Teenage son attempted suicide - need support

[3Blues]

So its going to be a long one... I just need to sense check I'm not going crazy and I'm doing the right things here.

Teenage son, 14, is the middle child (DS 15, DS 7) and has always been wild and unique. From age 6 I suspected some form of neurodivergence, but was fobbed off by school because he wasn't presenting or showing those signs in school, but at home. So, DH and I managed and worked our way through it to help with sudden anxiety in our DS, grounding techniques for when he got overwhelmed or overstimulated, and just learnt together what was best to help him. I must have gone to the GP 10-12 times by the time DS was 11, showing a diary of how he was escalating and showing riskier behaviours - self harm (across arms and chest), compulsiveness, lack of self-control (to the extreme), compulsive lying and so on. At the same time, increased anxiety.

They eventually referred him to CAMHS and he started sessions with them 6 months later when he first attempted suicide by taking 30 paracetamol. At the same time, I requested help from MIND councillors at the doctors (5 sessions) and put him on a waiting list for local mentoring. He was doing sports, he was very popular, and we continued to follow guidance and advice for setting boundaries, gentle parenting, and how to make sure our other sons were not adversely affected and left out.

Fast forward to 2024. DS behaviour rapidly getting more and more out of control. Running away, refusing to come home, abusive messages, abusive behaviour inside the home (holes in doors, walls, vandalism), many MANY calls to the police and missing persons reports, bunking from school, suspensions, one arrest, behavioural contract with the police... and the support and advice we get is to maintain boundaries. Gentle parenting. Keep calling the police. We'll refer him for an ADHD assessment, but that will take years. So we save for an ADHD assessment and get it booked in for next month (waiting list - even for private). We get him a mentor. We try to work with CAMHS but they want to discharge him and wait for assessment. We speak to the police. I even called Social Services and safeguarding organisations on myself - we need help. What can we do to help our son? How can we ensure our other two are not affected or traumatised by what is happening?

I get asked, multiple times - am I looking for benefits? Am I searching for carers allowance? No. I receive no benefits. I work full time from home so I can be available at the drop of a hat. DH also works full time. This is not about benefits - why are these questions more important than getting help for my son?

Fast forward to the last three days. Son has demanded a lift somewhere. Husband has said no - i am in bed seriously ill, DH is making dinner for our 7 year old DS - and it's late. Son hits the roof and sends 38 abusive voice notes - now threatening to stab my husband (his DF) in the neck, and more and more abuse. DH ignores the messages, not wanting to escalate things, and we call the police to report this. We also, report him missing by this stage because he is in the middle of a massive hyper cycle and this is when he gets more reckless with his own safety.

Next day - abusive messages continue. Threatens to sleep on the streets. Refuses to come home - despite gentle parenting. Go looking for him. Nothing. Call thenpolice, report missing, and they find him a friends house to stay at so we know he's safe.

Yesterday - DH collects DS from friends house and brings him home to talk to him calmly. Offer support. Hyper cycle is wearing down. DS walks straight back out of the door saying he wants to die. DH immediately goes to look for him, can't find him. I call Social Services and the Police. Social Services won't do anything. Police file missing persons report. Third time in three days. DH - in the middle of me making the report, receives a message from DS saying goodbye and a bridge. We are frantic. DH races in the car to stop him, im screaming at the police on the phone to help. He gets there in time because a couple walking sees DS in the bridge and stop him. Trying to talk him down.

Police come to the house, offer so much support. Help me make a plan for what our next steps should be. Give me a crime number so Social Services will start helping with safeguarding. Tell me to call 111 to get urgent mental health support for DS.

111 Book an appointment for DS to go the A&E and see Mental Health professionals. Very concerned. We go to A&E. DS is agitated, angry, and keeps saying he just wants to die. Nurses in A&E are amazing. We wait, in a room because he is starting to swear, punch walls and kick off that he doesn't want to be there. Mental Health workers come in, kick me out, so they can speak to him. Amazing. We're finally getting somewhere. Or so I thought. I go back into the room - they tell me we're being discharged, they're going to make a plan with CAMHS and I will hear from them in 7-10 days. Keep an eye on your son. They will inform GP and school. That's it.

If you got this far - thank you. But also - what the ever living hell?! Is that it? Your son is suicidal - wait 7-10 days and we'll have the ever useless CAMHS to support. Is that all there is?

If they thought he was truly a danger to himself, they'd have kept him.

Whilst your son is obviously in pain, it's possible they picked up on his suicide threats not being serious. Even mentally ill people can use threats of suicide to manipulate others into doing what they like.

If your son wanted to jump off a bridge, he would've done. He wouldn't text you about it.

He's not attempting to commit suicide, he's threatening suicide. There is a difference between the two. Again, obviously still in need of help, but threats are not attempts.

Do you know what’s triggered it all off? I know that’s an overly simplistic question to ask but it seems a really extreme escalation of behaviour and I wonder if there was a trigger point. How is he at school? Any bullying going on?

This is awful. I’m sorry you’re going through this.

Can you contact cahms or the mental health crisis team at the hospital and ask why he wasn’t accepted by the cahms crisis team? Which aspect of the threshold did he not meet. I am really surprised he wasn’t accepted by them. It is so hard. You should have been offered a chance to speak to the crisis team without your son there as well.

With respect I don't think the advice that Agix gives that talk of suicide means someone won't go on to die by suicide.

www.suicidepreventionalliance.org/about-suicide/myths-misconceptions/

There is often very little help for mental health and you might get help navigating the system from one of the dedicated charities eg Papyrus UK.

Thank you for the replies. So to answer questions:

• His behaviour is wild at school. He is suspended constantly, and we struggle to get him in. We do have a "Team around the Family" to make sure that all the kids schools are involved and we are meant to get support through that
• nothing that we know of has triggered this. We suspect Mental Health issue - ADHD or, based on patterns and behaviour - bipolar. But his circle of friends are quite frankly thugs, and he is very much one of them (not blaming everyone else) - despite being brought up differently and our other two DS's not behaving anywhere near this way.
• Potential escalation in behaviour could be down to hormones. But we have been seeking intervention and help for over 8 years now. This is not brand new, it's getting more and more dangerous - not just for DS but for others too.
• I fully intend to call CAMHS today, and anyone else I can find - to understand what's not being met here. Police (yes, all three units from the past three days) have all offered to write full statements to social services to make sure there is a full record of what we are doing and what they are seeing.
• for the first response above, he was stopped by a couple walking - just long enough for DH to get there. And with suicide, there tends to be a plan in place - not spur of the moment always, thoughts of how you will go and then saying goodbye. Whether in a note or other. It's not as simple as "Just doing it". He had planned that that was how he was going to die, for weeks or months - based on what the MH team at the hospital told me. It was the when he hadn't decided on. He met the criteria.

I don't think this is totally true. From my experience CAMHS are a nightmare. My daughter went through similar. Self harming behaviours gradually getting worse over a few years. So many CAMHS referrals and they turned her down again and again as she has ASD and they wanted to put all the blame on that. She had 3 actual suicide attempts before they would help her. The first time she badly slit her wrists and the second two times were paracetamol overdoses. Only after the third time did they help her. But she wasn't admitted or kept a close eye on. They have her weekly therapy sessions which do absolutely nothing for her. People think CAMHS are this magical answer. For some people they do really help. For others; like my daughter, they massively fail.

Op, I hope you can get the support you need. My daughter didn't get to the lashing out at others stage. She only ever hurt herself. She spent nearly a year refusing to leave her room. Self harming even though I thought I'd kept everything away. She'd find things like sharpeners and take them apart to use. She barely ate or drank anything. It was such a worrying time. She has turned a corner now but it's not been easy. I'm sorry I'm not sure what to suggest with your son but wanted to reply to say I get it. So many don't. It's such a hard battle.

I'm sorry you're going through this.
But you ask is this all there is - yes, basically. CAMHS highest level of support, IF he's accepted for that, is a weekly appointment. Social services won't offer any additional support than you already have, they won't give you any parenting strategies that you don't already know. There's no special safeguarding involvement that will make any difference to your son. It sounds like he's ND and struggling with that. He needs a tailored approach possibly including medication so thank goodness you're getting him assessed privately. Does he accept he is likely ND? Does he want help when he's calm and out of the hyper stage?

Thank you @Phase2 that's exactly what I have learnt and understand based on research and speaking to professionals when looking for how to bed support my DS. I will look into Papyrus today - thank you

@Lemonmelon1 I'm so sorry you've had to go through this. I'm so glad your daughter has turned a corner - I'm desperate to get to that point. He has been seen by CAMHS - but it was sporadic at best and they had no interest until he had an assessment. Which by their waiting times now they have all the paperwork - is years. We have no choice but to go private - and trying to find one that doesn't "take the money for a positive assessment" and ACTUALLY assesses for ADHD is difficult. If he doesn't have ADHD - what's the next step? Where do we go next? He is definitely ND - but how can we find what and then as an outcome, how best to treat and help him?

Absolutely horrific for you OP, and I can only guess at the pain and trauma this is causing you all.

Initial thoughts, and just thinking aloud, but is he on antidepressants? Aside from possible neurodivergence has there been any discussion about depressive disorders? Your mention of his ‘hyper’ phases made me wonder about mania.

@InkHeart2024 thank you. Yes, he accepts he's ND but he wants to know what and how he can get better. His calm stage lasts about 24 hours at the most at the moment. It's a constant cycle - 2-3 weeks of hype, filled with reckless behaviour, inability to sit still, slowly turning into aggressive behaviour in and out of the house, sneaking out at night to sleep on roundabouts (we have put cameras all around the outside of the house and hide keys to back doors etc) and then a huge low for a week where we basically don't sleep because we need to make sure he's not hurting himself and that he is eating, looking after his hygiene and sleeping.

@3Blues my daughter was diagnosed asd at 11 and adhd at nearly 15. The problem is that even with these diagnosis in our area there is no support. If anything, having ASD diagnosed prevented her from accessing CAMHS for many years. By the time they did accept her she had lost all hope in other people helping her.
After waiting 18 months she now has an occupational therapist provided by specialist CAMHS. This only started 2 weeks before Xmas so it's early days but they sound more helpful. We have a lovely lady come round once a week and she will help my daughter to do day to day things she's struggling with. Also hopefully help her get back to school as she hasn't been at all since the summer holidays (waiting on a specialist placement).
Sadly having a diagnosis doesn't get any extra help. My son also has asd and adhd diagnosed in primary school and they wouldn't give him any extra support. He's now gone on to develop fnd too.
It's really tough fighting to get your kids the support they need. It really shouldn't be so hard.

I have asked about medication - no one will do ANYTHING until he has an ADHD assessment. Including GP, CAMHS etc. Nothing.

If you’re struggling to get him into school and his friends are thugs / he’s wild at school I am wondering if he would be better to be completely signed off school medically - he clearly needs some sort of ehcp / intervention in that regard. I am saying this with kindness - my own son aged 13 had a whole year signed off medically (via the GP with anxiety and mental health issues) because he was so unhappy with mental health issues and the school just wasn’t the right environment. My son does have a diagnosis of autism so that’s different but he was referred to CAMHS and had therapy under them during the year he was off school, we then moved him to a specialist school for children with autism and on the whole he is much happier - it’s not perfect and like many ND children I suspect he’d rather not be at school at all (I understand this, I have autism myself and always hated school despite being in the top sets etc, it was just too overwhelming for me). On the other hand I do recognise this may make things worse for you all. It’s a very difficult situation to be in.

In my experience with dd (then 14) CAMHS were pretty useless. She made two attempts following a period of erratic and risky behaviour which culminated in her being horrifically attacked.
We only got somewhere when we got her referred for private therapy (and even then the referral
Had to come from CAMHS (who couldn't even seem to write the letter we needed without endless requests for it-I had to physically sit in their office after one of DD's appointments and have them write it there and then after being told they would email it when it was done and it never appearing-5 times).

Do you think he might be taking drugs? Dd got in with a very poor groups of friends and her behaviour got dramatically worse-and it turned out later that she was smoking weed and had tried some pills-she wasn't even sure what-and she was drinking a lot (which we knew about but it turned out to be far far worse than that).

The good news is that she is now, at 17, much better. Just to try and give some hope.

It's awful OP. The stress of it all on the rest of the family. The absolute helplessness you feel. My hair stated to fall out at one point due to the stress. So I'm sending you lots of love and real hope you get some help for your boy.

I know this might sound ridiculous but have you looked into the links between thyroid issues and rapid cycling bipolar symptoms? I only know about it as my brother has had serious mental health issues including multiple suicide attempts and had similar manic highs then crashes. It wasn’t the case for him but I did think it was interesting and perhaps worth exploring? I am so sorry you and your family are going through this. It’s exhausting, frightening and heart breaking.

So our son had VERY similar events like this young chap. Threatened etc found on bridge rescued by friends (we were not there and unaware). At age 16 he said he had sat in the bath and wondered about all the different ways he could end his life. We also had two younger children we were trying to protect/support and also called social workers in a panic and were completely ignored. CAMHS were booked up months ahead and while he was referred our son said he would refuse to go. Social workers just sent leaflets. Fast forward ten years our son has gone to uni got a good job and a flat in London. One September morning at 2am he ended his life with no warning to anyone. He had made 'threats' as you call them and in fact carried out what he fully intended to do at some point in his life. We are devastated. Please always take seriously anything someone says about thoughts of self-harm or suicide. They are not 'empty threats' as so many ppl think they are. To the poster - I hope you get the help you need my heart goes out to you and your family.

So sorry @fatandhappyxxx

How awful for you, I have personal and professional experience of what you’re going though.

Professionally, I see people in extreme MH distress turned away from ED daily, told to wait for community follow up, that they’re not ill enough, the threshold for intervention is so high its scary. Lots of people don’t make the wait. I don’t know what to suggest other than keep shouting to all the relevant authorities you can, use words like accountability and safeguarding, especially how they will keep your other children safe from your son given his threats. You’re doing all the right things but I know you’ll feel like it’s still not enough.

Personally, I have a loved one who had undiagnosed ADHD for years and it nearly cost him his life. Do you suspect drug use? Unmedicated suffers often turn to this as it hits their receptors in their brains that all haywire because of the condition (our adhd nurse explained it much better than I can!). If you pursue a private diagnosis you will have to fund treatment privately until he gets seen on the nhs, and even then they may refuse to accept your private assement and make you go through it all again. Luckily in our case, the nhs saw how severely affected he was and agreed to immediately treat. It’s been a long hard road and I hope things move quickly for you.

Hello OP. Firstly you sound like the most amazing parents. He’s so lucky to have you. My daughter is 8 and has ADHD so I know what it’s like having an ND child although mine is still little. She still has bursts of anger and talks about harming herself and I know I’ll have to be v careful about her acting impulsively as she heads towards her teens. As the previous poster says if it was me I think I’d pull him out if school completely and focus solely on keeping him alive for as long as is necessary. Much of his behaviour sounds impulsive (and low levels of self control) and like he’s in a cycle he can’t break. Have you looked at Rejection Sensitivity Dysphoria? You might look into Pathological Demand Avoidance too. The two things might be contributing to his behaviours.

I know this is possibly really unrealistic and might sound bonkers but if you have the means can one of you take him away from home and spend some time somewhere in nature, far away from devices and friends while he’s waiting for his next assessment? If possible for a few days? I’m in Australia and my DD is out of control I drive her into the forest or to the beach and make her take her shoes off and just stand still for a bit. The grounding effect is phenomenal and I see her whole body just release all the anger. She can play on her own for about 15 mins at home, or for hours at the beach. It also gives us chance to talk and reconnect. As an ND person myself I find the world just throws stuff at us nonstop and mixed with hormones and media and noisy, busy environments, plus finding people pretty confusing and worrying constantly about whether we’re getting it right our brains just overload. When he’s alone with just some trees or the sea and mum or dad and nobody is watching to see if he’s saying something cool, or funny etc he might just allow his brain to rest for a moment. Wishing you all the very best x

I’m so, so sorry. 💐☹️❤️

I worry that the possible ADHD element is muddying the waters here. From what you describe it sounds like there is another factor at play - I would really be wondering about rapid cycling Bipolar. Is there any capacity for a private psychiatry appointment?

I don’t have advice, I just wanted to wish you all the best with it because it all sounds unbelievably difficult and stressful. It sounds like you’re doing all the right things as parents but not getting enough support.

I hope you can find some help for your son and that things get better.

Papyrus are brilliant. Really recommend giving them a call, even if your DS won't engage, they will speak to you.
My DD told us a week before Christmas 22 that she had a plan, and only because a friend had realised and talked to her all night, then forced her to tell us, did she not go through with it.
I spoke to Papyrus and they helped me no end to rationalise and make sense of what was happening (DD was diagnosed ASD 3 weeks later). GP referred her to CAMHS but told her there was no support and she (GP) would be support. CAMHS triaged her and said they would be in touch...the call came 10 months later 🙄
How old is he? Our GP prescribed anti depressants - she was just turned 17 at the time and the GP said she absolutely could prescribe as noone else would....
Good luck, it's a really, really horrible situation. You sound to have been an absolute rock for him and I know just how helpless you feel.
We DID come out of the other side, and I pray you do too.