Children’s Mental Health

What if my child is angry, depressed, has anxiety, is being bullied or just not acting like him/herself lately?

The first step is to bring your child in for a free screening. Community Hospitals provides free screenings that are conducted by a Registered Nurse or a Masters Level Prepared Therapist. After you register, you and your child will meet together with the screener, followed by one-on-one sessions with the screener. Once all of the information is gathered, the screener discusses and reviews the data collected with the psychiatrist. The psychiatrist then determines the best course of treatment for your child, which could include any of the following:

Participation in Outpatient Services

Participation in a Day Treatment Program – this service is only provided by referral from the Psychiatrist

Admittance to an Inpatient Program

They might determine that your child is just having a bad day

What if I fear that my child may hurt him/herself or others?

If you ever feel that your child is going to hurt him/herself or others, or if his/her behavior is out of control or dangerous, the first thing you need to do is call 911. This decision can be extremely difficult because there is a “fear of the unknown” factor like what will happen to our children if we call for help. However, the thing to remember is that you don’t have to wait until your child is at the point of endangering him/herself or others, you can call for help at any time. Below is an overview of what to expect when you call 911:

When you call 911, a law enforcement official will be sent to assess the situation.

If the officer doesn’t feel like your child meet the requirements for the Baker Act, he/she may recommend that you take your child to the Emergency Department or other location for a screening. They may recommend calling a therapist or Psychiatrist.

If the officer feels your child is of danger to him/herself or others, and could also have a mental illness, they will institute the Baker Act and take your child to Behavioral Services or to the Emergency Department.

Parents, it is extremely important you follow your child in a vehicle as the law states that the officer is only able to transport your child in their car. Your child may be handcuffed, however this is not mandatory but, at the discretion of the officer. The first responder has to do what is necessary for the safety of everyone involved. We are telling you this not to scare you or upset you, but to prepare you.

Once in custody, your child will go through a screening process with a Registered Nurse or Masters Level Prepared Therapist. They will interview you together and then individually to assess the situation. You will be asked to sign consent forms on behalf of your child as he/she is a minor and cannot consent to their own form of treatment. It is imperative that you are there with your child to relay any and all information to the screeners. The more information they have to better understand your child the better they can assess what services may be required.

Information such as medications they are on, whether they are currently receiving services from a therapist/psychiatrist or even triggers that bring on certain behaviors will be collected. As stated previously, the psychiatrist will determine the best course of action for your child which could mean that they need to be admitted to an Inpatient Program, participation in Outpatient Services may be suggested, they may be referred to a Day Treatment Program or the Baker Act may be lifted entirely.

What if my child is at school and their behavior is radical?

If a child is at school and is posing a threat to him/herself or others, the school will notify the legal guardian of the situation. For the safety of the child and all involved, the school does have the right to call 911 and request that the child receive an emergency evaluation under the Baker Act. There are specific criteria that need to be met before it is determined if the child can be Baker Acted, such as having a mental illness and if the child is considered a harm to him/herself or others. The Baker Act can be initiated by law enforcement, physicians, psychiatric nurse practitioners and licensed therapist/counselors.

What if I fear that my child may hurt him/herself or others and this is outside of the screening hours?

A child will never be turned away. If you call 911 outside of the screening hours of 8:00 am – 8:00 pm, and it is determined that your child needs immediate intervention, the first responder will take your child to the Community Emergency Department. Your child will be admitted and remain at the hospital until the screeners and Psychiatrists are available for assessing the situation.

During this process it is recommended to stay with your child as they are a minor and cannot consent to treatment.

What Outpatient Services are available for my child
my child?

Every child and situation is different and the recommended treatment will be directly aligned with your child’s needs. Once your child has completed the screening process, and the psychiatrist determines that your child does not meet the requirements for an Inpatient Program, they could suggest any of the following Outpatient Services:

Evaluate the need for medication

Determine if he/she needs to continue the medication they are already on

Discuss Therapy Services

Offer Case Management Services that can be provided in the home

Attend Outpatient Therapy Groups

Reconnect with an existing outside provider and schedule follow up appointment

What can I expect if my child is admitted to the
Inpatient Program?

If your child is admitted an Inpatient Program, the first process is to ensure that they do not have any harmful items with them. Personal belongings, such as jewelry, cell phones, wallets and unsafe clothing will be returned to the parents or be safely stored in a locked area on the unit. A registered nurse will then meet with your child and perform an assessment to gather additional information focused on their medical and mental health. Within the first 24-hours of admission, there is a Family Therapy Session and the typical daily routine consists of the children attending classes based on the Volusia County School System, participation in recreational therapy, group therapy sessions and individual therapy sessions.

Your child will work on daily goals that have been identified and incorporated into their individualized master treatment plan. Registered Nurses and Mental Health Techs are on-site 24-hours a day so all children are constantly being monitored. Visitation is a few hours in the evening. As part of the therapeutic program, your child is also seen daily by a psychiatrist to evaluate how your child is progressing and to determine when they are ready to be discharged.

When will my child be discharged?

Each child comes to an inpatient program for different reasons, which is why programs have individualized master treatment plans that identify the issues they face. There are specific goals that the child will need to work on and achieve on a daily basis while they are a patient. Based on the daily meetings with the psychiatrist, it will be determined when the child has met all goals and is ready to be discharged. Upon discharge, the psychiatrist will recommend follow up instructions to ensure success outside of the facility walls. This can range from being seen by a psychiatrist at the facility, or with another one they have an existing relationship with, and/or outpatient services including therapy and case management. If they are leaving inpatient care and are on medication, they will be required to see a psychiatrist within 30 days of discharge.

Frequently Asked Questions

How do I know if my child is just going through a phase or needs professional help?

While it is natural for children to go through phases where their behaviors can be more challenging, there are some common indicators that a child may need professional help. Behavioral Services has professionally trained staff that can screen your child to determine if services are needed. Some common indicators they look for are disturbed sleep patterns, poor academic performance, withdrawal from social situations, and unsafe behaviors such as recreational drug use or becoming violent when emotionally overwhelmed. Some children are better at hiding their symptoms than others, so it is always wise to have a professional assessment if you have any concerns.

If my child receives mental health services, does the school have to know?

You do not have to share this information with your child’s school. Mental Health Services fall under the category of Protected Health Information.

Do I have to put my child on medication?

Medication is not always prescribed to treat the child’s symptoms. However, if the doctor recommends a medication for your child, you have the right to refuse. It is best though to discuss your concerns with the doctor. Often, parents have pre-conceived ideas about psychotropic medications that are untrue.

Will medication sedate my child or make my child act like a different person?

Parents are often concerned that medication will make their child “zombie-like.” The goal of medication is not to sedate or alter your child’s personality but to treat their symptoms so they can attain a higher level of function.

I am divorced. What if I think my child needs services but my ex disagrees?

If you decide to seek treatment for your child, it is a good idea to involve the other parent as much as possible. Parents do not like to feel helpless or left out in the decisions that affect their children’s health. Also, it is helpful to have professionals who are available to answer questions and concerns.

Sometimes when we are arguing, my child will make suicidal statements. How do I know if the threat is serious?

When children, especially teenagers, are emotionally overwhelmed, they may make threats to harm him/herself or others. It can be tough to discern a real threat from blowing off steam. If you find yourself questioning the seriousness of the statements that is a good indicator your child may need help. It does not hurt to have a mental health screening performed. They are free and can provide peace of mind to a parent who is afraid the child may act upon the threats.

I think my child needs help, but I am afraid of what my family and friends will say. Who all has to know?

It is up to you if you want to share that information with friends and family. Some children are fine with their friends and family knowing they receive services. Others would like that information to remain private.

What is the Florida Baker Act*?

The Baker Act protects the rights of all individuals examined or treated for mental illness in Florida.

Criteria for involuntary exam are that the individual:

Appears to have a mental illness;

Presents a danger to self or others;

Refuses voluntary exam or is unable to understand need for exam is an indicator that your child may need help. It does not hurt to have a mental health screening performed. They are free, and can provide peace of mind to a parent who is afraid the child may act upon
the threats.

Information for this article was provided by Halifax Health.