Full disclosure: This post was written with the complete permission of my son. He has read it and approved its publishing. That said, we’ve chosen to publish it anonymously. This post is part 5 of a 5-part series, following Part 1, Part 2, Part 3 & Part 4.
He stayed 3 nights. Since a typical stay is 5-7 days, we were surprised to get the call. Initially, I felt relief, but it was quickly replaced with anxiety. I compare it to bringing home your baby for the first time. Remember leaving the hospital with your newborn and driving slowly? Remember wondering if you could do it alone without nurses right down the hall? It was like that. We had this new baby with complex needs. Could we protect him? He was so comfortable with his “brain on vacation” at the hospital. Would he feel good being back home?
I suppose most families have these concerns because when the psychiatrist called me, she added “And don’t worry, you’ll have a family meeting before discharge to discuss the next steps.” Three days seems like a short time away, like maybe normalcy would be easily achieved. When you go through something like this though, things are anything but normal.
The Family Meeting
I had so many questions during our meeting. How could we make sure our son, who was suicidal just days ago, wouldn’t feel suicidal again? How could we keep him safe and trust him to regulate his emotions when, moments ago, he could not? The first step was making our home physically safer. We learned that the number 1 method of suicide for children is medication overdose with Tylenol as the lethal drug of choice. The social worker asked if we had Tylenol in the house. When we said we did, she asked if we actually use it. “No, not really.” “Then get rid of it. Or, if you keep it, don’t keep more than 15 pills.” She told us to lock up all our other medications. Our kids are past the babyproofing stage where I worried about them eating Tide pods, so this would be an adjustment. She advised that, if we have guns, they needed to go. How far did we need to go with this? Would we be back to the gadgets that lock all the kitchen cabinets to keep crawlers out of cleaning products and poisons? What about electrical cords? Should our home be as safe as the behavioral health hospital?
My mind was racing. We would anything to protect our child, so if that meant living in a bare cardboard box, then that’s what we’d do. How could I protect him at school? The social worker sensed my frenzy and allayed my worries with her explanation. “We can’t protect kids from everything. If you try to babyproof his whole world, he’ll sense your worry, which will increase his own anxiety. Show him he can be trusted. Maintain open and often communication.” Essentially, make potential future suicide attempts more difficult. Locking up medications is realistic. Banning shoelaces is not. Thankfully, open communication was one thing we’d been doing right. After all, it was the open communication that brought us to this point, thank God.
Moving Forward to Overcome
Although most parents don’t generally discuss suicide with their 9-year-olds, we do now. Suicide. It doesn’t just roll off the tongue in casual dinner conversation. It does for us now. I worried about making him uncomfortable, but he owns the term. Just like private parts and sex, unambiguous and correct clinical terminology is imperative. We do daily check-ins and add, “Are you having any thoughts of suicide or wanting to harm yourself?” We learned that thoughts, however morbid they may seem, are okay while we work on things. We just all have to be on the same page about whether there is desire to act on thoughts. Suicidal ideation with intent and a plan is vastly different from suicidal ideation alone.
He sees his therapist weekly. He sees the psychiatrist biweekly for talk therapy and medication management. We’ve read two books together from the excellent What to Do series. His teachers are part of our village, checking in with him and making modifications per his new IEP. Hospitalization wasn’t a miracle fix, but it’s not meant to be. The hospital stay served to keep him safe emergently and stabilize him to allow us to eventually take back over. Though there is still much work to be done, we are learning daily and feel equipped to support our son going forward.