I hear this from a lot of people, and it’s always worrisome cause it’s a form of denial masked by hope. Recently I was trying to help a mother get her son proper outpatient mental health services upon his discharge from the hospital, and she was adamant that he not return home without treatment in place. So, I started to work on options for outpatient treatment, however, when the hospital discharged him home the mom turned around and changed her mind.
“My son is doing fine now.”
Her son has been hospitalized multiple times this past year. He knows how to present in front of doctors when he is admitted, so he is able to return home. Once he is back home, he is not med compliant, so eventually has another episode, and ends up back in the hospital and the cycle continues.
It’s always a hard conversation to have with family members cause I want them to have hope in their loved ones getting better and being healthy, and I’m not trying to be negative but there is an underlying denial issue that inevitably impedes their loved one to get help. So then I have to turn around and say the following:
“Caregivers die first.”
Usually that resonates with people, cause they can’t deny that their own mental health can become comprised when they have to worry and care for their mentally ill loved ones. Often times the caregivers become depressed, they experience anxiety not knowing if or when their child is going to have another break, yet sadly, it’s not enough to realize that just cause your son or daughter is doing “fine” more times often than not it’s only temporary. Hence, the vicious cycle of going in and out of psych wards becomes the norm. When the child is in the psych ward a parent is all set to get their child outpatient help, and sometimes say he or she can’t come home unless their loved one agrees to treatment but then, they turn around and change their mind. As a result, everyone suffers. I’m not trying to be a Debbie downer but, I’ve seen it occur more often than not and it’s frustrating. So then I drop another bomb:
“Your son is sick, just not sick enough.”
This scenario happens frequently when you see a person go in and out of the system. They are not gravely disabled so go from hospital to hospital with no chance of conservatorship and remain sick, just not sick enough. And the challenge with that is most mental health services are voluntary, and most mentally ill individuals know their rights and may agree to outpatient treatment just to get out of the hospital then quit once they are out the doors and the responsibility falls back onto the parents. So the parents get all excited that their son or daughter is finally agreeing to get help without fully understanding their is a high chance the tune will change once they are back home. Their child is back in their room shut out to the world. They are back to pacing in the middle of the night. They are back to a downward spiral of depression, or mania, and next thing you know they are back at some other hospital.
Having hope and denial can be detrimental to all family members. Again, I’m not trying to be negative but I think it’s important to be honest with yourself. Pay attention to your own decompensation when you are struggling with a loved one suffering from mental illness at home. Be aware of the potential for your loved one to fall between the cracks when they are sick but not sick enough. Really think about what you are saying when you think your loved one is “doing fine now.” Now is only temporary, and in my opinion is a sign of denial that you cover up with feelings of hope.