<p>My sister’s youngest son, 16, has been having a lot of violent outbursts. He gets upset over small things and flies into rages. He tears stuff up, puts holes in the walls, slams his head against the wall, and threatens to kill my sister. The last time it happened she called the cops. They took him to the ER and the ER refused to treat him because he was so violent and because they don’t have insurance. The nurse said he had “cold” eyes and she believed he really wanted to kill my sister.</p>
<p>I’ve been concerned about my nephew for a while. For a few years I’ve gotten a weird vibe off of him and I’ve wondered if he might be a sociopath. AFAIK he hasn’t killed or tortured any animals, but he did cut the whiskers off a cat “just because.”</p>
<p>He lived with his dad until a couple of years ago (court ordered). Once he was old enough he went to live with my sister. At that time his dad basically self-destructed and succumbed to alcoholism, quit or lost his job, and now sleeps on his sisters couch and has zero contact with them.</p>
<p>His dad was also given to violent outbursts, which is why my sister divorced him.</p>
<p>My sister is trying to find some way to get him treatment, but without insurance it is basically impossible.</p>
<p>DougBetsy is right - the public school should be of help. He could qualify for state run insurance Blue chip or even medicaid.<br>
There is mental health help availabie for juveniles. I don’t understand the hospital not treating him. they should have transferred him to a mental health facility.
What state is he in?</p>
<p>Agreed that the school system could be a place to start. Per PAVenturer’s comment, if he threatens her again she should call the police. If he appears to be mentally ill AND is threatening her, then they probably could put a 72 hour psychiatric hold on him so he could be evaluated. It is hard to get that psych hold without a threat to himself or others, though. My two cents from having been through trying to get a psych hold for a family member (and having it denied, with the person later committing suicide) is to call the police RIGHT AWAY when a threat occurs. If your sister waits a day and waffles (because they are a family member, etc.), the police are less likely to take the psych hold action if they are called after the fact.</p>
<p>If he is a threat to himself or others (your sister) then the police need to be told that. If he threatens your sister she needs to make it clear to the police and/or the ER that he is threatenng harm.
This is very scary and lots of well-meaning folks don’t like the thought of “locking up” their loved one. It is very difficult to do but must be done.
This will start the wheels turning so he can get the mental health care he desperately needs.</p>
<p>At the hospital - the police will take him there, not jail - they will evalutate him in the ER. He will then go to the mental health floor or building. He will be treated by a psychiatrist and may or may not have visiting hours right away. The psychiatrist should involve your sister.
Once he is in the mental health system he may be eligible for medicaid or other state help.</p>
<p>If this child is currently attending school - I am sure there must be issues there. Your sister should contact either the school nurse or guidance counselor. There are placements for students who have mental health issues. From what you describe it sounds like he should be hospitalized first.</p>
<p>Go to ANOTHER ER Hospital who WILL admit him and treat him. He likely needs counseling on anger management and some drug therapy for depression or other problems. Only a PHYSICIAN can help him. DO IT TODAY.</p>
<p>Be compassionate to him. Tell him you want to help him and to relieve the pain and hell he is living with now.</p>
<p>It differs in different states, but in most, the best way for the parents to get the kid help, i.e. get him out of the house and into a paid for program, is through the family court system. So unfortunately, they need to keep calling the police and have the kid arrested for his threats and actions. It’s certainly tough love, but sounds necessary here.</p>
<p>younghoss - mine neither.<br>
However - how does one know, even from one’s own child if a death threat is serious or not.
The mother took the child to the hospital who for whatever reason refused treatment.
That sounds suspect to me, if the mother told them she was threatened. Perhaps the mother was too frightened to tell them she was threatened.</p>
<p>If he is having mental health issues but not making a <em>serious</em> threat - the school is a place to start. Many times parents don’t want to involve the police. they are afraid they will take their child to jail. Public schools today have counselors and health care professionals who can help a parent navigate the red tape in getting state aid and treatment for their child. They can also arrange proper placement should a child need in-patient treatment.</p>
<p>The only way I know here if it is a serious death threat here is that it is “a given” here. We are told in the Op’s first sentence that “the kid means it”, and that the belief it was a serious threat was confirmed by a nurse.
If the Op’s real situation is different than what the Op told us, then certainly advice/comments here may be well-intentioned, but way off base.</p>
<p>My sister believes the threats and the nurse also believed them. I’m not there, so I can’t really just for myself. It looks like she might qualify for the health families program linked above. I will email her that info.</p>
<p>He’s not like this all the time. He will be fine for a few weeks, even a couple of months, then freak out. His dad was/is the same way.</p>
<p>If someone threatens to hurt themselves or others, It is a mandatory 72 hold in a psychiatric facility. The staff at ER should have transfered him ASAP. UCLA has 2 wards for teenagers, for ex. I don’t know where you are located, but many hospitals have their own psychiatric units. This isn’t a question of insurance, this is legal requirement.</p>
<p>The police have the ability to transfer and commit someone for this evaluation. Call them at first sign of trouble. Repeating what PAVenturer wrote, the local health dept can send people out too, but police faster.</p>
<p>This is a difficult and unfortunate situation. I have some experience with “struggling teens” and have worked with families in the same situation as your sister. A thorough mental health evaluation needs to be done- and this is difficult without $$$. There are a lot of very bad emotional growth programs out there, and, unfortunately, the reputable ones are very, very costly. In some cases, families have been successful with getting reimbursed by the local school district if a residential placement is required because the school district can not accomodate the child due to the emotional issues. There are educational consultants who work with families in this kind of situation, and it might be worth spending the money (not too much just for a consult) to explore the options. My opinion is that this kid is only going to get worse and some sort of residential program (wilderness followed by a treatment center or emotional growth school) will be necessary.</p>
<p>This sounds very much like a neuropsychiatric disorder of some type. Does your sister know her ex’s family history? Schizoaffective disorders/psychosis can be hereditary, and a lot of times, they’re undiagnosed in family histories. If your sister needs some extra fortitude in calling the police and reporting him next time he makes threats, tell her to try to keep in mind that she’s calling the police on the disease that’s taken hold of her son, and not that she’s calling the police on her son.</p>
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<p>It’s tough, though. Legal requirement is that the patient exits the unit <em>stable</em>, not that there is a long-term treatment plan in place. This means that you end up with a lot of people who “bounce”… They’re stable, but they don’t have the resources or appropriate support network to sustain that stability.</p>
<p>A good resource would be the local NAMI chapter. NAMI is the National Association for Mental Illness. They may have a better idea of the resources in your sister’s area.</p>
<p>It’s soul-numbingly difficult to face something like this. I’m so sorry that you’re going through this. My thoughts and prayers are with you and your family.</p>
<p>“At the hospital - the police will take him there, not jail - they will evalutate him in the ER. He will then go to the mental health floor or building. He will be treated by a psychiatrist and may or may not have visiting hours right away. The psychiatrist should involve your sister.”</p>
<p>Hmmm… do you live in California? That’s not going to happen where I live.</p>
<p>“If someone threatens to hurt themselves or others, It is a mandatory 72 hold in a psychiatric facility. The staff at ER should have transfered him ASAP. UCLA has 2 wards for teenagers, for ex. I don’t know where you are located, but many hospitals have their own psychiatric units. This isn’t a question of insurance, this is legal requirement.”</p>
<p>The requirement is subject to local interpretion of the threat. There is not a hospital within 45 miles of me, that has it’s own psych word. Psych wards are closing rapidly in NiCad, especially words for kids.</p>
<p>Where I live,I’d agree she needs to call police every time, and ask the police to make it "formal’. Press charges. Juvenile Hall sometimes has access to services you cant get in the community.</p>
<p>P.S. Healthy Families has been great from some of the kids I treat.</p>