.

  • Patty

    If you want to send a relative to a state hospital, check with NAMI first or other people in the know. Some state hospitals are really subpar.

    I was in a state hospital fora few days because of a medication reaction and all the community hospitals were full. Some of the staff were very abusive, honestly, I wonder if they had personality disorders, because they enjoyed having power over the patients and tormenting them. The level of training of staff was much lower than that in community hospitals. The more trained staff (with at least a 2 year nursing degree) NEVER came out of the glass booth except for a brief 5 minute conversation daily. I am in Minnesota, a state that probably puts more funding into public mental health care than most and it was this way. A psychiatrist told me that the people who got fired from the community hospitals often got hired on at the state hospitals. They've gone to 16 bed units in the past few years, and I have heard they are a big improvement over the larger state facilities, which there is only one of those left. In that facility, they were allowing women with problems such as severe mania to trade sex for money for chocolate bars. The staff KNEW. Hmmm, good place to put your spouse or other relative when you are trying to protect them from the consequences of full blown mental illness. So check it out, before you put your relative in a state hospital. I still haven't gotten over the abusiveness of those women, and it's 5 years later.