About Mental Health Emergency Services for Teens

While this post may seem to have most relevance for the parents of North Alabama, I think, sadly, the subject is hardly unique to this area, state, or region of the US.

Daniel Adamek, the father of the 15-year-old boy who streaked at a football game in late September and less than a week later committed suicide, held a press conference today in Huntsville, Alabama, to say that focusing on the events immediately preceding his son Christian’s death (likely “facing expulsion” and “legal complications,” as his principal announced on TV the night before the boy acted) “is a distraction from addressing the real problems.” He explained:

“We had been struggling for some time to get Christian through the pain of depression. The real issue here is why we could’t get the medical help he needed despite following every avenue we could.”

In his heartrending address Daniel Adamek said too that

“I’m asking that we do NOT make this story about any specific events or Christian’s particular challenges because those were his and we can’t fix any of that now.”

He’d like, I think, for Christian’s experience — and his family’s — not to be one that is repeated again and again. Here is a father who tried all the ways he knew to help his child, and the help he needed was just not there.

Daniel Adamek didn’t elaborate on his pursuit of help; to have addressed a press conference and answered questions must have taken enormous strength. To go through the whole futile search up on the podium under the lights — no.

So I don’t know the details of his journey, but I can tell you about what well could be a similar path as the Adameks considered or took.

Imagine that you live in Huntsville, AL, a fairly good sized American city, and the largest within a 100 mile radius.

ImageYour teen is very depressed, is talking seriously about killing himself, or perhaps you have even interrupted an attempt. This is an emergency, right? What would you do?

You couldn’t be faulted for taking your child to the Emergency Room of your local hospital, and the only hospital of any size for 100 miles in any direction, Huntsville Hospital for Women and Children.

You wouldn’t be unreasonable if you expected a Children’s Hospital to have a pediatric or an adolescent psychiatric ward. You would probably expect for there to be a pediatric or adolescent psychiatrist on call for the ER, too.

And you would be wrong and wrong again.

There is not a single psychiatric bed for a minor in Huntsville Hospital.

There is no pediatric or adolescent psychiatrist on staff.

So what happens?

A social worker is called in or a low-level intake counselor for Decatur Morgan Hospital West Campus (formerly Decatur General Behavior Medicine Center) over in Morgan county, Note, this is not a hospital. This is not even attached to a hospital, and is some 15 minutes away from the main hospital in Decatur.

There is not an MD on duty 24/7. The psychiatrist is a part-timer.

If your child is over 14 or 15, he has to voluntarily commit himself (unless he lands in the ER following a suicide attempt. Then he has the option of signing himself in, but if he doesn’t comply, an involuntary commitment will be sought by the hospital). Interestingly, although it is the teen who signs himself in as a voluntary patient, he can’t summon an administrator and sign himself out (and if he asks to, this will be a black mark on his chart).

If you decide to take the ER’s advice and have your child delivered to Decatur (and he will be transported by ambulance) sight unseen, what can you then expect?

He will be in a secure ward as long as your insurance benefits hold out.

You won’t see him or hear from him until after a family meeting with a social worker, so try not to have a crisis on a Friday.

Once you turn him over to the intake crew, you’re done. You won’t see his room or meet the nurses or techs directly involved in his care.

You’ll talk by phone with the psychiatrist for a few minutes once, maybe twice, but you will never meet him.

Twice a week you will be able to visit for an hour.

If he doesn’t break any rules, he will be able to call you for 5 minutes each night from the nursing station where there is no privacy.

When your child is released, you can expect perhaps a 3-week delay until his first follow-up appointment with a psychiatrist, assuming that the staff has managed to find one taking new patients on your insurance.

Adolescent psychiatrists are thin on the ground in Huntsville.

Later when your depressed child gets home, you will hear that there were some other kids in the place who were also depressed, but there will also have been a number there with serious anger management issues, many under court order. Your child will be able to describe for you various take-down techniques. You will hear about under-supervised, poorly trained techs who are in charge during the evenings and weekends.

But, yes, your child will be released to you alive. What will happen next is anyone’s guess. Maybe the oppressiveness will have a Scared Sane effect. Maybe your teen will come out vowing that the next time he considers suicide he’ll keep his plans well hidden, or the next time he attempts suicide, he will make damn sure he succeeds so he doesn’t end up in what amounts to little more than a detention center.

I think what Daniel Adamek wants us to know is that we don’t know what we don’t know.

After all, who among us gives thought to preparing ourselves for where we will go and what to expect if our child has a mental health crisis?


3 thoughts on “About Mental Health Emergency Services for Teens”

  1. Hello, I have a 16yr old that has mental health issues since he was little and my late husband passed away in 2014 and my son has been uncontrollable since the passing and his old doctor said that he might never get any better but he may get worse and he became physically and mentally and emotionally verbally violent to me and his little brother and to other people and himself, he hit,pushed me against the wall and pushed me down and I was hurting so much that I had to go to the doctor and she called the police and they took a police report and a couple days later he got violent to a case manager at a women’s shelter for abused women and she called the police and ambulance and they took him to the hospital and we sat in the emergency room for 2 days and then moved him to a room where we stayed a few hours and they gave him meds and sent him home and before he went to the hospital he was on lots of meds and now get gotten worse and I took him to a Swanson center and they said that he is to out of control that the state of Indiana won’t help us, they said that they can’t do anything until he kills someone and he already threaten me and my 14yr son that he will cut us up until we die.he has a nice person inside him and he has a demon inside him and he is listening to that demon, I can’t sleep because I have to protect me and my 14 yr old son, he needs to be put in a mental health hospital until he gets better because I have to deal with this demon that is inside of my son,and I can’t get anyone in Indiana to prosribe his meds and they don’t work and times I can’t get him to take his meds, he curse at me and my other son and threatened to kill us, my late husband made this person this way because everytime he has a acts up my late husband would give him anything he wanted so he would keep his mouth shut and I never gave him everything he wanted when he would act up,now he is very aggressive to me and my older son because I don’t give him everything when he wants it, I been trying for 2 years since my husband passed away and he keeps getting worse please I need help I was told from a friend to take him to Vanderbilt to ammit him in the mental hospital until he gets better, I fear for mine and my other son’s life if he lives with us with him being this way he is going to kill us or someone else or himself, he has ADHD,BIPOLAR, HE HEARS VOICESES,HE HAS A SEVER BEHAVIOR PROBLEM, I WAS TOLD THAT HE HAS NO SHORT TERM MEMORY, HE WAS BORN WITH PART OF A BRAIN, ALCOHOL SEMDEROM,EVERYTHING WAS DELAYED ON HIS DEVELOPMENT,(me and my husband is his guardian since be was 3 months old, know one will help me get help for him please send us in the right direction before it is to late… THANK YOU, RITA MANIGOLD

  2. […] 1. You can hope that the situation at Decatur Morgan Hospital West Campus (formerly Decatur General Behavior Medicine Center) over in Morgan County where Huntsville Hospital ships its psychiatric cases that come in through the Women’s and Children’s ER (and where those ordered by the Courts for psych evaluation land) has improved. See my previous post. […]

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