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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

To Think Stepson needs therapy and a possible sectioning

77 replies

Daviddaddy · 05/01/2015 17:15

Im new here i know I'm a dad but i think thats okay. I have seen threads on here but have never been a member. I would like to thank you for taking your time to read this I'm very grateful for all advice.

I will give you are background i have too sons aged 16 and (14 almost 15) from a previous relationship with my wife, they live with us full time and spend 1 night away every three weeks with their mum. I have 1 stepson who lives with us full time as his father sadly passed away 5 years ago due to a car accident. I have two little twins aged 1.

Stepson has a number of what i suspect as mental health issue. I believe stepson has a drinking problem, liquor and wine have gone missing in recent months and i have disposed of all alcohol to prevent stepson getting any drink. My son has caught stepson drinking in the park and told me. I believe stepson suffers from anorexia his weight is just over 8st and he is 6ft we went on holiday over christmas and you can see his ribcage and hip bones and he looks really thin compared to my son who is the same age (roughly). I want to help him through this and he needs support we have tried the gp but he refuses to go.

Any advice please David

OP posts:

crumblebumblebee · 05/01/2015 19:46

He sounds in turmoil, poor young man. B-eat www.b-eat.co.uk/ are a wonderful organisation who will be able to provide eating disorder specific advice and support.

AndyWarholsOrange · 05/01/2015 20:04

OP, I used to work in an eating disorders clinic and, generally, patients don't get sectioned unless they have a BMI below 13 which is classed as critically underweight. At the clinic I worked at, the patients on a section generally had a BMI below 11.
He won't get sectioned for an eating disorder unless his life is considered to be at immediate risk. To detain someone under the Mental Health Act requires 2 approved psychiatrists and an Approved Mental Health Professional (AMHP) to all agree. The role of the AMHP (who has the final say in whether someone is sectioned) is to safeguard the patient's rights and ensure that all less restrictive options have been considered first and detention is very much seen as a final resort when all else has failed.This is usually a home treatment team although they may well not consider they have the expertise to treat an eating disorder as they are more geared up to treating those in an acute crisis.
I don't know where you are but, in London, there are quite a few day programmes for eating disorders and specialist teams that work with adolescents with eating disorders.
Unfortunately, getting help for someone who won't admit they have a problem can be very difficult but I think you're right to be concerned.
I would try to just let him know that you're worried about him for now and that you think he may need help but don't push it too much just yet.
I agree with speaking to school nurse/pastoral team.
I also think you've had a really hard time on here, you sound very caring. Good luck.

crumblebumblebee · 05/01/2015 20:09

Andy it's a bit different for children and professionals tend to exercise more caution IME.

Daddydavid · 05/01/2015 20:22

Thanks again everyone we had dinner as a family and ds ate 3/4 of the meal. I've decided we are going to the gp this week and will be taking him their regardless of what he says. This will get him the support he needs and hopefull a diagnosis and referral to cahms.

Daddydavid · 05/01/2015 20:26

I was talking to ds 14 in some of ds classes. He said that dss has become isolated from class as people find him hard work to be around. I've told him to keep an eye on dss at lunch and to include him in groups regardless of what friends say. I'm going to sort this out, my wife is not in a good state after the little ones diagnosis but she is with me on this.

crumblebumblebee · 05/01/2015 20:48

You sound really genuine and caring, David. Being 15 is such a difficult time and he's dealing with so many changes in his life. A supportive family helped me slowly recover from anorexia at around his age. It was an uphill climb but not one I regret, it's made me the person I am today.

Please do contact B-eat. They were called something else back in the day when I was ill but they offered my parents so much support.

Daddydavid · 05/01/2015 20:49

We do live in London and have been googling and found a great deal of resources and groups

CatCushion · 05/01/2015 20:55

Agree with Andy...it matches our experiences with DD, and other teenagers we know with EDs.

Ok David I think you or his mum needs to have a phone conversation with his GP to see what the possible options are. He could be on a downward trend of weight loss and it could get to the point where he needs urgent admittance. It might be (probable) that the GP will not be able to say much without seeing him, but at least you can ask for your concerns to be added to his notes, and advice of what to look out for.. Better for you and your wife to be informed, and for the GP as well.

Try asking him why he won't see a doctor. For some people in his situation, it comes from very low self esteem, and they don't want to 'waste a doctor's time' or take up an appointment someone else needs. So its a matter of reasoning and walking them through to a more positive outlook. IME it is this type of reasoning which DD found hardest when low weight, but equally wouldn't put up with being patronised! My take on it is that it is up to qualified medical practitioners to advise and diagnose, not a parent. He's putting you in the position of having to give medical care without guidance. And most importantly, continuing to lose weight puts him at the mercy of a possibly unmanaged, undiagnosed eating disorder which is, frankly, trying to kill him (if that is what it is). Getting to the point where he needs emergency help can mean months of tube feeding in a hospital unit, and a risk of serious long term harm to major organs. Far more 'trouble' than a simple trip to the GP and referral to an eating disorder unit to learn how to manage it all himself. Getting medical help now will mean he can recover enough to manage.

Refusal is hard. He could cgange his mind any day though, so just be ready to drop everything without fuss.

CatCushion · 05/01/2015 20:57

X post with you. Hope it goes well. Be ready for a long wait for that referral. (All the more reason to see GP sooner rather than later).

BurningBridges · 05/01/2015 21:00

Second vote for contacting the Parent Helpline of Young Minds, this is exactly the sort of thing they deal with. Anorexia Bulimia Care (ABC) based in Bristol but work UK wide, also offers a specific parent helpline and can talk about self harm with alcohol as well as weight issues. There is lots of help out there. Good luck.

Baliali31 · 05/01/2015 21:55

OP, I am sorry to hear about your stepson and I think you sound like a wonderful stepdad. I'm not sure if your stepson is still at high school but if so he will have a 'named person' as a lead for his care. Please discuss concerns with them, they can refer to agencies such as CAMHS (adolescent mental Heath services) as well as good community led organisations which will help with issues around loss and bereavement. You can ask GP for a referral to CAMHS also. Best of luck

2015 · 05/01/2015 21:57

Is there anyone else that could speak with your stepson such as grandparents grandparents or aunts or uncles?

It is good that you have recognised that your son ( he's your son if you have adopted him ) is struggling. He may not realise quite how bad things have got.

I feel for your stepson and for the rest of your family. I hope your stepson gets some help.

Daddydavid · 06/01/2015 16:30

I have booked a doctors appointment at 5:15 and ds surprisingly has agreed to come, which is good news. Hopefully we can get a referral to cahms

2015 · 06/01/2015 16:55

That's good news. Are you able to let him speak to the GP alone for a bit?

Good luck.

CatCushion · 06/01/2015 17:33

Thinking of you, remembering DD's GP appointment at a similar stage. Hope it goes well and your dss can accept the help offered and engage with therapy and come to an agreement over recovery and self care (with help from you and the rest of the family).

Thenapoleonofcrime · 06/01/2015 19:05

This is so much better dealt with up front, it sounds like he needs help with eating problems and depression- there are resources out there and it's great that you are fully behind him in accessing them (especially as it sounds like you have a lot on your plate with the little ones).

Good luck with it all.

Tobyjugg · 06/01/2015 19:35

Am I the only one here to think this thread is a fake????

BarbarianMum · 06/01/2015 19:43

Toby if that's what you think then report it. Don't just post aspersions.

Daddydavid · 06/01/2015 20:14

First of all Tobyjugg no this thread is not fake.

We went to the doctors today and dss has been referred to cahms. Doctor spoke to dss alone for a while then me his mum and me spoke to the gp dss is underweight by 3% body fat he is just under 15% a healthy weight is 18%.

He has admitted he has an eating problem but said he is not depressed or alchoal dependent. To be honest he does not have all the symptoms of depression. We are going to contact a number of mental health support groups. The gp said we will have to wait a number of months for cahms so we may look into private treatment.

My dss said that ds 14 has been really nice and kind to him today and has said he "is the best brother I could ever have". This is a u-turn from last week where they hated each other with passion.

I think dss was crying out for help with his anorexia and that's why he went to the gp today.

I would like to thank all of you for your reconmendations and advice you have been really helpful to me and I will definitely continue to use this site.

Gruntfuttock · 06/01/2015 20:40

I'm so pleased to see that your stepson is getting help, Daddydavid

drudgetrudy · 06/01/2015 21:06

Once he is on the CAMHS waiting list you can contact them if you are worried. If he looses more weight they could prioritise and see him more quickly.
Also the school nurse will have links with CAMHS and will respect medical confidentiality. (Teachers aren't bound by quite such strict confidentiality rules). School nurse may be able to offer support whilst he is waiting and monitor his health. School nurse can also try to expedite an appointment.
I am glad that he co-operated in seeking help-that makes everything easier.
Young minds and B-eat can also help.

AcrossthePond55 · 06/01/2015 21:10

So happy. The journey has begun. Best wishes for you, DSS, and your family.

TwentyFifteen · 06/01/2015 21:58

Well done OP.

CatCushion · 06/01/2015 22:27

Very glad that your DSS saw the doctor. He might not be ready to accept a diagnosis of depression (it is one of those things, very hard for someone with depression to accept it or even recognise it sometimes) so I'm just saying don't take his word for it and keep an open, accepting mind without ruling it out completely. The weight loss will need to be addressed firt anyway. I'm so glad to read what he said about your DS and that he recognises that the whole family care about him and want to help. You are all bound to get it wrong sometimes, and he's likely to still lash out before he recovers, but just being there for him will make all the difference to how he gets through this.

As someone else flagged up, severe weight loss can be a form of self harm, as can alcohol abuse. Eating disorders can be tricky things to diagnose too, as the patiend is often unaware that there is anything unhealthy about their relationship with food, or they become obsessed with hiding how bad it really is in order to continue with it. The counting calories was what did it for DD. She knew/knows the calories in everything. She had to calculate the calories in everything she ate. Eating out became a series of monumental hurdles. There are some places we still can't eat out because she knows the menus too well and cannot pick anything.

I really hope your DSS can work out his problems and manage to look after himself and accept help.

Glad you're sticking around David. Need more like you on here!

Tribeca10013 · 06/01/2015 22:38

Im sorry to read the young man is having a turblent time,and impact on you all
Get a Gp appt and referral to community alcohol services for an assessment
also get a physical health check by gp inc blood tests.
Dont leap to detention under MHA, its not necessarily whats needed
Support him to approach services for assessment and treatment

Good luck and i hope this has a satisfactory outcome

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