I don’t understand what you don’t understand about mental health, but I do really think you need a little more education and training apparently. You see, a mental health crisis is just like a physical health crisis. Being sick impacts all of life and every single decision we make. When you are informed that one of your students is experiencing a mental health crisis, it sure would be nice if you took that seriously and actually helped the student, rather than adding to their stress and traumatizing the whole family by your actions.
It’s been two months since my son experienced a mental health crisis and while I’ve been busy on several fronts – finding him help, getting evaluations, starting treatment, fighting the school to understand mental health, demanding emergent IEP meetings, finding an advocate, demanding better IEPs – it has taken me awhile to process everything that happened and to share it.
The reason that I do share this personal story is to encourage other parents who may be going through similar situations and to offer support for those facing scary times, heart-wrenching times, frustrating times, and to provide hope. I thank those who offered me hugs and advice and hope over the past two months.
Laying beside one’s sweet growing boy in bed at night listening to him ask if kids his age (newly 12) commit suicide is agonizing. “Yes. They do,” I respond. It’s been a few hours since he talked about jumping out of the window to end his life. We’ve driven down to the psychiatric hospital but were not ready to go in. We’ve talked to someone on the crisis line. We talked about his big sadness. We’ve talked about hurting.
And, we’ve talked about the fact that he can get some help and that he will feel better. But right now it feels pretty awful and it feels pretty overwhelming. And it feels pretty surreal, like something that happens to other people but I wasn’t expecting within the walls of my house. And it feels pretty scary because I know it’s up to me to chart the path forward and figure out what to do next.
But after lying there and waiting for sleep to come to him, I got up and paced the house. Then I moved the big bean bag chair under his window and gathered up my pillow and blankets and eventually dozed off. I was a mess. We had driven thirty minutes into the city to the hospital, all the while I had thought he would ask to go home as I explained what might happen, including being admitted and me having to leave him there alone. All the while, I thought he would change his mind, but he didn’t. It was me who decided after the security checkpoint viscerally scared me that we needed to go home. And it was me who lay panicked wondering if I was doing the right thing.
The next morning, I reached out to family members and changed plans for the day so I could keep an eye on Mr. Ornery. I thought through what safety measures I needed to do and finally got the power screwdriver and put screws into the window frames so the windows in his bedroom could only open six inches. And I reached out to the counselor at his middle school so that she could touch base with him first thing in the morning. I let them know of this depression and suicidality and the fact that he wasn’t on any medications for his ADHD disability. I emailed his learning support teacher as well since we’d been communicating about medication changes over the past few weeks. I was assured they would take care of him.
I spent the day Monday in a state of stress and worry and researching and making phone calls. I called his pediatrician, his insurance company, the special program for teens with depression and suicidality (they didn’t think he was “bad” enough to warrant their services). I sent him to school to try to keep his life stable and hopeful, but I worried. Finally, I hit bottom and texted a friend mid-afternoon who I knew had similar experiences and said, “I need a hug.” Thankfully, she has great hugs. I got him an appointment at the pediatrician office on Thursday, but first available for evaluation was two months away. I kept talking with as many people as I could to get recommendations and to get help sooner.
Meanwhile, by Wednesday, Mr. Ornery’s apparently now heightened limbic emotional system decided it would be quite fun to create a boxing match with one of his best friends in the middle school bathroom. His underdeveloped and currently untreated executive functioning skills (ADHD) had no chance of stopping an apparently very appealing idea. The incident had gathered a crowd of boys in the bathroom and one of them recorded it. It wasn’t long before a teacher found them.
So he jumped in the car late after school in a state of panic. He had gotten into trouble at school and he was stressed because he didn’t even know what “suspension” meant. And in a typical “normal” mom fashion, I immediately began yelling at him for making a dumb decision. “What do you mean you got a suspension?” “How could you?” “Why would you do that?!?!?” Suddenly it hit me; in his current stressed state of mind, why would I even have expected him to make any good decisions at all. We sat in the car and cried together.
According to the National Association of School Psychologists, school personnel have a responsibility to responds to suicidal thinking and to never ignore warning signs, which include direct and indirect suicidal threats as well as changes in behavior. In addition, they note “severe disciplinary action” to be one of the “situations” that may increase suicide risk.
I made the school aware of my son’s suicide warning sign. I let them know that he was struggling and in a fragile state. Instead of keeping him safe, they provided a “suicide risk factor” on his third day in their presence and within five days of an active suicide threat. I kept him home for three days so that we could both calm down.
Every single night, I asked my son three questions:
- Do you still feel like hurting yourself? Yes.
- Do you feel safe at home? Yes.
- Do you want me to sleep in your room tonight? Yes.
I slept on the floor in his room for twelve days before he said, “I guess you could sleep in your own bed tonight.” I had made numerous phone calls to try to find treatment for my son. I had consulted with physician colleagues. I had spoken with parents who have had children with mental health crises. I got him an appointment with his pediatrician to go back to his original ADHD medication to help bring some focus to his thinking skills before we could find a child psychiatry appointment. I really did think that the school would be supportive and helpful. I was shocked to find them instead exacerbating the crisis.
I asked for an urgent IEP team meeting to review the situation. I came prepared to show how my son’s brain was sick and unable to make good choices. The principal was unwavering. He was involved in a “fight” (whether or not it was just boys pretending) and would therefore be suspended as soon as he returned to school (thankfully a “quarantine exposure” gave him another week to stay home). He was not, in her mind, acting on “impulse” since it took several hours to complete this goal. She had absolutely nothing to say about his mental health. From the schools’ perspective, he was “fine.” He told his teachers he was fine. He told the counselor he was fine. He seemed to be “fine”….as if a 12-year-old boy would share big, scary feelings with teachers.
And as I still wrestled with how adamant this principal was that he should be punished, I was floored by her words: “It’s better for you to hear from the school that he is being suspended for fighting, than to be called by the police when he is caught shoplifting.” There it was. He had been tagged as a trouble-maker, a problem child, a bad kid …. on the path to criminality and “thankfully” the school is just trying to nip that in the bud for me. What is it about him? Is it his slightly brown skin of being a multi-racial child? Is it his ADHD struggles? Is it his energy and creativity and playfulness? What is it about my good-natured, soft-hearted and loving son that has screamed out – this kid is destined for trouble? What is it that makes a principal completely discount an emotional and mental health crisis and focus only on “bad behavior,” despite the clear relation between the two?
A week after our school district held a community event to sing the praises of how much they help children struggling with mental health, they punished a kid’s disability in the midst of a mental health crisis. When I was stressed and floundering and scared and most in need of help, my son’s school hurt him more.
Now that we’ve had evaluations and started treatment and my beautiful boy is feeling better, I am driven to change this system that refuses to acknowledge the role of disability on behavior and completely ignores the impact of a mental health crisis. I will work to change a system that will not consider how the stress of a world-altering pandemic, ugly politics, and visible racism happening concurrently has affected the children in their care. A system that pretends we can all just keep going, expecting children to show up for school and do their academics as if the world around them didn’t just crash on its axis. There is a better way.
Recently Dr. Abby Schlesinger (Children’s Hospital child psychiatrist) was interviewed about the marked increase in the number of children and teens needing mental health care which has overwhelmed the capacity of the system to provide that care. One of her colleagues, Dr. Justin Schreiber, also provided an update to the pediatric community in May 2021 about the impact of COVID on the mental health of children. He noted that children are expressing overwhelmingly more depression and anxiety symptoms based on activation of their fight-or-flight system of stress. While the mental health services are struggling to meet the demand, Dr. Schreiber encouraged the pediatric community and the school communities to acknowledge the toll of stress from the pandemic on children and to support children’s mental health. I sat and listened to his webinar, taking notes, and immediately emailed him to say, “What can I do to help the schools understand this?”
I had been so focused on the older son’s clear expression of stress through numerous physical issues (stomach pain, diarrhea, headache, etc) that would make him stay home for 1-2 days every 2-3 weeks, that I didn’t realize how difficult the year was for the middle one.
Life is stressful in any given year. But on top of all our normal stresses, we all have been coping with a new and foreign stress. Where I thought my boys seemed resilient and coping well, I learned that’s not always the case. It seems to me that we need to offer to those around us (and particularly our children) just a little more grace and a little more understanding, a good serving of true empathy and some actual concrete help for those who are struggling.
Know that there is help and that healing is possible. That’s what I cling to.
Pittsburgh Re:Solve Crisis Services: (888) 796-8226
National Suicide Hotline: 1-800-273-8255
Suicide Text Line: Text HOME to 741741
The Pittsburgh Study List of Resources