What does hospitalization accomplish?

[almostvegan]

I know many of you have had to deal with hospitalization. We have come close to it but my daughters therapist always thinks it won't do anything fir her. Can you share your experiences please?

Thank you.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[heronbird]

Yes, good question I think.

Well, my BPD17, she has been in hospital many times over the last year. One of the things they first offered was a DBT programme for at least 4 months, however daughter declined ?

In UK, we have a different system, if under 18 my daughter goes into a private psychiatric hospital that is supposed to be the best, its paid for by NHS. Once she is 18, I am asking what they do in the local NHS hospital, and I will be finding out soon.

Now I have learnt over the last year that it makes my dd feel secure, she is locked in and has strict boundaries, it may make her feel safe and I think they like the structure. Did you ever hear that they like joining the army or some sort of cult often. It must be to do with rigid boundaries dont you think, Im not sure, havent read much on that.

My D could be admitted on a Friday and be sectionable, then on the Monday, back to normal and discharged. Then it helps her a bit I guess.

Also they can look at what medication she is on, change or increase it in a safe enviroment. The other thing is she sees a different consultant and he can discuss her with her P and put a different perspective on it, or her treatment.

I meta 52 year old pwBPD recently and she said she has a deal with the psychiatric unit that if she needs to go there for a few days she can, sometimes they just need it I guess.

Very interested in this topic, looking forward to seeing what others say

[Vivgood]

What does hospitalization accomplish?

It can save your life.

she has a deal with the psychiatric unit that if she needs to go there for a few days she can

There was an article recently that detailed the lives of several people who have serious mental illness yet function at a very high level... .a couple mentioned having similar arrangements. In that case, hospitaslization may not only save their lives, but helps keep them professionally and personally successful. Most unfortunate and short-sighted that this is not a regular practice.


vivgood

[lbjnltx]

We have come close to it but my daughters therapist always thinks it won't do anything fir her.

in hospital they can get:  medication evaluation, be kept safe (though it is temporary), be observed for a 24/7 period, possibly learn that they cannot threaten self or others without consequence, get referrals, get diagnoses.

therapuetically i don't think that any short term inpatient program will affect lasting postive change.  it takes a great deal of work over time to make real and lasting changes.

welcome almostvegan

lbjnltx

[thinking]

3 months at an RTC saved my dd's life. She would never had been able to make any progress if she hadn't been sent to an RTC. It was the best thing we ever did for her. Short term stays did nothing (week or less). The longer stayed allowed her Dr. to get her on good meds and give a real diagnosis. Well realish, can't call a minor BPD.

[almostvegan]

Yes I know if a person is under 18 they are not " technically" called BPD but my daughter meets the criteria and is being treated as such mostly because nothing else fits.

We all fear that she would ENJOY a hospital stay! No school, nobody to tell her what to do, she can stay in pajamas all day... .She has no fear of consequences. Or rather no concept. Even yesterday we were discussing something she had done and she said" well it's over so move on". Shes got no concept that actions build on each other and  repeat offenses are problematic.

Oh dear I'm rambling again. Sorry. Thanks for any insights.

Wishing everyone a stress free day.

[peaceplease]

Hospitalization will help a person get stabilized on meds.  Also, help to the family to get some rest.   

The hospital that I worked at, the patients did not sit around in their pajamas all day.  They had more structure.  There were scheduled groups, scheduled meal times, and they only had certain periods of time where it was free time.  They were seen regularly by the psychiatrist.    All of their acute needs were met.  And, if a patient chose not to attend group, then they were not permitted off the unit to eat, or to go out for cigarette breaks.(adults only for the cig breaks)

Hospitalization is good for crisis mode.  Residential is good for the long haul. Acute admissions are not going to cure a person, but it helps many in a time of need.  I have seen some psychotic patients gone off their meds, and they were a different person upon discharge. 

It all depends on the reason for admission.

[heronbird]

You can call a under 18 BPD now, if they have had the symptoms for over a year, they call it emotionally unstable BPD I believe. I just got it in writing from psychirist.

My BPD17 is currently in hospital again and she already feels better after only one day. They have a good structure in there and they wake them all up at 7.30 every morning, have a good regime for the day. They are taken out to cinema and gym. Sounds nice eh. But I think its important they know hospital is hospital and not home like if you see what I mean.

One time dd stayed in for 4 months, I thought that would make a difference because all the other times she only stayed for a month or less. It didnt seem to make much difference staying in longer. I think maybe a year would be better.

[jbmom]

I think it depends on where you go.

DD had her first hospitalization. It was awful. She received no help as the institution they recommended does virtually nothing on the weekends.I guess Mental Health takes a holiday -- every weekend.  They told she was going to get treatment, but all the did was "supervise" her, on some random scale. We consented to the admission because we were told she would get a full psyche work-up the next morning, started on meds, have some group tx, and 1:1 supervision. We received nothing of that.  The kids had the option not to go to group therapies and often they chose to watch a movie instead.

She learned a great deal -- new ways of self-mutilation (ie burning),  saw her roommate be assaulted by another patient, learned about lesbian and transgender behaviors, Saw her roommate go through a PTSD event and was threatened to have her face smashed in.  The supervision was lacking in that the another girl was able to sneak into their room. SO much for 1:1 supervision, I doubt there was much.

She is 13 yrs old, seems to have emerging BPD, they will not label her as she is still so young. It was a nightmare event, and yes the state has been called in to investigate the clinic. We were told   lies  from the screener through the admissions offices,to the nursing supervisors etc. We did get an apology from the director of the clinic... .but that that hardly makes up for the stress it caused. Complaints have been filed all-around to the screeners in our county too.   I don't think our family we will be the same for awhile after this incident.

My advice... .if you think you are going down the path to hospitalization start calling and investigating your options. We had to make a split second decision and were not given choices by the screeners -- kind of fed to this place. In the end we still don't think she got anything out of the hospitalization at all, and the place seemed to be a money making scam. Ie we requested her to be discharged - they said she would benefit from inpatient, we asked to transfer her to another place and then the suddenly agreed to discharge -- our take home message - she wasn't in need of overnight care, but they wanted to fill a bed.  A real learning experience of 'buyer beware'.

[heronbird]

Our first experience of hospital was the best hospital in UK apparantly, it was the best thing in one way because it gave us the diagnosis by one of the best Ps. After that, for the first time they started to listen to me re dd.

Hospital was so hard then for us, dd seemed to get attached to it, they didnt want her to stay, she had lots of problems there, its not nice really,  but hey, none of this stuff ever will be will it.

Well, my daughter was admitted into a adolessant unit yesterday, today she told me she has been diagnosed with ptsd, that makes sense because she has been through so much since last August.

So at least she feels safe there and they must know what to do.

Gosh, its a rest for me too, when my mobile rings now, I dont panic haha. I think I have ptsd too.

[kj]

I have this same question. SD13 has been in crisis treatment (72 hrs) four times in the past year. She was in a residential program for 2 weeks in 12/11. She is currently back in the same treatment center this week and they want to release her out after 72 hrs again since she is "stable". They have given us these options:  1) discharge her and continue with the current psychiatrist and counselor and meds 2) discharge her and try to find an oupatient DBT therapist to add to the mix   3) admit her to the standard 30 day residential treatment that does not include DBT but does offer group, one on one ect... 4) admit her to the 3-5 month residential  program that does offer DBT.   Insurance coverage is not currently an issue but the staff told us patients are often dropped by insurance during the DBT program and the family is left holding the bag.

So... .we are pacing the floors trying to decide.  Dh feels that placing her for 3-5 months will only exacerbate her abandonment fears and that she will never forgive him for "leaving her" .  She is so hard to handle on our own which is what we've tried to do for the last year.  If insurance drops her during the DBT treatment we would have to discharge her which could erase any progress she may have made.  Would part of a residential DBT program be better than nothing?

So many issues. Good and bad sides to all of them. It feels impossible to figure out what to do.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[jbmom]

Do you have partial hospitalization program nearby? We considered that for DD after her stint in the most worthless place ever. However at the end of the worthless weekend, we were told she wasn't there yet, and just to get her in with a DBT therapist - with more frequent visits.

Anyway I was given names of a few partial hospitalization places in my area. Never knew they existed. If we get to that point... .I think because of abandonment issues... .we would try partia;/day program before RTC. But then we are still feeling burned from our worthless inpatient experience (the bills just came in).

[heronbird]

We have had everything, from hospital for a week to hospital with DBT programme for 4 months. Nothing has been helpful really. One time she was put in a different hospital that freaked her out a hell of a lot, she cried frantically for the whole weekend, she begged the staff every 5 mins to let her go home. It killed me to hear her like that. I worried it would be so bad for her fear of abandonment. So I agreed to discharge. She promised me the world, said she would do anything I wanted and really be good. After that it went from bad to worse to te point of us trying to get her sectioned and they wouldnt do it. That was a horrible place to be in, she said we didnt want her thats why we were trying to get her sectioned so she left home to live on streets :'( that was so hard and sad. I felt like I lost her.

After two weeks of living on streets, she ended up drunk on a carpark roof nearly jumping, we managed to get her sectioned that time, and we said I dont care how much she is crying she can stay there for as long as poss.

[Abeula]

I've gained good insight from your comments.

When my BPD daughter was hospitalized I had no contact with the doctors as she was over 21 and she refused to have me down as next of kin, she would not allow me to visit her either. I nearly went off my head with worry and it turned her two older sisters into substitute parents as she let them have contact.

She's in DBT at the moment and has not been an inpatient for a year, she's allowing me contact now, this week she's been suggesting voluntarily going back into inpatient as she's finding all the basics too hard to manage, she won't move back with me, and I don't think it would work either, I also feel at a loss as to what is the best decision. This would be the first time she would not be there after a major crisis, and she is a little more receptive to therapeutic workshops etc so maybe... .but i never know with her what her motives are!

A

[lbjnltx]

group therapy of any kind for teens is beneficial... .living in a facility w/other teens who are workingon themselves 24/7 can be very beneficial... .a rtc that focuses on the family reunification w/lots of interaction (family therapy over the phone, family weekends, home visits, social calls) can be highly affective as well.  3-5 months may not be enough though... .we are talking about major change that requires much time and effort to solidify... .my d took 9.5 months and could have stayed another month but the money ran out.  today... .she is AWESOME!

lbjnltx

[jbmom]

lbjnltx... .how do you find a place like that?


DD's experience in short term hospital was worthless. No one wanted to get better, they just seemed to run away from the challenges. They opted out as a group from 2 of 4 sessions offered over the weekend. Prefering to watch movies, or just hang out.  That was my big issue... .nothing was done... .there was no positive role model for change.  It was a disaster.

I know you can google for RTCs or partial day programs... .but how do you really find one that works prior to losing a weekend, week, month and money.

[heronbird]

Hospital is a nightmare, but what else is there ?

I didnt like my dd being in the group therapies, all talking about how they want to kill themselves, hows that a good atmosphere?

They gave her tips in how to do it next time, take anti sickness tablets before you OD, nice eh.

In UK, they send her to top private hospital where all the celebs go. Its not that good, especially in adolessant unit, kids all rude to staff, kick walls and doors, smash windows, one even got in the meds room and took meds, they left it unlocked. They regularly break firealarms and run out, go to the local supermarket to buy food, while staff are phoning parents worried about them. As soon as they set fire alarm off doors unlock you see.

The staff get fed up, the night staff dont care, and dont have a clue.

The worse thing is, they change the rules all the time, dd cant cope with that.

When crying, they dont really do a lot either, guess shes just there to be observed and diagnosed. I think the doc there is good though.

[lbjnltx]

dear jbmom,

how do you find a place like that?

i searched the natsap website that lists all rtc's that are natsap certified and i started weeding them out according to my criteria which was:  gender specific

                                                           dbt offered

                                                           equine in high profile

                                                           group therapy daily

i learned alot about rtc's by looking at each rtc's website... .the different kinds of therapies they practice and how they function.  i narrowed it down according to my criteria and had to factor in cost as we were going self pay.  unfortunatly that is part of reality... .you may need to do the same based on insurance benefits, self pay, etc... .one thing i did not allow to affect my decision was location.  most of the rtc's are in utah because of their family friendly laws and guidelines.  it wouldn't do much good to send her to the closest one if it wasn't going to be able to help her.

if you are considering rtc for your child do some research, develope a criteria, weed through them all, spend a lot of time talking to the admissions staff, request a packet, ask for a list of references, call every one of them and spend time talking to them, ask very personal questions and be prepared to offer personal information to see if their child had similar issuess/diagnoses and how they are doing long term.  when you have narrowed down the list to 2 or 3 go and visit in person.  when i went to falcon the entire treatment staff set aside an 1.5 hours to meet w/me and my mom.  take with you anything that will give them insight into the severity/issues your child has.  and last but not least... .PRAY... .if you are a person of faith. i spent 2+months searching full time to find falcon ridge.

let me know if i can help you further

ps.  it won't take long to become confused when researching, i solved that problem by creating a form on the computer that had all the questions i wanted to ask and i would fill one out for each rtc that passed the mustard and deserved a phone call.

lbjnltx