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Mentally Ill Daughter

Question:

My 39 year old daughter is mentally ill and non-compliant with medications. She has had approximately 17 psychiatric hospital admissions, and 7 suicide attempts. She has had the Diagnosis of: Schizoaffective disorder, Schizophrenia, BiPolar,and Borderline Personality Disorder. She takes her medications sometimes but then does her own self prescribing because of the side side-effects. Then, she just goes off the wall.

She has horrible anger and rage towards me. One of the reasons was because I supported her son’s father and his wife to gain full living custody. Her son was 8 at the time and he is now 18 and doing great!!

My daughter now lives with my husband and I and is very isolated. She is again hearing voices through the TV, radio and computer. We have no control over her behavior. She goes into horrible, irrational anger rages towards both of us, but she it’s worse towards me. She won’t listen to us or go to Therapy or to a doctor.

Our experience has been that, if I call Mobile Crisis, they take her to the ER, but, if she’s not suicidal or homicidal, they won’t admit her. My husband doesn’t want to “kick” her out because she has no money and no place to go. We are both elderly and feel so trapped. We worry about what will happen to her after we are gone. We are members of NAMI and all we get from them is a lot of compassion.

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Answer:

It is interesting that the Emergency Room will not admit your daughter to the psychiatric unit of the hospital because she is not suicidal or homicidal. That is surprising under the circumstances and after all you describe. I can’t help but question whether or not the correct explanation is being used when you call the Mobile Crisis Unit.

It is true that most hospitals are reluctant to admit patients when the judge that things can be handled at home. Hospitals stays are very expensive and, like most people who are on Medicaid, reimbursement are small. However, in psychiatry, once a real danger is seen, there is little hesitation to admit. So, why aren’t they admitting her and what can you do?

What I am about to explain is my opinion because these things can vary from one state to another. First, when you call 911 or Mobile Crisis, it is important to report that she is being assaultive to you and your husband. That is the clear truth. Her unchained rage and verbal abuse are assaultive behaviors. Her behaviors put you at risk of being harmed by her. Somehow, I doubt that the ER doctors are clearly getting that information. The fact is that, if they send her home and you are she harms you, they are liable for the consequences and no hospital wants that. You must understand that her rage and verbal attacks are very serious and threatening.

In addition, if they for some reason, do not admit her, call the police or call the police the next time she behaves that way. In the end, the police will bring her back to the hospital and they will have to admit her. It could be that the ER doctors will be more worried if the police bring her in. By the way, the ER must be informed that she is non compliant with medication.

Two more items: First, it would be better if you and your husband go to the ER in order to make it clear to the doctors just how uncontrollable her behavior is. When they interview her, she probably makes it seem as though all is fine. Like many of these patients, she had learned how to hide the truth. Second, you can make it clear to the ER doctors that you cannot take her home. In fact, even if she is admitted to the hospital, you can let it be known that you cannot let her come home. It’s OK because they will find a safe living situation for her and with other patients in her situation and with mental health supervision for them.

Again, make it clear to the ER that she is uncontrollable and that she cannot live with you any longer. They are legally bound to do the right thing.

I hope my opinions are correct. In some states it works this way but I cannot vouch for all states.

Best of Luck

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Comments
  • distraught parent

    In Tennessee, that procedure does not work. With my daughter, they would release her with a cab to the homeless shelter if I did not pick her up. She has been in the mental health system for years, schizophrenic, but if I say she is combative they simply call the police, and jail her for a weekend. She is never hospitalized for more then a day , due to I am told my state does not allow involuntary admission-she would have to agree to it. They stitch her wrist wound up , and then release her--reminding her to come to her out patient therapy. It is truly a sorry system. I suppose they will involuntary admit her, only after she kills us.

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