Recently I was dealing with a teenage girl referred to me by her mother because she was scared to be by herself, “acting weird”, talking and laughing to herself.
After meeting with the girl twice I got her to tell me some information she had ever told anyone else. She was hearing voices and having extreme paranoid delusions of someone putting “voodoo” on her and making her do things against her will.
After further sessions and gathering more collateral information from her mom and sister, I diagnosed the girl with a psychotic disorder, with a rule out of paranoid schizophrenia. I referred the mom to a local psychiatrist so the young lady could be evaluated further and the mom was extremely hesitant. She questioned my every judgment, and while she was very concerned for her daughter, she hoped that it was “all in her head”. I tried to convince her mother that it wasn’t “all in her head”, but an illness, that according to her records, seemed to run in the family.
Their family history was peppered with undiagnosed mental illnesses.
Needless to say, the mother didn’t follow up on my referral until a few weeks later when her daughter had a psychotic episode that truly scared the mother. It was then she came back and thanked me for recognizing this when I did.
And then last week, I had a girl come to me extremely tearful. She had old and new self-inflicted cuts up and down her arm. She told me that she was suicidal, tried to walk out into traffic the day before but a friend stopped her. She had thoughts that day of hanging herself or jumping off the third floor of the school building.
I called her dad to have a conference and recommend that she be taking to the nearby psychiatric hospital for her safety. I didn’t need his permission to do that, but I thought it would be better for her.
When her dad showed up he was extremely annoyed, yelled at her for not being able to communicate with him, and said that she wasn’t suffering from depression, she was just “lazy”. He said she was failing school because she slept all the time, didn’t do her homework, didn’t want to be involved with her family and seemed aloof.
The more he described her “laziness” to me, the more he re-affirmed my diagnosis of his daughter being depressed. He argued with me that she was depressed because of her failing grades and being behind in her school work, even though she and I both tried to explain to him that the depression is what caused her to start failing school and get behind in her work in the first place.
He didn’t want to hear or believe that his daughter was depressed and suicidal. He said that it was a cry for attention, and it very well may be, but as a mental health professional, my job is the evaluate the situation and keep my client from hurting themselves or other people. I had her involuntarily hospitalized to a mental health facility for her safety. Her dad left with angry, probably thinking we were wasting his time, but I’d prefer him to be angry with me for being overly concerned than to be mad at me for not trying hard enough to prevent her suicide.
Even just recently I have been working with a girl suffering from severe depression and suicidal thoughts. She confessed to me that she had attempted suicide last weekend by taking 18 sleeping pills and was disappointed that it didn’t work. I convinced her to allow me to call her father so that I could recommend psychiatric help, possibly hospitalization. The first thing her father said to me over the phone was, “No, I don’t believe it. We are Christians, we don’t do things like that.”
It took me while to convince her father to actually come into my office so him and I can sit down and talk with his daughter, and even then it took nearly the whole session before he started to accept that his daughter was indeed depressed although he was still in denial about her suicidal thoughts or previous attempt.
Parents can be my biggest allies or worst enemies when it comes to dealing with children and adolescent clients, and their denial of their child’s mental health issues only complicates everything. I see so many kids who can benefit from intense therapy and maybe even medication, but their parents ignore the seriousness of the situation and write it off as defiant behavior, active imagination or they just hope their child will grow out of things such as torturing animals and setting fires. Denial is a defense mechanism and while it’s okay to be skeptical, being in denial is almost always unhealthy in the long run.