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 2 of a 5-part series, following Part 1. Part 3. Part 4. Part 5.
Getting Help
I froze for a few seconds, but once the pounding in my head stopped, I said, “Wait, what did you say?” He repeated himself. He was still tearful but very matter-of-fact about it. I stayed by his side and called my husband at work. “Hey, what’s up? I’m really busy. I’ll call you back.” “No, you need to come home now. It’s an emergency.”
I briefed him on his drive home. He reached out to a friend, a pediatric psychiatrist, for insight. We knew we needed to act, but where to start? Thankfully, she could see us right away. She talked to the three of us together. I couldn’t believe how straightforward my son was in articulating his desire to kill himself. I thought he might get scared. I expected him to deny or say he didn’t mean it. I was heartbroken. Then the psychiatrist asked to speak with our son alone.
When we reconvened, she told us, “I don’t think he is safe to go home. I think he meant what he said, and he’s smart enough to see that banging his head against his bed isn’t getting the job done. I am worried he will escalate.” I don’t think he is safe to go home. I knew this was a possibility, but hearing it was crushing. My child was not safe in our home with us, his parents, who have literally spent the last 9 years keeping him safe and well cared for. She explained to our son that she would like him to stay in the hospital for a few days. I was sure he’d resist, beg her not to make him stay. But, he was eerily calm as he replied, “Okay, let’s do that.”
The Process
When a physician determines a child is a danger to himself or others, they issue what is referred to as a Physician’s Emergency Certificate (PEC). A PEC requires the patient to be held until deemed safe. It is mandatory for the child to remain for inpatient psychiatric treatment. However, this doctor agreed to hospitalize my son under a Formal Voluntary Admission (FVA). We gave him to the hospital willingly, with an agreement for him to remain until cleared by the doctor. However, if we’d declined to have him admitted this way, the doctor was prepared to PEC him.
I was reeling. My husband, typically more emotionally reserved, sobbed. Our child had never even slept out before. How in the hell could we leave him here, to sleep alone in a hospital? The psychiatrist anticipated a stay of 5-7 days. The Children’s Hospital Behavioral Health Center was gorgeous. The staff is some of the best around. Still, this was not a regular hospital stay. Parents are not permitted to remain with their children. We would have assigned call times and an assigned 1-hour visit daily, but that’s it.
With the little bit of rational thinking, we were able to do, we concluded that no, we could not keep our child safe at home. He truly needed and wanted help. We had to put our fears aside and focus on our son so that he could get the help he so desperately needed.
A nurse practitioner did his physical exam and lab work while we signed the consents for inpatient treatment of Major Depressive Disorder. Security wanded him for contraband (any items that could be used to hurt himself or someone else), and a nurse cut the drawstrings from his shorts. We were asked to return with flip-flops since shoelaces were not permitted. If he agreed to use his Harry Potter book safely, a doctor might consider writing an order to allow him to have it.
We hugged our baby like we’d never hugged him before, our eyes filling with tears, and left him with a promise to return during visiting hours with the few items he was allowed. Our boy did not shed a single tear. The doctor commented that he seemed relieved to be here. He was relieved. How deep in it he must have been to understand that at nine years old, he needed help to the extent that he was grateful to be hospitalized. I can’t bear to think of how hard things must have been for him to get to this point, and I’d spend the next days wishing to trade places with him, anything to take his pain away.
You’re a very good writer. I’m studying to be a psychiatrist, and it really made me think about what patients and their families must go through.