Taking Your Child to the Psychiatric Emergency Department

THINGS YOU CAN DO PRIOR TO GETTING IN THE CAR AND HEADING TO THE HOSPITAL

Making the decision to take your child to the emergency department for acute psychiatric care is gut wrenching.  At the time I wrote this, Ben has had five visits to psychiatric emergency rooms across four states and Jack has had one visit.

The contrast between taking your child to the emergency room for a broken wrist verses being manic or unsafe is STARTLING.

The purpose of this post is to share some things you can do prior to taking your child to the psychiatric emergency department in order to make the experience a little LESS TRAUMATIC

A separate post will speak to advocating for your child once he or she is admitted to the psychiatric emergency department.  And to clarify, the psychiatric emergency department is typically a separate area within your local hospital’s emergency room.

OUR FIRST EXPERIENCE

Before most of our trips to the psychiatric emergency department, I had a sense it was coming.  Our first trip was the most emotional and I was not remotely prepared for the process ahead of us.

When the time came, I called our preferred psychiatric hospital (I did a little bit of research on psychiatric hospitals in our state knowing that we were more than likely heading in that direction).  The women in admissions informed me we would need to go to our local emergency room.  She added that they would assess the type of care needed and that if psychiatric hospitalization was recommended, then the availability of pediatric beds determined which hospital he would be admitted to.  She then gently shared that in New Hampshire, at the time, there was approximately a five-day wait for a pediatric psychiatric bed.  During the wait, Ben would be confined to the emergency department either in a room or in the hallway.  She suggested we go to the neighboring state due to a shorter wait time for a bed.

Ben and I drove to the recommended hospital and started the admissions process.  Ben loves to read non fiction books, most have hard covers.  He also enjoys drawing and doing origami.  I packed a bag of his favorite things and threw in some clothes (what to pack … a story for a different post).

Once we arrived at the hospital we were escorted to a sparse room with an attached plastic bed and an attached plastic “couch”, both with rounded corners.  The walls had obviously seen their fair share of abuse.  There was a glass window looking into the nurses station.

The door to our room was locked.  To exit and enter the room, I needed to buzz staff.  We were immediately told we could not have the hard covered books, the note pad with the spiral binder, or pencils in the room (humm, potential weapons).  And that my cell phone was for emergency use only.

We ended up spending over 30 hours in this room with no entertainment. Ben was 8 years old.  I was not prepared.  It was pure hell!

Not all of our psychiatric emergency department experiences have been quite this extreme; however, there are similarities regardless of hospital.  The following is meant to a brain dump (yes, a little scary) on what I have learned after going through this process six times.  Specifically, some things you can do prior to getting in the car with your child that might EASE SOME STRESS.

BEFORE THE HOSPITAL VISIT:  GATHER INFORMATION

  • Do a little research on the various psychiatric hospitals within your area; know the options … how many kids per room, visitation hours, typical schedule during the day, what can the kids bring with them, will you have a dedicated psychiatric team or a rotating team, etc. … knowing this allows me to make a request for a preferred hospital or make alternative plans if my last choice is the only option.
  • Call your local community mental health organization to ask what the wait time is for a pediatric psychiatric bed within your state or region; your local emergency room may also be able to answer this question … knowing this helps me manage expectations, prepare my child, and ask for help from family and friends if needed
  • Ask your local community mental health organization what resources are available to you and your family as you go through this process; they tend to be a good source of information and support
  • Call your emergency room and ask them what items your child can have with them in the room (hospitals have different policies on this); make sure you state that you are coming in for ACUTE PSYCHIATRIC CARE

BEFORE THE HOSPITAL VISIT:  PREPARE WHAT YOU ARE GOING TO BRING

  • If your child is on medication, then bring it with you; I also bring a list of current and past medications including reasons for prescribing, doses, and any side effects … by the way, keeping a list like this is worth its weight in gold and greatly appreciated by psychiatrists
  • Bring phone numbers of your child’s doctors, therapists, and any others who could provide insight and should be kept informed … and don’t forget insurance cards
  • Consider giving your psychiatrist, therapist, school team, etc. a heads up that you are taking your child to the hospital
  • Bring a phone charger; this may be stating the obvious; however, I have forgotten to bring mine when in crisis … and don’t assume cell phones and devices are allowed in the room or that cell service is good;  I often need to go to the cafeteria to charge and talk
  • Have your child wear comfy clothes; however, nothing with a draw string (pending the hospital, they either replace that piece of clothing or cut the strings off)
  • Wear layers; emergency rooms are on the darker side and cold … and don’t forget to ask for the heated blankets – the one perk
  • Bring a change of clothes and basic toiletries for both you and your child … you could be spending days waiting
  • Bring your child’s story … you will be meeting with various medical and mental health professionals who will ask about your child’s history, what brought your child to the hospital, triggers and or important events leading to the trip to the emergency room … within the first few hours you are typically telling your story to medical doctors, psychiatrists, and social workers; these folks then determine next steps;  organizing your thoughts in advance may prove helpful
  • Finally, TAKE CARE OF YOU; bring provisions for yourself, the wait is long and stressful … I bring some magazines, tea bags, snacks, and sometimes my headphones to block out the noise when my child is sleeping

BEFORE THE HOSPITAL VISIT:  HAVE A SAFE PLAN FOR GETTING YOUR CHILD TO THE HOSPITAL

  • If your child is unsafe, in a rage, or tantruming and you CAN NOT safely bring them to the emergency department, then CALL FOR AN AMBULANCE
  • If your child is unsafe, in a rage, or tantruming and you CAN safely bring them to the emergency department, then call the emergency room prior to arriving and ask for help getting your child from the car into the hospital; you can also ask for a more private entrance … I have also pulled up in front of the emergency department and left my husband in the car with our son and asked the front desk for assistance
  • Finally, THINK ABOUT YOUR NEEDS, don’t go through this process alone … ask for help and support
This is one of those times that UPFRONT PREPARATION REALLY PAYS OFF

For me, there is nothing worse than not knowing what I am getting into, not being prepared to make the experience a little less stressful for my kids, and being under dressed and cold.  This is a hard process to go through, I hope the above makes it a little easier for you and your family.

Unknown-2.pngAdditional posts will speak to advocating for your child once he or she is admitted to the psychiatric emergency department, what to expect during a psychiatric hospitalization, and how we can prepare our kids to talk about their experiences and answer questions from classmates once he or she returns to school.

 RESOURCES

https://www.nimh.nih.gov/health/find-help/index.shtml

http://www.samhsa.gov/prevention

http://www.cdc.gov/mentalhealth/gen-resources.htm

http://www.mhresources.org/

https://www.mentalhealth.gov/

 

 

 

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