I would say that overall my posts are fairly upbeat and my thoughts as well. This is not the case today. Be prepared for a sad tale.... but there is a message within this tragedy. Have you ever imagined that your child could be hospitalized and that you would not have have input into her care? If your "child" is 18 years old this may very well be the case. There are so many things that can go wrong when someone is hospitalized and it seems much more likely in the mental health arena. I have written in previous posts about my friend whose daughter is currently hospitalized for a severe mental health condition. She is in "no-(wo)man's land". She is not yet out of her teens but considered an "adult" in the legal world. She is too ill to give consent for her care, and now is spending her time in a horrifying limbo of health care hell. She has been in three facilities and is now at a state mental hospital. She is too ill to give consent for the initial recommended treatment and her parents are prohibited to do so since she is no longer 17 or younger.
How did this happen? This high school girl was struggling with a tentatively diagnosed illness but suddenly things took a turn for the worse as she spiraled into a psychosis and was hospitalized. She was unable to sign the paperwork allowing her parents into the system of her care. She was assigned a guardian ad litem. Doctors could not share information with her parents without breaking the HIPAA laws. The parents are seeking guardianship but this is taking too much time. The parents (a teacher and medical doctor) are seeking custody of their daughter; custody so they can speak with the doctors, make decisions and move thngs along as we would with any health condition. Meanwhile they wait in agony.
Their daughter's mind betrays her. She is lost and unable to find her way back to any semblance of normalcy. Her parents weep. No one knew that this insidious illness was coming as quickly as it did. It moved too fast to complete all the legal requirements necessary for the parents to make decisions for their daughter's care. It moved to fast for them to recognize that they needed to have an advanced directive in place. If these two highly educated parents cannot make things happen, what about parents that are unaware of this possibility? Laws were passed back in 1967 by then California Governor Ronald Regan, setting a national precedent of required judicial hearings for extended involuntary commitment and the prohibition of forced medication, among other mandates. I get this. We have moved greatly and thankfully from forced commitment and treatment but where-oh-where is common sense humanity?
There is no answer today for this horrible situation. The parents are struggling to keep themselves from falling apart while doing what they must to support their child. I urge parents to consider having an advance directive for health care in place by the time a child turns 18. The consequences can be devasting for everyone involved if this is not in place. Yes, it may be unlikely that your child will have a major psychotic break at the end of their teenage years but this time period is when these insidious mental health illnesses show up and sometimes quickly. As well, consider this for every member of your family. Linea and I heard Kay Redfield Jamison recently speaking about her new book, Nothing was the Same, and author of, The Unquiet Mind. She is a professor in the psychiatric department and co-director of the mood clinic at John Hopkins and a leader in the research and treatment of mental health conditions. She has bipolar disorder and spoke of her own advance directive for care. As part of my professional responsibility I will include this information in my classes and assure that our future school psychologists, school counselors and teachers are aware that student become independent from their parents at age 18.
I spoke with my friend this morning and she not only again gave me permission but wanted me to share her story. She is not ashamed. She is a terrified mother. Take care, good friend. Let us all send prayers and good wishes to her family. My heart breaks for her and her family.
(Solemn and Triumphant, Painting by Jordan Swain )