Hospital seeking behaviour

[Chickalily]

TRIGGER WARNING self harm (everyone is safe)

I am struggling to know how best to suppport my daughter at the moment. She has had a difficult year. She is 16 and in the middle of complex mental ill health. We moved 5 months ago because she was launching from crisis to crisis in our home town and I just couldn’t mange my job, my other child and her at once. My son and husband remained. We started well. She got a job and started a new school here. Unfortunately, as soon as she restarted school everything started to unravel. The job didn’t last long and she is no longer at school. The friendships she made did not hold. Despite that, she had a great month in June and started DBT, participating actively in therapy and doing her homework and spending time with me and extended family and doing creative activities. The last 3 weeks has been really difficult. We returned to our home city for a day and she saw an old friend and immediately afterwards (like the second they left our car) she started a pattern of mood change and associated previous behaviour: calling helplines up to 3 times a day; requesting to go to hospital; calling lifeline for emergency response (police at 1am); self harming at a rate she hasn’t done for a really long time. The last week (after spending time with new friends who really like her) she has escalated in her harmful behaviour to the point I am getting nervous and we are having daily trips to hospital. She finally said last night she wants to be in hospital and will keep going until she gets there. It is like a compulsion. When asked what hospital does for her she says ‘people there don’t judge me. I know how to interact with everyone there and the rules are clear. I can say things I think and people don’t get offended. I like the food. I know if I do anything to myself people will be able to save me.’ It seems weirdly naive thinking. She used to be a really insightful, independent kid (had a job, went to school, had friends). She currently has repetitive thoughts about how ‘nobody cares’ and it will be the fault of the medical professionals for not stopping her if she ‘does something’ so she has to prove they care.

She can articulate that these thoughts and feelings have been triggered by having good social experiences with normal kind kids. She thinks she doesn’t deserve it and when they find out who she ‘really is’ they will dump her (this is associated with past experiences including being dumped by a whole friendship group while in hospital last year). 
She is supposed to start TAFE on Monday. She has made some nice new friends. I have finally got a psychiatrist and therapy team in place and she is absolutely fixated on being admitted to hospital while at the same time talking about all the things she plans to do next week.

She has stopped doing therapy homework and spends all day in bed reading. 

i find it so hard to guide her through this. I do not believe hospital is helpful (nor does her treating team) but now she is fixated on it I am frightened what might happen if we don’t go with it. Her rigidity and fixations have lead many of the decisions we have made for her treatment and I don’t believe they have all been helpful.

One of the reasons I feel so conflicted is that once she has acted on the compulsion to go to emergency/harmed/phoned a helpline she is usually ok. Today we got wounds patched up, the staff all panicked and looked suitably concerned,, validated her feelings and expressed their care. We came home and made tacos, watched a movie and went to bed as if we had just been to the supermarket.

i have asked for an appointment with her psychiatrist tomorrow and I am equally scared of whether he will try for hospitalisation or not. Either way is potentially harmful.

Curretly I am sleeping in her bed as the hospital made me promise not to leave her alone even for 1 minute.

I don’t know what to do. I feel so sad that she is continuing this cycle when we have so much support in place and life is objectively good. I don’t know what I am looking for but maybe perspectives from people who have felt hospital was their answer? Connection with others whose kids are in this pit of despair instead of getting their learners permits and preparing for year 10 graduation?

[Ru-bee]

Hello @Chickalily 

This is such a hard situation for you and your family. I can only imagine the worry and stress that you are experiencing. 

I hear that all of your time and energy is going into caring for your daughter right now, but I just wanted to check whether you have any supports that you've been able to lean on yourself?

I don't have any experience with these situations myself, but just wanted to extend some support your way. Let us know how the psychiatrist appointment goes today.

[Chickalily]

Thanks Ru-Bee. I am doing counselling for myself as part of the DBT program. My husband is setting up to take some time off so I can be relieved. I have support from my parents and I am doing activities for myself when I can. Thanks for checking!

[Ainjoule]

Hey @Chickalily 

I can really relate to your daughter's situation. When I was much younger I did engage in hospital seeking behaviour. I was looking for security and for someone else to contain me. I did eventually have to learn to contain myself. It was a hard lesson to be honest. Also, when I was in hospital, the expectations were low and I could meet them easily. I slowly built coping skills and was therefore I was more self reliant in being able self soothe myself. I did find DBT helpful and hopefully she will too.  

[Chickalily]

Thanks Ainjoule.

I will keep her going with the DBT. On the hospital front, do you have an opinion about public versus private? We can access an. Adolescent unit (up to 17 year olds) in public setting or private (up to 20 year olds). I know I can’t control what happens but I am trying to minimise risks. She is naive and easily influenced and has picked up so much harmful stuff in hospital as she used it as an opportunity to connect with people.
Thank you.

[Ainjoule]

Hey @Chickalily 

Well, I would be in two minds about public versus private. I don't have private heath insurance any more but I did in days gone by. If someone is scheduled then they have to be public, and due to the pressure on the public system the cases tend to be more serious than that in the private. So, on that front I would say go private if you can....but 20 versus 17 age limit is quite an age gap when your daughter is 16. So I'm not sure given the age gap. 

[Chickalily]

Thanks. Interestingly, today the private hospital called and said they had a bed for tomorrow. My daughter chose not to accept it. She said she has activities planned with new friends and is starting TAFE so wants to focus on her future. I don’t know how long that feeling will last but I thought that was brave, to focus on moving forward when the comfort of being in hospital is safe and predictable. Since the doctor made the referral there has been no harmful behaviour as her distress dropped almost immediately just knowing someone had listened and there is a backup if needed. I wish I fully under All this.