From bad to worse

I hate to be always updating with bad news, but...

Marcus began to really struggle his third week at Hillside. He ended up having such serious tantrums that they called the police and the police took him to the hospital for a mental hygiene arrest. I think this happened four times in about eight days. The last one was only four hours after he had been brought back to the cottage. Things just kept escalating. It was really horrible to think of him in handcuffs going back and forth to the hospital. It became time to admit him.

He's been in the Strong Child and Adolescent Psychiatric unit at Strong hospital since Wednesday. So far he's only had minor agitation, no violent tantrums. But they haven't integrated him into the schedule yet so he hasn't come up against any significant limits yet. Echoes of his stay at John's Hopkins when he was ten are running through my head.

I am not sure why this has happened but I'm thinking that he's testing the limits to see how far they will go. Both the hospital and Hillside have firm limits and he tantrums when he hits them. Morris and I got into a pattern of negotiating the "no" so that we avoided tantrums, but this clearly has not helped him. It could also be a medication issue. The "hill" increased Ritalin and Haldol so that change also could have contributed. No one really knows yet.

This is the last hope for Marcus. He must learn to live with a "no" or he won't be able to be on his own, go to college, or get and keep a job. I still have the goal that he can live without institutional supervision but I'm terrified that he won't be able to. All I can do now is hope that Hillside can turn him around. Several staff have said they've worked with kids even worse than Marcus and have seen them turn around. Please let this be true for my son. 

In Residence

Marcus has been in residential placement for a few weeks now. The first week went well for him. He even called me the second day to say that he had earned 95 out of 100 on the behavior scale. Wow. What a difference from last year. He was suspended from school the first day last year. I had a tremendous mix of feelings. I know that this is the right thing to do, but the lack of incidents made me think he didn't need placement, that they would all be wondering why he was there. My therapist reminded me that placement is the "medicine" he needs and that it works doesn't mean he doesn't need it.

Well, the first week was a honeymoon.

The next week went a little differently. He began to struggle with limits and with building relationships with peers - both key reasons why he needs placement. Tantrums ensued as did property damage. Remember that, while only 15, Marcus is 6'6" and about 250 pounds. A mild tantrum can end up with lots of damage. Staff did call me, but not to have me come get him (my fear). They were informing me of restraints and asking me about the nature of his tantrums. They were doing their jobs. The worst part was that the week got worse as it went along and they ended up having to call the police who did a mental health arrest. That it's not a psychiatric issue complicates things because he doesn't need a psychiatric admission. As a result, he ended up spending all night in the psych unit lobby and going back to the cottage at 6 am. I realize they had to do it, but still. The hardest part for me was that they didn't want me to go to the hospital. It would have been interpreted as reinforcement and they have to establish the limits with Marcus firmly. I felt like I was in a weird limbo knowing my son was in the hospital but not going to be with him.

He came home for his weekend visit nonetheless (but with the understanding that if he has another week like this he wouldn't be coming for a home visit) and it was okay except for one glaring incident. Since he's been gone, my husband and I have begun to leave the locks we have on some doors (locks to keep Marcus out) open. We forgot to lock the attic lock in time for his visit. That's where we keep the sharp kitchen knives as part of our safety plan since Marcus threatened me with a knife some time ago. I don't think Marcus was home two hours before he had gone into the attic and taken all the knives into his room. I found out by going into his room without knocking (not my usual practice) and caught him. Scared me to death. His explanation was that he needed them to play "demigod". I believe him but I also know that things could turn quickly into a dangerous situation.

He still needs minute by minute supervision. We can't forget even for one minute. Another reason why residential placement is needed right now. It's a last ditch effort for Marcus to be able to live in community. Soon he'll be an adult and the police won't hospitalize him if he's violent in community...they'll shoot him.