When your agency’s youths are being hospitalized, is it a case of hospitalization manipulation?
In child and family agencies, it is not uncommon for youths to have thoughts of harming themselves or others. When the thoughts turn to plans, the next step is to evaluate the youth’s need for inpatient psychiatric hospitalization. Just to stabilize the youth and keep them safe.
But what if youths are using hospitalization as a place to run away from life and escape for a while?
Hospitalization by manipulation occurs more often than most agencies recognize. In some behavioral health outpatient agencies, the foster family, and residential agencies, up to 50% of all hospitalizations are the result of a youth manipulating the situation.
Here’s an example:
At an agency in the Los Angeles area, a twelve-year-old girl was at school. We’ll call her Carrie to protect her confidentiality. She attended her classes without any problems. But around her 4th school period, she instead went to the school nurse. She stated she was very upset. She planned to buy a bottle of pills and swallow the whole bottle.
The nurse called the local Mental Health Emergency Team. A social worker evaluated her and determined she needed an involuntary hold. Into the hospital, she went for seven days.
Two months later she repeated the same event at school.
When the agency’s department manager talked to Carrie’s therapist about this case, they looked at the antecedents to her behavior. Turns out she avoided going to her Math class and instead went to the nurse. Why? Because she didn’t like math and didn’t want to take the test scheduled that day.
A seven-day hospitalization at a cost of probably $15,000. All due to a Math test.
It’s common for youths to use suicidal or homicidal thoughts as a mechanism to avoid problems. At home, the school, or in the community. Family disputes. Abuse or violence. Or their own inability to manage stress.
And why not? At the hospital, they get meds. A cushy schedule. Avoid the pressure of life. Plenty of attention. A reprieve from life.
Many youths do face personal hardships in their daily lives. These exacerbate their symptoms and lead to behavioral and emotional problems. But they may be able to avoid hospitalization.
This requires the agency and therapist to do a review of all hospitalizations, the triggers, and antecedents that lead to the youth’s true or fictitious reason for inpatient care.
What does the youth avoid? Trouble at home? A test? Bullying? A girlfriend’s rejection? Or abuse?
What need does hospitalization fulfill for them? Safety? Stress management? Socializing with their hospital buddies?
Youths, like adults, do things with good intentions. It’s self-preservation. But their actions are misguided at times. Knowing the purpose, and the function helps develop strategies to intervene.
In Carrie’s case, a Math tutor helped her stop being hospitalized. Resolved her fear of Math.
Got questions? We've got answers.
PRAXES is a nationwide behavioral health software, consulting, and training company. No one in the behavioral health industry has a better reputation, and if you give us the chance, we’ll show you why! At PRAXES, our services improve the efficiency and structure of behavioral health agencies serving children and families nationwide. PRAXES brings over 45 years of administrative and clinical expertise. With more than 100 client companies nationwide, we offer the expertise to advance the quality of behavioral health services. We accomplish these goals through our new clinical decision software, our training of best practices, and helping companies meet regulatory standards. At PRAXES, we believe in being creative and fostering new ways to serve children and their families. Our vision is to empower the families our agencies serve with skills that not only improve their functioning, but help them to thrive in their everyday lives. When you give us the chance, you’ll be connected directly to our friendly staff, so you can expect immediate attention to your inquiry. So, don’t wait, call now!
Dan Thorne has unique perspectives on the field of mental health. As a clinician, he has had over 40 years of experience working with clients in the Southern California area. After obtaining his Bachelor’s degree from the University of California at Irvine, he worked with children in the Orange County Juvenile Hall. Here he honed his earliest techniques on at-risk children. After that, he obtained his Master’s degree in Counseling from California State University, Fullerton.
In the 1990’s, Dan turned his attention to the clinical and administrative side of behavioral health organizations. For three years, he was the Assistant Administrator of Starting Point, a chemical dependency facility in Costa Mesa, CA. In 2001, he took an opportunity to be the Director of Harbor View Community Services Center in Long Beach. When he arrived, the Center had only 80 clients and 13 staff. When he left, there were over 400 clients and 75 staff. Dan created several programs through their contract with the Los Angeles County Departments of Mental Health and Child and Family Services. Under his guidance, Harbor View became one of the leading providers of children’s services in Los Angeles County.
While improving the results of the client’s parents at the Center, Dan reflected on his experiences as a parent. His children themselves had special needs such as mental and intellectual challenges, and Dan knew the toll it takes on the parent. In order to help the child, the parent has to be healthy. From this concept, he created his parenting program. After years of refining it, teaching it to his staff at the Center, and then taking the results and comments from these efforts, he became the developer of the current PRAXES program. It is a culmination of Dan’s personal trials and tribulations as a parent along with empirical results and research of over 40 parenting programs.
Our vision at PRAXES is to advance the strength of parents and caregivers of children with special needs (mental health, intellectual, or physical) through education, support, and empowerment. Thus, they can live healthy and functional lives while caring for the child.
Apogee is a clinical decision software designed to help behavioral health practitioners with their treatment and patient engagement. It provides evidence-based and research-based components. Not only do they consist of elements from such practices as Cognitive Behavior Therapy, Seeking Safety, Dialectical Behavior Therapy, Motivational Interviewing, Functional Behavior Analysis, but also the Intensive Models for Parents, Youth, and Children.
PRAXES has over 30 years of accreditation experience. We know what it takes to get your organization accredited. Whether it’s Joint Commission, CARF, or COA, our team can provide an evaluation of your current status and review the standards which need improvements. We will assist you with the policies, documentation, and training required to be accredited.
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