(11- 27-17) I constantly receive emails from parents frustrated because they were unable to get their adult children hospitalized. Here’s one from a mother who ran into the opposite problem recently when she sought help from a psychiatrist who works for Kaiser Permanente.)
Dear Pete,
My adult daughter experienced a traumatic event at college. Her grades began slipping, she started losing weight, she had trouble sleeping and she was on the edge of tears or crying continuously. She told us that she had suicidal thoughts but that she did not think she would act on them.
As you can imagine, we were very concerned. We took her to see a psychiatrist at Kaiser Permanente, believing we would get help.
What happened was a nightmare!
She initially saw the psychiatrist alone and then I was called into the room. The psychiatrist said he was very concerned about her and that he was recommending inpatient hospitalization or at very least attendance at an intensive 4 or 5 day a week program for several weeks.
I understood that my daughter had expressed some suicidal ideation and I completely understood the psychiatrist’s concern. However, I asked if there were less restrictive alternatives for her that would not be so disruptive to her life.
I explained that she had a very supportive family – a brother and older sister in the home, as well as, my husband who was retired and would be with her to help. I added that could adjust my hours at work, if need be, to insure that she was safe. I thought that we could – along with some medication and intensive therapy and support – provide her the oversight and monitoring that she would need to help her through this period. I explained that she wanted to return to at least some of her classes during this time. She was very worried about not attending classes. I saw this as a good sign – she was thinking about her future.
The psychiatrist said no. He insisted that she either go to the hospital or an intensive day program.
My daughter said she was afraid to go to the hospital and she did not understand what would happen at a day program. She also didn’t want to be out of school for days and fall behind. She started to become more upset.
Rather than taking time to explain and reassure her, or listen to me, he announced that he had other patients to see and that my daughter had to make up her mind within a few minutes, otherwise, he would force her into the hospital.
That escalated the situation even more, making my daughter more upset. I realized what was happening and tried to calm her down. This seemed to irritate the psychiatrist. I asked the psychiatrist for more information and more time. What was the rush? But he didn’t want to do that.
Because my daughter was an adult, he insisted that she make the decision and when she couldn’t, the psychiatrist told me that he was calling the local county crisis team to have them come and do an assessment for forced hospitalization.
That threat did not concern me because I knew our county only had one team and it couldn’t immediately come because of all the calls it receives.
He called and, not surprisingly, they said they could not come.
At this point my daughter was now completely upset – crying, rocking back and forth, and holding onto her head. The psychiatrist gave her one more chance to choose between the hospital or intensive day program and of course, she could not make that decision because she was so distraught.
How did he respond? He picked up the phone and called the police.
I could not believe this was happening but knew what would happen when the police arrived. The psychiatrist would have certainly been able to convince them that my daughter was a danger to herself because she visibly appeared to be in bad shape – in my opinion because the doctor had done everything possible to escalate the situation. I also realized that she would be taken to the hospital in handcuffs by the police. That would further traumatize an already traumatized young woman.
I stood up and told the psychiatrist that we were leaving.
He said we couldn’t do that and staff came down the hall to try to stop us, but we walked out and drove out of the parking lot at the same time as the police were arriving.
We went home, she calmed down, and when the police arrived at our home, she was calm. She told the police officer that she was okay and that it had been a misunderstanding. I confirmed this and the officer departed.
I cannot tell you how angry I was at the psychiatrist and at Kaiser. Even now, writing this, I am fuming.
What an outrage! What a way to treat a young woman who came seeking help. The help she received was a call to the police. Is this how we would treat a person with diabetes in crisis? I think not. And we wonder why people don’t want to go to MH services? I don’t wonder now. I completely understand it.
What if I was not knowledgeable enough to know what would happen when the police came? What happens to all those families who don’t understand and sit and wait for the police? What impact would handcuffs and hospitalization have had on my daughter?
Did he mark her as “non-compliant” in his Kaiser treatment chart? I bet he did.
Am I labeled in his notes as problematic parent who interfered with her treatment? I bet I am.
Did the psychiatrist do his job in his mind and cover his rear end? You bet he did.
Until we all acknowledge that our system is seriously flawed, until we stop using the police to manage mental health crises, until we acknowledge that the treatment of highly educated and highly trained professionals can be part of the problem, until we build a continuum of evidence based care that people want, until we begin to treat people in a compassionate, caring and helpful way where we truly listen to them and support them in their recovery – we will continue to have a system that seriously fails people in need and their families.
My daughter has slowly built her life back. She is living independently, working and taking a class towards her degree. I would not say she is out of the woods – she still suffers from depression and anxiety and some days are a struggle but she is getting help from someone other than that psychiatrist.
Thank you for sharing my story.
(I have chosen to withhold the writer’s name to protect the family’s privacy.)
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