re: Behavioral Health - Inpatient center?

There are a few private in-patient centers in Baton Rouge.

Cenikor LINK
Baton Rouge Behavioral Health LINK
Apollo BHH LINK

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He has a therapist and a psychiatrist, privately. That's why the public system let him out so quickly.

Don't want to call the therapist or psychiatrist today in regards to this incident because they will have to report it and then he's back in the public system. Make sense?

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One, any acts of self-harm, particularly having another incident after just being released, is nothing to underestimate or downplay. You could be quite right and these could be calls for help, which shouldn't be looked down upon or viewed as being dramatic (there is a strong correlation between a history of self-harm and suicide), and no, I'm not saying that's your attitude here. It seems like you're trying your best to find help. Lining up pills and shallow cuts to the wrist are most likely calls for help. WITH THAT SAID, never underestimate how quickly these things can escalate.

You say he's seeing a psychiatrist and a therapist, how long has he seen both? Were these the first acts of self-harm that he's committed? His treatment team seems to have a zero-tolerance policy when it comes to self-harm; sometimes that's a good thing, sometimes it can make matters worse, depending on the patient.

Do you know what their diagnosis is or what he's discussed with them?

Has he seen either since the first act of self-harm? It's important to discuss with them their reaction to the act, how he felt being sent involuntarily in for crisis management, and whether or not they're willing to ease up on automatically sending him to the ER; if he knows that he wants to self-harm, or has already done it, but knows that they'll send him in automatically that's going to cause trust issues and likely breakdowns within the therapeutic relationship as he could easily continue to self-harm only in places that aren't visible and will never discuss it with them out of fear of their response. And then you have a case where self-harm continues, most likely increases in severity (it's like an addiction, a few shallow cuts might provide relief this time, but as he continues he'll most likely develop a need to cut more frequently, more deeply, etc., it's like any addiction in that you quickly build-up a tolerance and have to escalate; and that's the best case scenario, he could escalate to the point where he attempts to take his own life).

What's his history apart from these two incidents? Have you noticed changes in mood? If so, what kind, how long, etc.? Has he ever hurt himself before?

It's important not to write off the public system in crisis situations, if solely for the fact that you can get him into a safe place very quickly. Also, private institutions can vary in quality just as much, if not more so, than public institutions. I live in Florida, so I can't recommend a local treatment facility, but it's something you'll want to deeply research. In the meantime, you should be able to contact his psychiatrist/therapist and see if they have any recommendations. Also, I’m not sure of the laws in LA, but it’s possible that even if you found a treatment facility that no one could force him into (as opposed to public facilities/ERs) since he’s not a minor. I’d definitely try to get him into seeing one of his normal providers as soon as possible, particularly whichever one he’s closest to (if you happen to know, or can ask him).

As for insurance, you'll find that a lot of private clinics don't take insurance, which means they'll bill you and then you'll have to contact your provider to see what they might cover. And even if you find a place that does take insurance, it's highly unlikely that your insurance will cover even the majority of costs of his treatment program. That's something you'll need to contact your insurance about depending upon if/once you decide on a particular facility.

Who does he live with? You don't want to push harder than you need to, that could cause him to isolate and go back to self-harm, or worse. But at the same time, it's important that there are people in his life that can monitor him (parents?) & check in on him.

Wherever he lives, you'll want to try to limit his access to means of self-harm, but again, that can be tricky because let's say he cut himself and then all knives or sharp instruments are removed from the house - that's a possible trigger that could cause him to seek out other means to hurt himself or worse. Just a side point, if there are any firearms in the house make sure they are locked up and out of his reach.

Also, if he's seeing a psychiatrist his therapist has no business managing his medication; that's not something they're trained or qualified for.

Thank you everyone who took the time to respond

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Thank you everyone who took the time to respond

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The mental health hospitals in Louisiana are shite.

That being said, it sounds like he may need a three week stay somewhere and soon so you don't have time to contact out of state residential treatment centers at the moment.

You're also correct about not being able to cherry pick but a way around that is to call the treatment center that you want him to go to, talk to a lead nurse about your situation and they will possibly let you know when a bed opens up. Once that happens, get the kid to the ER near there asap and he'll likely get that bed. It's not a 100% guarantee but it worked for us twice.

Once you get him in safe. Start researching out of state facilities that are covered by his insurance. You want a place with a low staff to patient ratio.

Do NOT send him to Meridell in Texas.

Joe, I have been in that young man's shoes. I have been in a state hospital and a facility run by OLOL back in the late 1990's.

The right medicine along with family support can work wonders. A major depressive episode requires medication, therapy, and a faith that the mental illness can be treated. I found a psychiatrist 16 years ago in Baton Rouge who started me on two medications for depression and delusions. Within four months, my thinking became more clear and I felt in control. The symptoms went away and I have been free for the past 16 years. I stay on a low dose if both meds to prevent relapse.

There is hope. My family made sure that I took my medication and went to see my doctor. It can be done. Exercise and diet can aid in eliminating depression. Don't give up !