I hate to admit it, but I frequently watch a show on Monday night called "Wife Swap". This show takes two women from two families and places them in each other's homes for 2 weeks. During the first week, the swapped "wife" must follow the rules of the household she is sent to. The second week, she makes her own rules, as she sees them, and the family must follow them. They are reunited with their 'real' families after this and meet as a group with their husbands to share their experiences. For the most part, the wives are total opposites and this makes the show interesting. Since I have been watching this, I have realized why a lot of the children that are admitted to the Adolescent Psychiatric Unit where I work have the behavior problems that they do. I am not basing this conclusion on just one episode of this show; I have observed many with the same issues that I am writing about and it disturbs me.
Last night's show had a mother who wanted to be her children's "friend". She did not work, she devoted every waking hour in making sure that her kids were 'having fun'. The father accepted this and worked fulltime as well as did what housework he could because Mom didn't have time to clean. The house was deplorable, and when I say this, I mean that the Health Department should have intervened. The woman had a total of 25 different animals or pets living in the house. The animals lived as freely as the kids and excreted their waste in the house wherever they needed to. There were no rules, no bedtimes, no limits, no scheduled meals, they ate fast food for the most part. They didn't even have a dining room table because they ate whenever and wherever they wanted. There was a teenage boy, another boy and a little girl living in this total lack of structure, filthy home. This mother was convinced that she was raising her child to be healthy, productive adults. They could have sleep-overs with their friends whenever they wanted without even requesting permission to do so. The mother took them wherever they wanted to go regardless of the time and whether or not they had school the next day or not.
One might think that this is unusual, but it isn't. I have seen several mothers on this show as well as on other shows such as SuperNanny where a nanny is called in to solve 'behavior problems' and also on Dr. Phil where the parents can't cope with their children's acting out. I find this so sad. Parents are not parents anymore. It is not rare to have a young child, even 4 to 5 years old brought in by the police department where I work for admission. Can you believe it? Well, it's true. We have become a nation of parents that want to be friends, buddies, pals with their children and they are doing them a horrible disservice. They are not being parents.
In this country, currently children are encountering an increasingly hostile culture resulting in a growing number of children experiencing mental health problems. Mental health resources are currently treating only one of five children requiring treatment, and resources are diminishing at federal, state, and local levels. When children are admitted due to lack of parenting, this only compounds the problem. Most of these children that I have commented on above are not mentally ill, they are behavior issues that are not handled by parents. They are forced onto our police departments and our adolescent psychiatric facilities, which are decreasing by the day and they eventually will become part of our criminal element if this problem is not addressed.
Teachers now are required to dispense medication in the school to kids with 'behavior issues'. Teacher are not medically trained to do so, but due to the lack of School Nurses, they are forced to. This is a very dangerous trend, in my opinion, dispensing medication without the knowledge of pharmacology and medication side effects is a slippery slope. I don't blame the teachers, they are actually forced into it in order to conduct their classes without behavior outbursts. Our police are now forced into becoming the intermediary by going to the home and taking the child (usually in handcuffs) to the psychiatric facility that is available, if they accept children of course.
Children need structure, they need limits, they need rules to become emotionally healthy adults, they don't need parents who want to be their 'friend'. I hope that our country's parents wake up and take responsibility for raising their children. If they don't, their children will pay dearly in the future for this growing problem of lack of parenting.
In my previous post, I mentioned that we try to counsel our patients and teach them life skills in the short period of time that we have them. We frequently use the message below and I am not sure of the author. However, the message could apply to anyone, not just the adolescents we share it with:
Just for today I will try to live through this day only and not tackle my whole life problem at once. I can do something for eight hours that would appall me if I felt that I had to keep it up for a lifetime.
Just for today I will adjust myself to what is, and not try to adjust everything to my own desires. I will take my luck as it comes, and fit myself to it.
Just for today I will try to strengthen my mind. I will study, I will learn something useful. I will read something that requires effort, thought and concentration.
Just for today I will be happy. Abraham Lincoln said, "Most folks are as happy as they make up their minds to be."
Just for today I will exercise my soul in three ways: I will do somebody a good turn and not get found out. If anybody knows of it, it will not count. I will do two things that I don't want to do for self discipline.
Just for today I will have a program. I may not follow it exactly, but I will try. I will save myself from two pests: Hurry and indecision.
Just for today I will have a quiet half hour to myself, and relax. During this time I will try to get a better perspective of my life.
Just for today I will be unafraid. I will not be afraid to enjoy what is beautiful, and to believe that as I give to the world, so the world will give to me.
Just for today I will be agreeable. I will look as good as I can, dress becomingly, talk low, act courteously, criticize not one bit, not find fault with anyone and try not to change or improve anybody but myself.
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As you read each of these, don't you think that if we all practiced these simple life lessons, just for today, we could live in a harmonious world, a world without war, suffering, and pain. We would be more tolerant of different lifestyles, different skin colors, different religions, creeds, ideals. What a wonderful world that would be...................
Over the past several weeks the Adolescent Psychiatric Unit that I work at has been extremely busy with many admissions and discharges. This is unusual because during the summer our census is usually low. I cannot remember being this busy or as easily frustrated with my job because I love what I do.
The mental health workers that I work with are excellent and have become as frustrated as I have. We work many times without breaks and many are working overtime. We sometimes get angry at parents for their lack of parenting skills. These parents bring their kids to us and expect us to 'fix them' in a short period of time and then return them better.
One cannot become judgemental, one has to remain professional in spite of your feelings toward that parent. We also see kids who are autistic, mentally challenged, substance abusers, sexually abused children, as well as physically and emotionally neglected children. Due to budget and healthcare cuts and the closure of most adolescent psychiatric facilities, we now accept children from cities that could be 50 to 100 miles from us.
Last night, after one of the busiest nights I have worked, we made sure all of our patients were cared for, medicated if needed and put to bed. We maintain constant supervision and must check them every 15 minutes as they are all on general suicide precautions. My male and female mental health workers are the best I have ever worked with. However, last night we were all ready to just give up. Frustration does that to you. Nate, my male mental health worker, who was doing a double shift as he frequently does said "I can't do this anymore" because of all of the issues we deal with. We discussed whether or not what we do, what we teach them, what we counsel them on actually makes a difference. The average stay is about 3 to 7 days for most kids. That is a very short period of time to even attempt to undo or repair the damage these kids have experienced. You only hope and pray that you made an inkling of difference in their lives. Did one statement, one short period of counseling them, one instance where you showed that you cared, did anything stick?
We then began discussing some of our really difficult patients in the past 2 years. We had one young girl who came into our facility many times and each time, we dreaded her admission. She was defiant, hostile and very difficult to manage. We gave her timeouts, we put in our Quiet Room, we gave her medication to control her behavior, we had to physically restrain her many times. She pushed everyone's buttons and at first, none of us liked her. One night as I was driving home from work after a shift with her, I said to myself, "I can't deal with her anymore" which I do frequently. I woke up the next morning and decided I had to deal with her, she is my patient and I had to find a redeeming quality in her and focus on that. She had called me every swear word in the book of swear words, she tested my patience to the extreme, but I had to teach myself how to deal with her. So, the next time that she was admitted I tried a different approach with her. I took her aside and listened to all of her complaints, and told her that rather than act out and create chaos on the unit to come to me and ask me for her medication or a private talk and I would stop what I was doing and give her my full attention. She looked at me baffled by my new approach, but she agreed. She became calmer but was still being transferred to a longterm residential facility. She could not return home. This is so difficult for children to accept. They feel abandoned and unloved and act out more. I fully believed that once she left, her behavior problems would accelerate and that there was little hope for her future. We all felt that way, but we tried our best anyway. She is just one example of kids that we try to fix, some stories are even worse.
We began discussing 'Amanda' and her behavior last night and I wondered what happened to her. I found out that she was no longer in placement, was going to college and was leading a good life. I almost cried, it did work with her! We made a difference in her life. You cannot imagine how good that makes a healthcare professional feel. It is all worth it, it does make a difference. Nate then looked at me and said, "yeah, I guess handle it for a little bit longer now that I know she is doing well".
We encourage our kids to call us after their release if they have any problems they can't handle. We have several of these 'discarded' troubled kids call us even late at night. We always take their calls and listen, counsel, and encourage. We are sometimes the only person they trust, but we have earned that trust because we care about them and they know it. We bring them in little 'gifts' such as coloring books, scrapbooking supplies and other things. Nate is a big Star Wars fan and one of best mental health workers I have had the privilege to work with. Sometimes late at night before we put the little kids to bed, we make little 'capes' out of hospital gowns and let them become Jedi warriors. Nate has a 'real' Light Sabre that glows in the dark and they run around the unit with their little capes flowing behind them and their light saber. How could you not love this line of work when you see that?
Our country must take a look at our medical crisis right now. We are closing psychiatric facilities at an incredible rate. We have over 45 million people in this country without health insurance. This must become a priority in our country! We are denying future generations the healthcare they deserve. We are funneling billions of dollars to other countries, we are spending billions of dollars in the Middle East and watching our soldiers die at an alarming rate. Yet, people in our own country are being neglected. This has to stop, our children are our future and we are forgetting that.......................
