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Jfoster99

Juvenile Mental Health commital

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A friend has a 16 year old daughter going to counseling. She is depressed, and had a friend from school commit suicide last year. On occasion she hears voices described as a muffled crowd in the distance.

 

She is not currently on any medication, has no history of suicide attempts, other then spending most of her time in her room while home, she has no outward suicidal indicators. she has active social life, tons of friends, good grades at school, desire to do even better to get into elite colleges.

 

The concern is today she told the therapist she sometime thinks about suicide but would never act on it. This set off alarm bell with therapist and parents were advised to bring her to Hackensack ER for evaluation by a psychiatrist. The psychiatrist is recommending a voluntary committal ( can last 3-7 day) and if parents refuse Deyfus(sp?) will be called to force them. She said if she is forced she will never speak to a therapist again.

 

The girls health and safety Is the main priority however, The psychiatrist sees no negative concerns with a committal and we know that is not true.

 

Do Juvenal committals follow you into adulthood? Any advise on voluntary or in-voluntary?

 

She has plans to become a police officer some day. Can this ruin her chances.

 

Any help or advice is appreciated

 

 

 

 

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I am not a doctor and I cant answer your questions

 

But that child needs help.  If is what you say is true.....  she is a slight push from hurting herself or others.

 

I dont care about the future, I care about the now.  Unless those parents want a corpse on their hands. 

Just let that sink in...I hear voices......   I think about suicide.....  let those things sink in 

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IANAL nor an MD.   But first and foremost she needs to get the help she needs. I am not qualified to judge whether a commital is appropriate or an over reaction on the part of the mental health professionals. I do really feel for the parents who no doubt are going through a difficult time dealing with their child’s problem.

With that said, and given the fact this is a gun forum, a few additional considerations.  If the daughter ever wants to purchase a firearm in NJ this will follow her into adulthood.  Refer specifically to questions 24 and 26 on the sts033 application.   Also, if the parents own firearms, I would seriously consider moving them out of the home and legally store them elsewhere (e.g. Gunsitters in Whippany, NJ) and do so ASAP.

 

 

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On 8/18/2018 at 8:29 AM, Jfoster99 said:

“I would seriously consider moving them out of the home and legally store them elsewhere (e.g. Gunsitters in Whippany, NJ) and do so ASAP. “

 

 

Good suggestion re: Gunsitters....

 

 

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Move any firearms out ASAP. With the new red flag mental health law the police might come for them even with avoluntary committal. 

https://legiscan.com/NJ/text/A1217/2018

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To me, this is a lot of red flags: Auditory hallucinations... a friend who committed suicide... suicidal thoughts... and a therapist (who presumably knows her?) concerned enough to refer to the ER.  I'll ditto what others said... her health (life!!) is the #1 priority! She needs a full physical and psychiatric work-up... leading to a proper diagnosis so she can get the right treatment, whatever that is. .

In-patient care may indeed be the best way to accomplish that and it would also help ensure her safety while that was happening (she'd be on "suicide watch" with people regularly looking into the room, she'd have no access to sharp objects, etc.). 

As for career options, honestly... you're talking about her very LIFE...under the circumstance, career is so far down the list of priorities, it's a non-issue as far as I'm concerned. 

Edit: 2 things...

1) if she's still at home right now while they're making this decision, they should do their own "suicide watch" at home and take some simple precautions (like asking her to keep her bedroom door open, disabling the lock on her bedroom door for quick access, and having someone else in the house 24x7, etc.. - better safe than sorry).

2) they should ask the hospital if they have a pediatric/adolescent psych unit. And if the answer is "no", they might want to ask which hospitals in their region DO have that... it might be an affiliated children's hospital. My parents both worked in the mental health field - I visited them at work (on rare occasions) as a kid and I can tell you... it could be VERY scary for a 16-year-old girl to be on a unit mixed with adults... especially if she were to see a large male patient "act out" and get taken down by the aides, for instance (which does happen on occasion). No sense scaring the living daylights out of the girl while she's already feeling vulnerable!  Might as well ask that quick question! It needn't delay admission to find the right place. And if she feels more comfortable wherever she's admitted, the experience will be better and there'll likely be less resentment on her part, too.

SENDING GOOD KARMA to your friends and their daughter!

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Working in a hospital emergency department for these types of circumstances, I have seen good therapists send people to an er when they can not safety plan with a person, and I have also seen bad therapists send people to the er because they do not know what to do.  Bad things can happen if left unchecked.  Safety first.

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On 8/18/2018 at 3:54 AM, Jfoster99 said:

The concern is today she told the therapist she sometime thinks about suicide but would never act on it. This set off alarm bell with therapist and parents were advised to bring her to Hackensack ER for evaluation by a psychiatrist. The psychiatrist is recommending a voluntary committal ( can last 3-7 day) and if parents refuse Deyfus(sp?) will be called to force them. She said if she is forced she will never speak to a therapist again.

i can not assert enough the dangers of forcing someone into care. i am not saying that they dont need help, but if you threaten childprotectiveservices you are potentially making everything worse for all involved. all parties involved need to tread lightly.

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If this was my daughter, the ER would not be where I would be looking for actual care.   She would spend some time somewhere but not involuntarily.  I would work with the therapist to find a place where we could take her for treatment other than getting an evaluation from an ER Psychologist who gets called in from home to do a hit and run evaluation.  The outcome will always be an involuntary commitment because to do any less puts the hospital at risk for not doing enough.

A close friend of mine was sent to the ER for an evaluation when she was 15 or 16.  She was rebellious but not mentally ill.  She was committed involuntarily (just like everyone who ever had an ER mental health evaluation).  Her parent's insurance covered 21 days of inpatient care for mental health.  She was diagnosed with several serious mental conditions but was miraculously cured on day 21 and sent home.

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On 8/18/2018 at 3:54 AM, Jfoster99 said:

 

A friend has a 16 year old daughter going to counseling. She is depressed, and had a friend from school commit suicide last year. On occasion she hears voices described as a muffled crowd in the distance.

 

She is not currently on any medication, has no history of suicide attempts, other then spending most of her time in her room while home, she has no outward suicidal indicators. she has active social life, tons of friends, good grades at school, desire to do even better to get into elite colleges.

 

The concern is today she told the therapist she sometime thinks about suicide but would never act on it. This set off alarm bell with therapist and parents were advised to bring her to Hackensack ER for evaluation by a psychiatrist. The psychiatrist is recommending a voluntary committal ( can last 3-7 day) and if parents refuse Deyfus(sp?) will be called to force them. She said if she is forced she will never speak to a therapist again.

 

The girls health and safety Is the main priority however, The psychiatrist sees no negative concerns with a committal and we know that is not true.

 

Do Juvenal committals follow you into adulthood? Any advise on voluntary or in-voluntary?

 

She has plans to become a police officer some day. Can this ruin her chances.

 

Any help or advice is appreciated

 

 

 

 

Sent from my iPad using Tapatalk Pro

 

The parents should immediately get a new therapist.... You don't send people to the ER if there isn't an immediate emergency as if the individual was saying they had a plan to act on it. The ER may evaluate the child, but unless she is having a mental episode, they will not admit her.

 

My Wife tells me they wont use the ER ever unless the individual shows an immediate danger to themselves or others. "thinking" about something does not constitute an immediate danger, talking about your plan to do it does.

There are a lot of fine lines here, but a good therapist will not be sending a patient to the ER because they feel a certain way, only when they think they are going to act a certain way.

IMO this is highly overreactive and unnecessary. Sending a kid like this into an inpatient setting can have SERIOUS negative side effects. 

 

******I would find a Psychiatrist outside of the hospital to do an evaluation. 

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They have decided to try out patient treatment first and reassess in a few weeks. The initial therapist and ER Dr. we both meeting her for the first time last week.. There was no immediate danger and the therapist should not have sent her to the ER...

She may still do a voluntary in-house but after spending a few sessions with someone who gets to know her.

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54 minutes ago, Jfoster99 said:

They have decided to try out patient treatment first and reassess in a few weeks. The initial therapist and ER Dr. we both meeting her for the first time last week.. There was no immediate danger and the therapist should not have sent her to the ER...

She may still do a voluntary in-house but after spending a few sessions with someone who gets to know her.

Good to hear.  It initially looked like it might be more appropriate for outpatient care as long as the clinician is not using inpatient and outpatient care interchangeably and for the same symptoms.  I recommend inpatient care when there are immediate safety issues and outpatient when there are none.  Some clinicians are good and some are not. 

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