<p>Taking a deep breath here before asking for help…longtime poster with new ID…I feel like I suddenly don’t have a battle in front of me but a war.
Our wonderful, brilliant, beautiful child has evidently been able to cover/hide some symptoms of serious problems for several months, but it’s now obvious that our kid needs more mental help than we could ever have imagined.
Symptom: serious paranoia…we thought the lack of communication was due to new relationship and not having time for boring old parents. Turns out she doesn’t trust phones or email. Her brother was in her city today and is spending the night there. He made an excuse to go for a walk to call us because he is so concerned. We will be flying out to her city in the next few days, but dont know what to do once we get there…Bro reports that she is beginning to see significant others as spies and threats.
If you have experience with navigating mental health care for an adult, please help us!
She was seeing a psychologist but her insurance ended when she left her job in March - we tried to get her to work through COBRA and offered to pay for coverage and if we can get her cooperation we might be able to still do that, but she needs serious help now. Inpatient? How do you do that? We can pay but she has to be willing? </p>
<p>Aaaaaaarrrrrgh! If she had cancer I would know what to do!</p>
<p>Bring her to the emergency room. My hair stylist is also a social worker in the emergency room at a very big hospital. According to her, it is very common for people in the midst of a mental health crisis to show up in the emergency just as they would if they had a medical condition that needed emergency treatment.</p>
<p>If she trusts any of you in her family enough to do this, agree to try to get her to the ER. You might check around ahead of time regarding what hospital in the area she is in provides the best treatment; the NAMI organization is a VERY good resource for families in your situation, and they may have a local chapter you can contact.</p>
<p>There is (literally) no way to get an adult who does not want psychiatric treatment into an ER or any other treatment unwillingly, unless they are considered a threat to themselves or others. The attitude of law enforcement regarding what constitutes “a threat” varies widely, depending on their training and what part of the country you are in. If ANYTHING happens that you would consider threatening to herself or others, take careful note of it; it could be very important as you seek treatment for her.</p>
<p>If she is close to her brother, ask him if he thinks she is using drugs. Even marijuana can really compound paranoia issues (there are studies showing a higher incidence of adult-onset schizophrenia in marijuana smokers, but that is a topic for another thread). If she does not use any drugs, count yourself lucky in that respect, as it complicates dealing with mental health issues.</p>
<p>My family has been there, and I wish you the very best of luck in dealing with this.</p>
<p>You should be contacting a psychiatrist or psychologist and a lawyer. I would try to get a power of attorney signed by her when she is lucid and competent, should there be follow up episodes.</p>
<p>Usually mental health patients can only be committed to an inpatient facility for 72 hrs., for evaluation.</p>
<p>When we had a similar situation in my family with an older family member, we were able to get him to go to the ER…but it took a LOT of convincing. It is frightening for a person who is suffering from paranoia to turn themselves over to the doctors and nurses in a hospital. Hard enough for any of us under more normal circumstances!
In our case, our loved one was evaluated at the hospital and released (not a danger). He was put in touch with a psychiatrist and put on meds for anxiety and depression. I will say that he did suffer from some paranoia during this but I think it was a manifestation of his anxiety rather than a psychotic break…so don’t jump to conclusions. Let the doctors do the diagnosing and, when dealing with your D acknowledge that it is frightening for her. If she feels that she has some choices to make in the process she will be more likely to cooperate with getting help. </p>
<p>By the way, our family member was very successfully treated :)</p>
<p>try a community mental health center if she will go, or a family practice doctor recommendation to a therapist- form a relationship and they will recognize there is more to it than issues and refer to a psychiatrist/nurse practitioner in psych. basically any one in the medical/social/psychology field that she does or will trust- ‘i see you are looking sad lately or anxious- have you thought about seeing someone about it? i would be glad to pay for it so that you can get back to feeling more like yourself’ did she like the psychologist- say ‘i think you looked like you liked your psychologist- how about going back and we would be glad to support you in it- we will not talk to the doctor- but would be glad to go with you if you want’</p>
<p>sounds very scary as a parent, sorry you’re going through this. unfortunately, the way the system works, unless she is posing a danger to self or others you will not be able to commit her. </p>
<p>I’m a mental health professional, and my suggestion is that you try to gain her trust by acknowledging her concerns and see if she’s willing to seek help for her “identified concerns”, and get her to the therapist she had seen, (even if just for an up to date evaluation, worse thing is you’d pay out of pocket but for out patient session it would be only be approx $100-$150) I would call the therapist and inform him/her of your concerns and see if he/she would be willing to see her, (possibly at a reduced rate until insurance is restored). the therapist can’t share infor with you, but you can provide your behavioral observations to him/her. imho, taking a paranoid person to the hospital may aggravate or escalate the paranoia and reduce her trust in you following the episode. and frankly the hospital won’t be able to keep her, so it may only worsen the situation…</p>
<p>any medications been prescribed in the past, on any now?</p>
<p>Honestly, if you think she is a danger to herself or others, find out the best psych hospital near you, and take her there. Stretch the truth a little if you have to regarding what she has told you. You could say that she said voices are telling her to harm herself or others. That will at least get her observed for 72 hours in most states. Seriously, that might get her started on the right meds, at least get her some treatment. Any small thing she might have told you or her brother could be used to get her in at least, providing you stress that it points to harming herself or others. It’s worth a try, because you can’t force the issue any other way. Good luck to you and your family.</p>
<p>So sorry for your troubles. This does warrant prompt attention. If there is a way to get that COBRA in place quickly, it would be the way to go. Accessing treatment with insurance may go more easily and allow optimizing choices. That said, if it is a catch 22 of her paranoia not allowing her to do COBRA, or letting you walk her through it, it is probably better to seek help sooner than later. If you can get information about how to get her on COBRA and the timeframe in advance it may help. This may be on a company website for example, but it may not be accessible to “outsiders”. Also, check the cost of COBRA and what benefits it would provide against other options and plans available. Plans vary and you may have a better fit for her needs elsewhere at a similar cost. It is good that her brother has been able to visit. There are quite a few possibilities for what illness or circumstance is causing the paranoia, and there are many treatment options. Hang in there and all the best with this.</p>
<p>COBRA expires usually if you don’t make a payment within 30 days of job termination. </p>
<p>“Stretch the truth a little if you have to regarding what she has told you.”</p>
<p>This is not a good idea, as it will be difficult to assess what treatment options are available, and will most likely result in her being over or incorrectly medicated.</p>
<p>^^^
I agree with that and it will compromise any trust she may still have in you. I know that my loved one, when going through similar issue was afraid of losing control of his own fate once the diagnoses/treatment ball started rolling. Lying about or exaggerating symptoms…she will not see you as an ally.</p>
<p>But if the evaluation shows that they are a danger to themselves or others, the commitment period will be extended.</p>
<p>Also, a skilled psychiatrist might be able to convince your D to sign herself in as a voluntary patient. I realize this would be a challenge for someone who is paranoid, but it is something that a psychiatrist will attempt, if you can just get her to an ER.</p>
<p>EPTR shared words of wisdom. there is a lot of fear that comes up when dealing with a family member who is “out of control” particularly with paranoia, however please be careful to not destroy what trust you still have with your daughter. Even if you lie and claim she is a danger to herself, frankly the evaluating physician, ER will be assessing what she says to them. I have tried to hospitalize patients, and even when a person tells you they are suicidal if they deny this to police, ER etc. they cannot be committed. Typically you will be told that the police officer, or physician needs to hear this directly from the person. I realize, this is very frustrating, but helpful for you to know, so you don’t pursue an option that can backfire.</p>
<p>That’s a big “if.” I know two people who committed suicide within a week of checking themselves out of the hospital against the wishes of their families, who clearly perceived them as suicidal. It seems as if the bar can be awfully high. Why, I do not know.</p>
<p>I am not a mental health professional and cannot offer any useful advice regarding treatment, but I have had experience with paying for hospital care when uninsured. Public hospitals are required to offer indigent care, and the individual need not be what we might think of as indigent to receive it: you can own a home, for example, as long as your income is low enough. In our state, you may be asked to apply for Medicaid and be refused first. Virtually anyone who owns a home–or even a car, in some cases–will be rejected by Medicaid. Then, realize that the uninsured are routinely charged literally twice as much as the insured, whose insurance companies negotiate a different pricing structure. If you appeal an initial bill, the hospital will knock it back to the insured rate. Another consideration is that this applies mostly to the hospital’s portion of the bill: doctors often bill separately. Doctors will also reduce their bills to the “usual and customary” amount upon appeal, and in some cases will write all or much of it off to their personal pro bono allotment. It is also possible to make arrangements with a medical practice to pay a monthly amount rather than the entire sum up front. It is important not to rush forth to pay her medical bills until this process has been completed, unless you are a bottomless pit of cash. While not trying to cheat anyone, it is important to remember that she may need a lot of care going forward.</p>
<p>I am very sorry that your family must deal with this difficult situation. Me best to you going forward.</p>
<p>COBRA can sometimes be picked up as late as 90d, but not a day longer. Hurry to figure out if you have any room. Once she has a diagnosis, it could be paranoid schizophrenia and that will make getting new coverage difficult. </p>
<p>I would seek out a psychiatric facility that has 24/7 intake evaluations. This might be an inpatient or outpatient facility. If you go to ER of local hospital, you will end up being referred there, or they will transfer her there anyway. The savings of going directly to mental health intake can be huge.</p>
<p>Know that trying to do this may escalate the paranoia, and if it gets bad, then definately call 911. She will first go to the ER, then be triaged to a mental health facility.</p>
<p>The mental health facility will help you with the legal aspects, and assist in determining her competency and assisting you in getting power of attorney. This will be complicated. You may have to think about bringing her “home” for a time. Get to her, get her assessed, get her stabilized, then think about bringing her home. She will not be able to manage by herself. She might be put on meds that make her feel normal again, and she will want to stop them. She will end up back at square one.</p>
<p>What city and state is she in? That would help in making specific recommendations. You can PM me. I am an MD but not a psychiatrist. But I have been involved in triaging and assisting in evaluation and stabilization.</p>
<p>Some will. When we were faced with this situation about 10 years ago, the response was “That’s what we charge. Please remit payment or work out a payment plan.” You MAY have more negotiating room in a non-emergency situation if you dicker before you commit to a hospital.</p>
<p>Nothing to offer in terms of information or advice but I have many prayers to offer and will keep your daughter in my prayers. It is so hard to help an adult child with mental health issues but I hope you can navigate this path with few problems. </p>