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?

I know camhs can be useless, but the difficulty with therapeutic support and counselling, is that the young person has to know and accept that they need help and want to actively engage with it. It's not a passive process. Often camhs psychiatrists will prescribe antidepressants and part of the reason for this is to help the young person to better access therapy.
As I said, it's not a passive process. Even when a child is sectioned, they're encouraged to engage fully in therapy.
I'm so sorry you're going through this.
I suspect medication and inpatient intervention will be needed here. Does he want to get better, understand how bad things are? Does he want therapy?

Thank you. My concern is the lack of routine for him, but he keeps his own routine as it is and won't listen or rationalise when he's in his hype cycle. But I have made both myself and my son a doctors appointment today to try and get to the bottom of what our options are. But I've definitely added this to the list. School just don't want to deal with him, so they suspend him constantly and I know that will also be having a mental affect on him feeling like no one cares - when at the same time they have hundreds of other children to deal with. It's just knowing what's the right thing to do.

Remember to think about everyone else's safety too. There might come a point where he has to stop being your priority.

Im sorry you have been through this. So so sorry. I don't believe he is taking drugs. Before I get called naive - we have spoken - at length - about the potential affects drugs would have on someone like him and with his brain. I know he was pressured (although he is capable of making his own decisions) to try weed this weekend and he had one drag and hated it. But that is part of his lack of personal safety cycle and something he will not repeat. He said he feels he has little control over himself as it is, and doesn't want something else added to the mix.

Is it normal though that coffee/caffeine actually calms him? Only temporarily, but it doesn't make him hyper or worse, just calmer?!

I'm so sorry things are so tough- mental health services are dire at present and so many people are not getting the support they need (I say this as someone who works for mh services)

I agree with PO that the ADHD sounds like a red herring. Can you afford a private psychiatric assessment? You shouldn't have to pay but it's so shit right now.

I really hope he turns a corner soon.

I'm really sorry to hear what you are going through. We have had similar issues in the past, though our children are adopted so it's easier to understand where it has come from. Our eldest was like this around 14 to 15 - I think with her it was all about the fact she had huge difficulties with peer relationships and coping (not coping, her behaviour was a constant issue) with the demands of school. She did get an ADHD diagnosis but I don't think that explains her fully. She made a series of suicidal threats at school, did things like put ligatures around her neck or sit in the road, though she never actually harmed herself beyond a few cutting episodes. She also ran away, always it would be after school, so she wouldn't come home nor answer texts or calls. We often called the police. They'd ask about who she could be with but at that time she only had one friend whose home address she didn't know, so we knew there was no one. She was unable to really express her feelings verbally and we did our best to be accepting, loving and kind when she was home. Strangely, other than being rude or abrupt, she never really had an obvious problem with us. I think it was just general unhappiness. She had CAMHS from age 6 but couldn't really engage - I found it more helpful as support for me. Only when she was around 16 / 17 did she suddenly want to talk to the therapist (actually a psychiatrist) by herself. I can't offer advice in particular, only to say that from 17 things gradually improved and she's now mid 20s, living at home, has a job and manages friendships.

We have also had mental health issues with our youngest, who went to CAMHS from around 13 but is much more able to express her feelings. Lots of self harm crises and she was given lots of support - at one time she ridiculously had 4 separate professionals working with her. She also demanded medication and was given antidepressants at 16. She's over 18 now and things have calmed down a lot but anxiety has always been an issue for her. She now engages fairly well with adult services who have been surprisingly good so far - took a more holistic approach and have helped dd understand herself better. Maybe we just live in a well-serviced area.

I know that adoptive children tend to get more support - or did, don't know about now, so we were lucky in a sense. But really it was us as parents that held it all together somehow (luckily eldest had settled when youngest took off so we only had one set of crises at a time!)

Both dds have been kept overnight in hospital - eldest once because she was caught trying to climb the fence of a bridge, but let go the next day. The youngest twice - once as she refused to come home with us from hospital and once because she had to wait to see CAMHS in the morning to be assessed. We've certainly never had inpatient offers.

So much sympathy, I know how draining, worrying and difficult it is. Outcomes can never be known but we've made it though so far. Hoping you find a way through. All the best.

I completely agree. And this is what I have been saying to social services and the police. If, and when, our DS eventually get physically violent with myself/husband (which feels like it's not far away as the threats are getting worse) - our 15 year old will try to step in. I'm worried about our 7 year old being caught in the Crosshairs. I'm scared to sleep when he's in a hype cycle. He's 6ft1, our 15 year old is 6ft4 - they are big lads. I'm scared of what can happen and SS don't care about safeguarding the other two because they are high performers at school, in after school activities and neuro-typical

He is the exact same as me at that age I am now 20 and still sometimes feel the same I 100 percent think it's down to adhd mine was it's called impulsive decision making so you feel a certain way and the adhd clicks and without thinking of anything you do it so example you feel upset within them 1-5 mins you think I don't wanna live like this and impulsively take the first thing you see or have around you to try stop the feeling then the regret kicks in i highly believe he should be on adhd medication and melatonin at night to help sleep and ease the taughts I had many of these episodes until I was put on this hope it helps in some way (also never opened up and never wanted to it made me worse so if he doesn't like opening up just let him know ur there for him but don't make him say anything he doesn't want to)

Sometimes. When he's low. When he's in a hype cycle his whole voice changes, the way he walks, his facial expressions, the way he breathes - he's a completely different persona. When he's low, he's depressed, but his mannerisms are back. The him that we know - although extremely unwell, exhausted, depressed and sad. I agree that he needs medication. But I am getting pushback from health care professionals. It makes me think that maybe I'm crazy or imagining things

In my area camhs isn't fit for purpose. They are constantly looking for reasons to not pick up cases. My own child had what looked externally like an extreme behavior change that on my own safeguarding training was worthy of a urgent referal to socail care. The only thing that happened was the ht telling me I was a trouble maker and camhs via gp taking 6 months for a urgent MH assessment. My older ds also had a urgent camhs referal that took three months for suicidal thinking and got discharged at triage.

I don't have any answers. I also suspect adhd but my child really needs a short period of medication on anxiety meds to go back to be calm as a normal. It's impossible via camhs as they want to try everything else first while offering nothing. Private as you say takes ages too.

No - I honestly didn't know this existed. Thank you - will add this to the list for today's calls and appointments!

Is your son not 'eligible' (sorry can't think of the correct wording!) to be an inpatient at a children's mental hospital?

I am so so sorry that this is what has happened to you, your son and your family. I don't even want to imagine your pain. I am so sorry.

Private psychiatrist may well
Help.

They will be able to prescribe a it depressants and or consider if it is bipolar and prescribe effectively.

No there is very little help out there.
We tried Camhns and were on a waiting list for years.

Coffee having a calming effect is classic adhd.

Consider how to protect your other children. You may need to look at having other relatives etc who can take them in an emergency so that they are not exposed to/don't get involved in physical violence.

Consider getting martial arts training for yourself and your husband, not so you can overpower your son but so you have more confidence in dealing with these situations - looking at how to block punches etc.

This is normal! My ADHD DH finds coffee chills him out and can drink buckets all day and evening without it affecting his sleep. It's to do with the part of the ADHD brain that is acted on by stimulants.

The ADHD is absolutely not a red herring. This boy's experience sounds like classic undiagnosed/unsupported ADHD in teenage boys. It's textbook. The mood swings and hyper cycling is also ADHD. Far less likely than bipolar disorder (though obviously that's a possibility)

I don't know what you mean by 'social services don't care about safeguarding the other two'. What do you think they should be doing? All they can do is explore what safety planning you have in place as their parents. They don't have special resources to safeguard siblings of children with risky behaviour. You are the resource.

Mental health inpatient care is only available for children who are at immediate risk of harm to themselves. In any case this isn't a treatment, it's just a way to stabilise them to the point they aren't about to kill themselves before discharging back home.

I can't express how sad I feel for you and your family. You are in an intolerable situation. I hope you get the help you need.

Sounds like my son. I can't offer any practical advice, because like you I did everything I could re contacting the relevant authorities, but the help just wasn't there (I'm so pleased to read that you've had a lot of support from the police). It was just a game of ping pong.
It took DS being criminalised in the end, to get anywhere. As part of an order he was given, a youth worker identified that school was a source of trauma. He said that every time he was at school was re-traumatising him over and over again. I raised my eyebrow at the time but DS is 20 now and has been working for a couple of years now, settled in a job he is enjoying. He's not 100% perfect, I still believe there have been so many missed opportunities to diagnose him with something. But most of his problems were to do with expectations around school. He just couldn't do it. It bled into everything and putting it all behind him turned out to be what helped him most.

Can you get him on medication for ADHD? even if you source it yourselves if the docs won't do it?

With re caffeine-it's a common thing-it's like a little dopamine hit for them. We worked out that DD's behaviours were all about that-seeking hits and stimulation. She is awaiting formal diagnosis for inattentive ADD (though her CAMHs worker, her therapist, her school and I (I work with adults with LD) can see that this fits her perfectly. She is very high functioning academically but can't organise herself, make rational decisions, control her mood a lot of the time-so either very happy or very sad-and control her impulses around things that give her a little high.

I hope the GP is helpful. As for pp dd was medicated for two months (fluoxetine and quetiapine which helped her sleep and calmed her mood cycle) before she would even agree to theory and it wouldn't have been helpful anyway if she hadn't been medicated to get to that point. Awful as it is I really think you should push for this.

@fatandhappyxxx I'm so sorry for what happened to your son and to you. Lots of love.

Thank you for sharing this. I do "date days" with all the boys individually to go and explore the woods, or go for a low key lunch or just do something 1 on 1 (having three - we need to make sure that they all get individual time as well as family time). But I agree a longer weekend out camping away from tech and people may be a great idea. Not as lucky with Australian beaches in the UK, but will definitely look into this!

Well my friend's son (v different situation) is in a residential school and gets respite care because they were struggling to care for him given his needs and behaviours so maybe that's the sort of thing OP might expect social services to look at.

OP I'm sorry you are struggling so much. It's shit the lack of support in situations like this.

it may be worth looking at Young Carers resources for your other children?

It sounds like his needs may be complex eg not "just" ADHD, I hope you get some answers soon

This. Mental health support on the NHS is very poor. Partly because you don't have much choice on the therapist and type of therapy. If you can get him in to see a private therapist it can do wonders, try a few different things and see what works. Once he clicks with a therapist or type of therapy he can come on in leaps and bounds.