Need info/advice- family member to be confined to state hospital

[Dayannight]

My own nursing background is mainly med/surg. My adult son will son be confined to a state hospital here in California for an indefinite period of time. (His dx is paranoid schizophrenia.) I would appreciate any insight about what to expect regarding treatment/therapy/etc., that those of you who have experience in psychiatric nursing could share. Also, thoughts about mentally ill patients who are non-compliant with medications. It seems to me that the "right to refuse" needs to be looked at a second time when the patient's decision making capability is impaired by their illness.

I know there are some excellent websites that focus on mental illness, and in fact, have posted my son's story at schizophrenia.com. However, I'd really like to some feedback from fellow nurses that have experience working at state hospitals, etc. Thanks!

[MollyJ]

Hi. I don't claim psychiatric nurse experience, but I formerly did case management for tech dependent children. As you already know, this situation is going to play out over time and have ups and downs. It will likely never be "done, for once and for all". Like any chronic condition--diabetes, heart disease, substance abuse--it will need management over time and some folks stabilize and others do not, and some stabilize for a time and then de-stabilize. Only time will tell.

Your challenge is to be an advocate for your son and to take care of yourself. "Non-compliance" and schizophrenia are not strangers to each other. It can be part of the picture. It is a nursing/case management problem that must be dealt with and managed over time.

In my checkered past, I taught Lamaze (I really am a jack of all trades) and one of the sayings of Lamaze is, "Don't get ahead or behind in your labor." Well this is like life, too. You can spend time worrying about, "what if they let him out too soon?", "What if he doesn't comply again?", "what if he gets severely paranoid again.." but all of those what if's are beyond your control AT THIS MINUTE. Get to know the SH staff and become partners with them. Go with the problems that are in your reach and grasp at this time and notice the small but significant signs of improvement that you see. Advocate for your son, if he is returned to the community, to receive case management services out of his local mental health clinic and get to know that cm.

Take care of yourself. Realize that you cannot make it all better for your child and that you did not cause it. This is the life challenge that both of you have been given. Have fun. Laugh. Have a life. realize that the final outcome is not entirely in your control. Love him and try to avoid enabling behaviors that eat you alive. I have a step kid who is in recovery and we walk that line all of the time.

Good luck and let us know how it goes.