When headlines about a mentally ill young person on a violent rampage flash through the news, we get angry at our house. Of course, we are angry on behalf of the victims -- but we are also angry on behalf of the mentally ill perpetrator and his family. Why? Because we have a mentally ill child ourselves. We know what kind of comments are coming in the media. As talking heads line up on TV to ask, "Where were the parents?" and "Why didn't this kid get some help?" we know the likely answer to those questions. It's an answer nobody wants to hear: There isn't much help to be had.
Our son is diagnosed as both rapid-cycling bipolar and autistic. Usually he is a great kid, but he's had periodic episodes of violent behavior since he was 8. These were mostly manageable until he hit sixth grade, when things suddenly got worse. His "manic" episodes include violent rages at home and highly inappropriate behavior in public -- including things he'd be arrested for, if the police weren't aware he had a mental illness. He reports hallucinations; he hears and sees things in visions, smells things that no one else can smell. He's threatened and attempted suicide too many times to count. He has thoughts of wanting to strangle neighborhood children. He assaulted a police officer who came to the house during one of his manic rages. He's tried to kill us using knives, sticks, large rocks -- you name it -- during his attacks.
The things our son does when in a bad space are pretty obviously sick and dangerous. You would think that such behavior would qualify a teenager and his family as deserving some help, right? Well, let me tell you how our search for help has played out.
The first social worker we met with in the hospital was not there to help us: She was there as a gatekeeper. An ER social worker recently told me this to my face: They don't want to make it easy to get kids into the mental ward.
In our experience, it helps if the police take the child to the hospital in handcuffs. Still, even when things go well, even if you say all the right things and your child exhibits all the proper symptoms on cue for social workers, there has to be a bed available. And you have to be able to pay for it somehow.
There is no assurance that a bed will be available for a mentally ill child in the Twin Cities at any given time. If there is no bed, the child will either be sent home or, if the parents agree to it, sent by ambulance to a hospital in Duluth or even North Dakota. You're then expected to take time off work and make three- or four-hour drives (one way) to visit your child and tell staff information that is already in the file.
Once you get your kid into a hospital, you think now, at least, the experts can help. But you may be asked to attend "family meetings" where a new social worker who hasn't read your child's file has nothing new to say. You play phone tag with a psychiatrist who suggests med changes that might help your child, or might make him worse -- no way to tell without trying. While the days tick by and your insurance coverage runs out, your kid will be doing crafts and talking about his feelings. And you know from experience he is going to come home and DO IT ALL AGAIN.
There are no long-term residential hospitals for mentally ill teenagers in Minnesota, or in many states. If your child is a "runner," or his behaviors cross the lines of civility too many times, the residential treatment centers won't take him. So your kid comes home after a short stay on a mental ward.
How about the police? Nobody wants to call the police on their child, but when he is a danger to himself or others you have no choice. We have called the police out many times. The St. Paul police are mostly very good with our son, firm but gentle. But what can the police do? Once they ascertain that a person is mentally ill, they do not take him to jail; they take him to the hospital. And then we are back to the hospital problem.
The police can't do much more than transport someone with a known mental illness to the hospital. Hospitals can't keep the person long enough to really help with the problems. Schools, therapists, crisis help lines -- none can provide the kind of intensive support required by a kid like this.
They all told us to call the county for help. In our experience, dealing with the county meant ineptitude, bureaucratic snarls and daunting expense. We tried to work with the county, but after numerous phone calls, letters and some tears, we were overwhelmed, too busy trying to keep everyone safe to pursue it further.
So it goes. People in the know about mental health care will affirm what I am saying: In most states it is close to, if not outright, impossible to get help for mentally ill kids. Our son has two articulate, well-read, informed and persistent parents with master's degrees. We are lucky to have an insurance policy with extensive support for disabled children. We finally got our son into residential treatment for a year. Not in Minnesota -- there is no such thing here -- but in Texas. We did therapy by teleconference and began to rebuild our ravaged lives.
Residential treatment helped him -- we see that, and he says so himself. The cost was huge: We sacrificed one retirement fund, and made large payments on medical bills for over a year. How many people are able to fight this costly, ridiculous battle?
We know that, God forbid, if our son ever takes it to the next level, if he ever takes a gun to a political event or otherwise hurts someone, the talking heads on TV will say the same things they are saying now in Tucson: "Where were the parents?" and "Why didn't this kid get some help?" And then, just like now, nobody will want to hear the real answer: We tried. We tried and tried.
Most of the time there just is no help out there.
Karen Sylte, writer, lives in St. Paul with her partner and their son. She is a source in MPR's Public Insight Network.