What Will Happen Once Your Child Is In
The key bit of information to understand up front is that the sole purpose of an inpatient stay is to stabilize your child enough to be discharged to outpatient care. In other words, they aren’t going to cure anything here. At best, your child’s symptoms or behavior will improve 10 percent, maybe 20 percent.
As with other hospitals, nothing of substance happens on weekends. A child who enters on a Friday, Saturday or Sunday won’t be evaluated by the regular team on the unit until Monday.
Once the doctors have visited with your child (you won’t be there when this happens), they will come up with a working diagnosis.
Your child’s day will be structured on a schedule that includes a daily (brief) check-in by medical staff, school (usually only an hour or two, of limited educational value except that your child will get attendance credit) and various group therapies. These may include classes or groups on coping skills, information on mental health and family therapy. Some hospitals also use experiential therapies that incorporate animals, music, art or horticulture. There is unlikely to be any individual counseling. Remember, the goal isn’t to get to the bottom of anything. The goal is to get your child stable enough to move to outpatient treatment, where the long-term work takes place.
The television in the day room will blare during free time, and much of the day will be very low-key. This can make it seem that the hospital isn’t doing much of anything. What they do is provide structure, medication and monitoring.
Rules and privileges
You may be shocked by the limited visiting hours, which may make it difficult to visit. You don’t need to come every day; the most important time to visit is on the weekends, when there’s less structure and less for the kids to do. If you bring food (which your child will probably beg you to do), ask in advance about what’s allowed. Bring it in a paper bag; plastic won’t be allowed.
There will be a ton of rules. The ridiculous nature of many of them will likely be the topic of your conversation with your child. Likewise, most psychiatric hospitals use some kind of system in which the kids earn privileges if they comply with behavioral expectations. Your child might gripe about them, too. Your job is to nod and empathize.
The doctor is usually required to discuss medicine changes with you prior to implementing anything. If your child already has a psychiatrist, make sure the two doctors are in contact throughout the stay. Besides knowing your child better than the inpatient doctor, your child’s psychiatrist will also be responsible for monitoring any medication changes over the long haul, so communication is important.
Things to ask about medications (and take notes about):
- What is the doctor’s thinking in choosing this medication? What alternatives are there? If you have family members with similar problems, tell the doctor which medications have been effective and which haven’t. There’s no guarantee your child will respond to medication in the same way, but when you have a range of options it’s worth considering the one that worked for others in your child’s genetic pool.
- How long will it take before the medication kicks in? A few psychiatric medications are effective the same day. Many take a good amount of time to take effect. Antidepressants, for example, may not reach full potency for 4-6 weeks. What you want to know is what to expect and when. You may also want to ask what happens if the doctors don’t see that effect. Because changes might not be visible until after your child leaves the hospital, make sure your child’s outpatient psychiatrist is included in medication decisions that are made while your child is in the hospital.
- What are the common side effects? How long do they tend to last? Many side effects pass after a while, but some don’t. Sleepiness, for example, is usually more of a problem in the first week or two. Other meds are notorious for weight gain, so speak up if diabetes runs in your family. You should also be told about any dangerous but rare side effects, when these are likely to show up and what they look like. Lamictal, for example, causes a rash in a small percentage of cases that can be very serious.
Keep good records of what medications your child is on, when dosages change and any notable changes in behavior.