Let's imagine, for a minute, that your child had an illness. It is a serious illness, enough so going to school has become very troublesome, so that they scream much of the day, so they don't sleep, so they are in obvious pain. Let's imagine this illness is physical, not what we call mental. Imagine that everyone agrees the child needs help, urgently. What would you do?
You'd probably go to the hospital. So let's picture a scene there. The hospital agrees you child is very ill, and needs longer term hospitalization to deal with this illness. However, there are very few hospitals around that treat this particular form of illness, and they are full. There might be an opening in a day, there might an opening in a week, there might be an opening in a month. It might be longer than that.
Let's say the hospital says, that despite the fact they themselves can't treat the illness, your child needs to stay there until there's an opening at the specialized hospital. You can't take them home and care for them there, even if you feel able to, because then you'll lose your place in line for the specialized care.
You are in the ER, being told this. There might be a room available at the hospital that can't treat your child but insists on keeping them there. Or there might not be, in which case you first must just stay in an ER room until a regular room is available. This might be for a few hours. Or it might be days.
When the room, essentially a waiting room, is available, you are moved there. And told your child can't leave that room, for any reason, until you get a bed at the specialized hospital. You aren't going to be treated there, aside from having your child's vitals taken every four hours. You are just going to wait. And while you wait, there is going to be someone posted in your room, someone called a sitter, who does just that, sits there around the clock watching you and your child, to make sure they don't leave the room.
Because there are so few openings at the specialized hospital, you wait and wait and wait. You wait there, despite the fact your child is very ill, just waiting.
When finally, finally, there is a space for your child (and the specialized hospital accepts them---decides they are the right age and sex and type of child they want, which is totally their decision and based on rules you aren't told), your child is moved, by an ambulance ride, to the specialized hospital.
When you and your child get to that hospital, you are told you have to leave them there, alone. You can visit, but there are very strict rules about your visits, what time they can be and how long they can last. But you breath a sign of relief. Finally, your child is going to get some help.
Except they aren't. The hospital houses them there until insurance will no longer pay for them to be there. Then they tell you the stay is over. They don't give you any advice for how to treat the illness at home. They don't talk to your child's school about how to treat the illness. They might give you a new medication, which might or might not help, but they don't follow up on if it does. When you take your child home, they are no better than when the whole ordeal started. You beg the hospital for at least some guidance. They send you a report with generic information, information you have long ago read on the internet. In places where your child's name is mentioned in the report, sometimes it's the right name, sometimes it's a whole different child's name, because the whole thing is cut and pasted badly.
And your child is home. Worse for wear, as are you. Stunned, overwhelmed, horrified. And you have learned one valuable lesson. Don't take your child to the hospital looking for help with this illness. Ever, ever again.
If you haven't figured it out, you are probably saying "That would never happen! Our society would never treat a sick child that way". But you probably have figured out this story is Janey's and our story, and the illness is not a physical one, but a mental one, a flare up of symptoms related to her autism. We lived this story. You can read about it starting with this entry ( here's the link ) There are a long series of them, giving pretty much every detail of the ordeal when Janey was 10, her six day stay as a "boarder" at Children's Hospital (starting with a day in the ER that stands out in my mind as the most hellish day of my life), and then her 18 day useless stay at a psychiatric hospital in Rhode Island.
I am thinking of all this because Janey is having quite a spike in her behaviors the last few weeks. At home, it's been tough but not critically tough. She's been screaming a lot, but not all the time, she's been sleeping quite badly, but there have been times she slept even worse. But at school, she's been screaming all day. She hasn't been like that since starting high school, and understandably, her wonderful teachers and team there are concerned and upset. Her teacher called yesterday to talk to me about it, and one of the ideas they've had is that she might need to be hospitalized in a psychiatric hospital to adjust her medication. In an ideal world, this would be a very reasonable idea. In our real world---well, let's just says the very idea of it sent me into a wave of post-traumatic stress that was...bad.
In the seven years since that awful day we went to Children's when Janey was in crisis, things have gotten worse and worse, by all reports, in terms of how "easy" it is to get a child mental health help in a psychiatric hospital. COVID, especially, has lead to an increase in need and decrease in beds. I've read so many horror stories of children being "boarded", the term for being held at a general hospital waiting for a psychiatric hospital, for long, long periods---sometimes many months. I will not ever take Janey to an ER for psychiatric help. It will never happen.
I would consider a direct admission to a psychiatric hospital for children if it were not the one she went to before. I know there must be better ones. We are told there is one in New Hampshire. We were told about that one back seven years ago---told it was one of only 2 in our area, which is a very big area, that could deal with children with severe psychiatric needs that also had severe developmental delays. We wound up at the other one. But from everything I understand, children are basically never admitted directly to such hospitals (or I won't say never, as I've learned over the years that if you know the exactly right people and have the exactly right means, things can happen for you, but we don't know those people or have those means).
It's been striking me, thinking about this all last night as I didn't sleep (and Janey didn't sleep, and she is home today, because school when she's in this state really isn't doing anyone, mostly her, any good), that the whole deal feels almost like a punishment. You have a child who needs help with the symptoms of mental illness? Well, we're going to show you just how we feel about that. We're going to put you and your child through hell for wanting that help. We are going to make any help out there extremely hard to get. We are going to show you that they have the "bad" kind of illness, not the "good" kind of illness that hospitals are really meant to treat. We're going to teach you to just shut up and bear it all, even if what you are bearing is seeing your child in anguish. I'm sure no-one is consciously doing this, but it's happening, anyway. Society is not putting its resources into helping those with severe mental illness.
And so---what do we do? This is long enough for now, but next time I'm going to write about my daydreams of a system that would actually help Janey and all the kids like Janey out there. Until then, we'll go on as we have gone on. We love our Janey more than words can say, and we will give her our best for the rest of our lives. That we can do, but the incredible person that is our sweet Jane deserves more.
