If I'm admitting someone to the hospital, that person needs to meet certain criteria. This means that he must be, and I quote, "homicidal, suicidal or psychotic". I think the list is pretty self explanatory and the criteria is the same for adults as well as children. All these admissions have to be cleared by a doctor, a "Certified Mental Health Professional" (c'est moi) and............an insurance agent (foreshadowing).
Today I'm focusing briefly on kids.
If a kid says they're suicidal, let alone makes an attempt, it's pretty much a no brainer. For the record, I've got some philosophical issues with just tossing a kid in a mental institution because they're suicidal. I'm not saying that parents or guardians shouldn't get help for their kid, all I'm saying is that I hate that the default mode is: Suicidal? Psych ward! Especially for kids in state custody. God forbid a foster parent choose not to hospitalize a child because they geniunely believe things can get worked out at home. They might as well tell a worker they're performing an appendectomy with only the aid of Gray's Anatomy. Of course, I have a problem with tossing adults in the hospital if they say they're suicidal too. This is why we do the evaluation--there are always monkey wrenches and the social dynamics of each case is different.
I digress.
The threshold for admitting kids is lower than the threshold for admitting adults. So, for instance, if a kid has been intentionally cutting on themselves within 24 hours, they automatically meet criteria.* If a kid takes pills, even if they say they AREN'T suicidal, they can get admitted. If a kid writes a deeply disturbing threatening note about other people they can get suspended from school. And then admitted. If a kid has a serious drug and/or alcohol problem they can get admitted.
You get the idea.
However.
If a kid is having serious fantasies about a particular person--a person whom they know quite well and has fixated on for several weeks? A fantasy invovling cutting this person's throat and sucking their blood?
Well, they aren't homicidal, suicidal OR psychotic, are they?
Admission denied. ->
*I was taught at a training last year that actually hospitalizing some cutters is a really bad idea. If a kid is a "social cutter", meaning they cut with friends, all you're doing when you put them on an in-patient unit is potentially exposing her to others who cut. Have you heard the same thing?
Read the complete post at http://feedproxy.google.com/~r/blogspot/tXCM/~3/NDssk3cJf1Q/criteria-hows-that-for-boring-blog.html
Posted
11 Jun 2009 4:05 PM
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Trench Warfare
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