<p>I would like to hear from other parents of mentally ill students whose illness first appeared in college. Especially, I would like to hear from parents of students who were in denial about their illness and refused treatment. What was the response of the college? What did you do in order to get your child treatment?</p>
<p>Even though my daughter has had issues in the past, we never seriously considered the possibility of her becoming mentally ill at college. We now know how stressful freshman year is and how 18 is a marker age for the appearance of many mental illnesses. In hindsight, we should have done more while we had the legal right to get our daughter the help that she now refuses. Has anyone resorted to lawyers?</p>
<p>My daughter is a freshman at a small LAC. She started to spiral downward within the first two weeks of school. It took us a while to figure out that she was truly ill--not just subject to freshman stress or trying to break away from her family to forge her own identity. Her physician believes she is bipolar and in her second manic episode, her first being at the end of her junior year of high school.</p>
<p>My spouse and I have tried to get her help She refused. We have asked the college to require her to get help. They will not do so because she has not acted out in public and is managing to hold herself together with the help of a few friends. I do not believe that the college administrators understand serious mental illness. They are treating her symptoms as purely psychological. They do not understand that at this point her brain no longer is functioning at a rational level. She does not have the power to choose help.</p>
<p>All the medical professionals with whom I have spoken believe that our daughter is headed for a psychotic break unless she is assessed and receives the proper medication.</p>
<p>We are struggling to determine what to do next.</p>
<p>Contact competent legal counsel in your jurisdiction. There are involuntary commitment procedures that you can be ready to use (when appropriate). You need to be familiar with the in's and out's. Other than that, as parents you need to meet with potential mental health care providers and determine what she'll be looking at and what treatment would be covered under your insurance (assuming she's still on it). Remember yourself in this process. You'll need a little help, too. Good luck.</p>
<p>And BTW Bob, "resorted to lawyers" ? Well, after you try leeches what's left but us, right? Seriously - this is a time to keep cool. That wall really is brick. Recognize that reality and work around it. Keep the lines of communication open. Don't fret about little things. Let them go. I would guess it would be a bad time to make demands (school? What school?). Keep it together. Don't add to her stress. Sorry, that's all I've got for you except a shoulder squeeze and a pat on the back.</p>
<p>I have always liked to work cooperatively. I am not adversarial by nature. Also, I am patient and understanding of everyone's perspective. I think I used the phrase "resorted to lawyers" to mean turning to a more adversarial approach. My spouse and I are very calm, given the circumstances. We have been discussing the matter with the college for almost a month. They are not going to act until our daughter has that psychotic break...if she makes it that far given her increasing involvement in risky behaviors. So, what do we do now to save our daughter's life?
I have been told that the interpretation of privacy laws, etc. has been changing on college campuses since Virginia Tech. I am wondering what the range of responses have been from the colleges at which CC parents have had students.
I think when every parent sends a child off to college, they have to realize that they no longer can protect that child...that at some point every individual has to take responsibility for their own wellbeing. However, if medical professionals tell me that my daughter no longer has the rational capacity to take care of herself--do I sit back and say "well, the law says that she's 18 so she can self-destruct if she wants"?" The problem is that the law is reactive not proactive--we want to help her before the psychotic break. Not hope that she is alive afterwards.</p>
<p>I agree that adding to the stress is not desirable but I have seen parents deliberately do it in an ER waiting room that had an inpatient psych unit. They were determined to get their adult child admitted. They very quietly started verbally provoking their child. Their voices were low and I could not hear what they were saying but the adult child became more and more agitated. The louder he got the quieter his parents got. The child finally crossed whatever line it took for the watching intake social worker. The adult child was escorted by security to the inpatient unit where he could be held for 72 hours. I would not recommend this, but these parents evidently felt they had no other choice. I hope everything works out for your daughter.</p>
<p>Is there any hope of collaborating with your daughter's friends to stage an intervention? Perhaps, even in her very ill state, she might listen if Mom, Dad, and 3 friends sat her down and ALL expressed their concerns? If they are her friends they have likely noticed that something is up with her, and would likely be glad to help her parents help her.</p>
<p>Whew. My heart goes out to all of you. Since she is coping in a way that the college finds acceptable for the moment, I'd focus on gathering all the information and resources you can and consolidating your relationship with the college as collaborative parents who are interested in the good of everyone and the health of your daughter. There is strong evidence that avoiding each incident of full blown mania is important to the overall lifetime impact of the illness, so it may be important to educate the college about this. It is not a good idea to wait until psychosis happens. There is a lot of work being done now on preventive psychopharmacology and a skilled psychopharmacologist or psychiatrist will be a great ally. I'd give her every loving support you can and educate the school relentlessly in as non-judgmental, calm way as possible. It can be helpful to focus on the critical role of sleep in this illness. Sleep is something everyone needs and the general culture supports medication to regulate it and often clients will be willing to take medication to help with sleep (unfortunately that part is often really difficult with college kids!!!) In any case, find other parents who have been through this passage for support too. You can find resources through the NAMI website. Hang in there. Getting the diagnosis and some acceptance of it is the huge and hard part. Many, many successful adults have this diagnosis and live well with it, once they get to the acceptance phase. The college may need some serious education on this topic as it is still in the shadows for many.</p>
<p>I woulod recommend that you go to <a href="http://www.nami.org%5B/url%5D">www.nami.org</a> (national alliance for mental illness) as a resource. They have communties and they are a great resource for family members. I think you will be able to get some good information there.</p>
<p>Bob, I second the suggestion of working with the friends. I know a situation where the parents were in denial (not your case, thank god) and a couple of the friends were able to persuade the kid in trouble to go to a hospital ER and have himself evaluated... If you can talk to one or more of the friends and explain that you admire and respect their support for your daughter, and how important it is that they stand by her, but that sometimes all the love and friendship in the world can't take the place of professionals, meds, and an appropriate intake evaluation. You might want to remind them that if she were diabetic their support would not be enough... she'd need insulin and regular monitoring as well.... and that in this case she also needs professional intervention. They may be able to get her to a facility voluntarily. </p>
<p>Is the roommate involved? She may have observed behaviors that the other friends or college officials have not.</p>
<p>I am not a parent of a mentally ill student but I have often been in the position of talking to families of patients who refuse treatment. First, let me share my sympathy. </p>
<p>Usually there is little anyone can do unless the patient is a danger to herself or others, and this is largely defined by the jurisdiction you live in. Where I live involuntary hospitalization is difficult to make happen, and even that does not include involuntary medication. Even a 72 hour involuntary commitment is unlikely to be of long term benefit. If your daughter has a well defined mental health diagnosis, this should be thought of as the begining of a process. If it is not well defined, patience may be helpful. "Psychotic breaks" are hard to avoid if they are going to happen, so you needn't feel responsible. I think NAMI is a great idea, particularly if you keep in mind many members willbe patients themselves, who believe they should have the right to refuse "treatment". There was a time when families, doctors, or authorities could force treatment that was not in the patients best interest.</p>
<p>I would explore all options for treatment now, so that when the opportunity comes you are prepared. I had a college roomate with a breakdowna and I remember feeling helpless. You should definitely reach out to the roomate. </p>
<p>There is a great book that came out in 2007 written by a law professor with schizophrenia. She writes with amazing candor about the episodes and all she went through. It it a must read for you. It explains in part how a college student who is experiencing symptoms compensates and doesn't want anyone to know. Maybe there are some ideas there.</p>
<p>I do have experience with mandatory treatment and at least in California, it's not helpful because the holds are short and require very strong evidence of danger to self or others.</p>
<p>I think researchermom is referring to Elyn R. Saks, The Center Cannot Hold.</p>
<p>The take of the book might perhaps be summarized by this quote:</p>
<p>
[quote]
In England, treatment recommendations [for patients in psychiatric hospitals] were just that--recommendations. To leave a hospital, to stay in it, to take medications, to participate in group activities or not--they never forced any of it on me, and each time the decision was mine. Even at my craziest, I interpreted this as a demonstration of respect. When you're really crazy, respect is like a lifeline someone's throwing you. Catch this and maybe you won't drown.
<p>second the suggestion to seek experienced, professional wisdom from <a href="http://www.nami.org%5B/url%5D">www.nami.org</a> that will tap into wherever she lives now with a local chapter so you might make the bridge between your home and wherever she lives now.</p>
<p>As well the NAMI headquarters in Washington DC provides oversight and is a resource for local chapters.</p>
<p>My brother, who has survived bipolar disease now for 60 years, works for them and trusts them because they are client-oriented. ("client" is what you or i might call "patient")</p>
<p>My daughter has two close friends with mental illness. One is actively managing her illness with the help of her doctor and checking in when she feels a worsening episode. The other did not take her medication or check in. You can probably guess which one missed only a few days of school and which missed a semester. I agree that she should be actively managed. On the other hand, I agree with ADad that an element of respect is part of the package. I also agree with researchermom that some preparation of the roommate is in order. If the roommate is like my D, she probably has an idea something is not right. ( If you read the OP, he and his wife are past the roommate stage.) One of issues that might brought up in discussion with a student refusing treatment is that if they become a danger to themselves or others the college will make them drop out for a semester whereas a student who voluntarily enters treatment just takes sick time.</p>
<p>What exactly is she doing? Could it be you going off the deep end? After all, the school says she has not been observed to be a problem? Is she saving it all for you? </p>
<p>Without knowing what she is doing, how she is acting out or what harm she presents to herself and others, I can't tell if it's her or possibly you that may have an issue? </p>
<p>I'm sorry but some parents go off the deep end when the kids go away as well. </p>
<p>Ask the school counselors to touch base with her and let the school know your concern and ask them to keep an eye out with potential help. They aren't going to ignore you, but they are going to hog tie her either without due cause. </p>
<p>You could even ask your MD to contact the school's student medical services to keep an eye out. </p>
<p>I don't think anyone is going to jump without proof so what you're asking or upset about is unreasonable.... until she actually does something in front of somebody else.</p>
<p>Bob, I'm sure this is very frightening and frustrating for your family. You've been in touch with the college, and mention college administrators. I presume that you've also spoken to a psychologist or counselor at the Counseling Center. If not, give it a try. There is often a very fine line that separates when the college or the community can/cannot intervene to compel a student to be assessed against her will. Often and ongoing dialogue/consultation can occur between the counselor and parent, such that appropriate intervention can occur if/when that line gets crossed. As others have noted, if your daughter is threatening or engaging in serious self or other harmful acts, or if she is showing signs of psychosis and is unable to care for herself, there are laws that permit involuntary (if necessary) evaluation in a secure medical facility. Another angle the college may have is to use their judicial process. If your daughter is spinning out of control, she is likely to be disruptive to the campus community. (Usually, students suffering from a bipolar disorder create some turmoil). This is one area in which the college does have some control. This permits them to "reel her in," require her to get her behavior under control as a condition for remaining in school. They can suggest options for doing that and strongly urge evaluation/treatment. They might also share with her whatever options exist for a medical leave.
If your daughter is not to that point yet, that may actually be a good sign. It means that she is exerting some judgment and control over her behavior.</p>
<p>I appreciate all of the suggestions. However, my focus in posting was to ask other parents to share their personal experiences.</p>
<p>I have posted details of my own experience on another thread. We are not overreacting.</p>
<p>I have been in touch with NAMI family advocates from two counties, a mobile mental health assessment team, the clinical adviser for my health insurance company, the intake adviser for the hospital we'd like to take her to, the social worker involved in my daughter's adoption, my daughter's physician, and several therapists. All say my daughter is in danger given the behavior we have directly observed and what has been reported by her friends. (I realize that we are guessing at the diagnosis until she is assessed by a psychiatrist. She has already been tested for attention deficit problems--that's not the problem.)</p>
<p>Our daughter is able to hold her own in short meetings and she has friends who support her...as in get her to class and coax her to bathe and eat. She is very smart and able to pass her classes, although her performance has been slipping. So, the college does not feel it has legal room to do anything but wait. They have advised her of the support services that they offer. She does not think that she needs help. </p>
<p>Mental health professionals have told us that her behavior will lead to a psychotic break. At the end of her first episode, she had a psychotic break during which she tried to harm herself. (She went from lucid to completely out of it within a matter of hours.) My family was there and able to prevent this. She was hospitalized briefly. (We didn't know what we were dealing with, so we didn't have her evaluated at that time. We bitterly regret this now.) At school, she has a private room and is alone a lot. She is hostile and has broken off communication with everyone who loves her. She has few friends. We are very worried and do not seem to have many options other than to wait.</p>
<p>Again, I was hoping maybe another parent had been through this and might share their own experience. I was hoping there might be something we could still do that I have overlooked.</p>
<p>Bob. Please re-read my post. Seek competent local legal counsel. If you approached me with this problem in my county I could tell you what MY judge requires in the way of a "threat" and what evidence of that "threat" would be sufficient. I could even get what we call on this board a "pre-read" from the court administrator I have known for 25 years. I could also tell you the name of the ad litem likely to be appointed to represent the interest of your D. I could also tell you the name of a doctor the court often agrees with on issues such as these (and also those he doesn't agree with as often). I have no doubt there are attorneys where your D is that can do the same. </p>
<p>The law is the brick wall. Protection of her liberty, however painful it may seem to y'all at this time , is considered in making this policy choice to have that wall (in accordance with our Constitution) . It's not there by accident. It was built brick by brick by patient's rights advocates (and often for good reason). That's why the rules are so tough. </p>
<p>I'm not trying to argue with you about what you think "should be" the law. I'm telling you what it is. Not to be mean but you are just howling at the moon. (They'll be plenty of time to do that, too.) </p>
<p>Contact a competent, connected, experienced lawyer in the jurisdiction you will be taking action. Good luck, and hang in there.</p>
<p>Thank you, curmudgeon. I had already planned to call the NAMI family advocate on Monday, but was not too hopeful that it would help. Your post encourages me. We have been so confused because all of the mental health professionals are telling us that the college is not doing enough, but the college says otherwise. All I know is that the daughter we took to college is gone, and all that is left is a very sick young woman who no longer can decide what is best for herself.</p>
<p>Bob, make sure that "NAMI family advocate" is a competent, connected, experienced lawyer in the jurisdiction you will be taking action. Nobody else is likely to know what it is you need to know. All sorts of people can tell you what they think. You need somebody who did this for a client in that jurisdiction last Tuesday.</p>