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?

That's a great idea. I will look into this. I was thinking team sports might be better for comradery and building new relationships in a more organic way.

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Awful post, you should be so ashamed. Failing institutions should not be defended. Don't gaslight the poor OP, you're talking complete rubbish and causing harm.

OP I'm so so sorry. I don't know what to advise other than going to the press or moving abroad.
For every great professional in our services there are 5 box tickets bringing everyone down. Your son needs help, you need help.

You sound like amazing parents and that you have done and are doing everything you can. Probably, the only thing to add to all the great advice here is that there is nothing else you can do at this point and you and your husband must take care of yourselves as well as your amazing efforts for all three of your children.

Yes. I pushed team sports for the same reason. But found that putting my son in groups / teams didn't work. So much pressure to be 'the best' and be selected for the team etc

I am going to suggest this at the next TAF (Team Around the Family) meeting that we change his school. I have pushed for him to have alternative provision schooling - which is where 2-3 days a week he goes to a specialist school that does a mixture of practical activities and learning. I'm worried that changing his school will remove that provision/make him start from scratch.

I do want to change his school - they did a dyslexia test on him without telling me because he told them he couldn't read or write. They called me to say he had dyslexia. I called bullshit and asked them how he read Lord of The Rings from beginning to end during covid and then wrote a book report on it. Before watching the films. He managed to completely mislead them. For fun.

I have been through some of this with my now-adult child, although his actions were turned inwards rather than outwards.

I agree climbing is worth a punt - it was a rare activity that he could engage in positively when things were starting to get hairy.

We had been kicked from pillar to post by the various services so often I actually burst into tears at one assessment when they said they couldn’t help, and I never cry. I have all the sympathy in the world.

We did end up paying for a private psychiatric assessment. The reason it was useful was actually stupid and insulting, but it worked.

A letter to the GP stating the seriousness of the situation from someone with the right degrees after his name meant that the interventions from the NHS finally kicked in; he met the threshold.

The GP referrals as urgent, the crisis events, everything we flagged as parents and his own behaviour weren’t enough, despite it being relentless for 2 years and endless referrals.

So although I don’t know if it would help for you and your son, it might be an avenue to explore. Not funding endless private sessions, but a one or two appointment assessment with a psychiatrist.

My heart goes out to you all, and to @fatandhappyxxx . Our children being in distress and dangers to themselves and others is a burden no one should have to endure.

So sorry to hear all this @3Blues. Obviously it's not possible to diagnose over the internet but given the extremely short duration of single day periods of stability peppered in amongst seemingly standard extreme emotional reactivity, along with the reason for his latest suicide attempt, Borderline Personality Disorder is another possible condition to consider.

I mention this only because understanding the triggers & avoiding them would be helpful until you can get proper diagnosis. The triggers are criticism & perceived rejection.

Whilst ultra ultra rapid cycling can occur in bipolar, the triggering event stands out to me as a definite 'perception of rejection' trigger. It is the biggest trigger for those suffering with BPD. DS may have perceived your DH refusing to drive him because he was cooking another DS dinner as being less loved than his younger sibling, his needs not mattering, confirmation of his worthlessness, etc.

Have a think about other times he's wanted to end his life or reacted badly. Could these triggers also fit criticism or him perceiving rejection?

If it's a common theme, I'd strongly suspect BPD & advise sensitive, diplomatic handling of such occasions, as well as strong reinforcement of the fact he is loved & cherished & a focus on his good qualities.

There is no specific medical treatment for BPD but therapy (specifically Dialectical Behaviour Therapy) can be very helpful. DBT was created specifically for BPD patients. Unfortunately it's rarely available via the NHS. However there's a workbook that is very highly regarded by people with BPD. Lots of positive reviews here:

www.amazon.co.uk/Borderline-Personality-Disorder-Workbook-Integrative/dp/1684032733/ref=pd_aw_vtp_h_pd_aw_vtp_h_m_sccl_1/259-8445102-7171947?pd_rd_w=ftMPR&content-id=amzn1.sym.a8cf24fd-b041-455a-8115-dc906fd0dfb6&pf_rd_p=a8cf24fd-b041-455a-8115-dc906fd0dfb6&pf_rd_r=9YJEEJ7QGTVKG05DJNFY&pd_rd_wg=DMDGo&pd_rd_r=7329cc9f-00b2-4124-b834-c957ed7068f5&pd_rd_i=1684032733&psc=1

Given the levels of anger DS is experiencing, the threats towards others & the attempts to harm himself, it is appalling that assessment & help is still being delayed. I'm so sorry you're all in this awful position & for the suffering your son is going through.

And I am looking into private psychiatrist - one of the lovely people on here sent me a recommendation that I am looking into

Hi, I'm sorry you're in this situation, how worrying for you. Although the assessment team will have seen the text message as 'self - rescuing', and this as 'care-seeking' rather than a suicide attempt, that doesn't diminish your concern as a parent.

It's impossible to reach a conclusion about what the diagnosis might be for your son from what has been said, but I will say this is extremely unlikely to be a first presentation of bipolar disorder given the age and timeline given.

In a way, although the diagnosis does matter, when you see CAMHS it may be worth pushing for formulation work. He is trying to tell someone something when he sent that message- that he is unhappy, angry, anxious etc. Formulation tells the story of his difficulties in a non judgemental way and can help understand what his triggers are and what can help.

By far and away the most helpful intervention I've seen for this age group is family therapy, if you have the means to go private, even better. Although there may be initial reluctance, I've seen some really oppositional kids benefit from it.

CAMHS won't be able to expedite the assessment but you could ask for

• appointment with psychiatrist in the team

-systemic family work -formulation work

Being frank the person you see won't consider it their job to direct you to appropriate support. They will see themselves as a gatekeeper and they will try to give you as little as possible to manage on, direct you to charities etc. Not their fault of course, but in this system the squeaky wheel gets the oil.

I see while I was typing out a lengthy blather, @Mirabai made the suggestion much more succinctly.

This does make sense. I agree a "pressure off" activity may be best. He's naturally athletic and (annoyingly) is great at most things he does. So the challenge of climbing may be a great one. I also love bouldering- so a good thing we can even do together on our 121 days

It's not helpful to give children diagnoses that they have a personality disorder, when their personality is not even fully formed and their brain is still developing.
So many neurodevelopmental disorders also get labelled as PD and discovered later on in more trauma informed services.

Residential school, if he were eligible, is accessed through education primarily if there is an EHCP in place. Otherwise it may be accessed through a disability social worker but the criteria for the CWDT is extremely high and the OP's son wouldn't meet it.

With the private assessment we've chosen for DS for ADHD, I have added on family therapy for us all together and individually to help us all have a way to live together and get individual support as well as collaborative. We do need psychiatric help too. I have also rebooked my older DS (15) to mentoring (he goes to the gym with a mentor and talks) so he can get some additional space and support as it's been a difficult few weeks.

I have been battling for an ECHP - but keep getting blocked by the "are you looking for benefits or to quit your job" brigade. No - I do not want benefits, I love my job - my son needs help!

You can buy melatonin online - try popping rock. You won't get it on prescription without a diagnosis unfortunately.

Blocked in what way? Have you submitted an ECHNA?

Yes. But they are pushing for diagnosis and saying he is just "disruptive". It's frustrating beyond belief. None of the different organisations speak to eachother

He's 14. He's clinically unable to meet the diagnostic criteria for a personality disorder. The mood cycling and low self esteem is also a feature of ADHD. Rejection sensitivity dysphoria is common. It's not helpful to start throwing in potential very serious life long mental health conditions like bipolar and EUPD when he hasn't even had a ND assessment yet!

This with bells on!

This.

Also, the 'brigade' are often taking a position informed by their own experience of perhaps having given up work to home educate their SEN child due to EBSA and the school failing to meet their child's needs. DLA and other benefits are often necessary in order to help SEN children.

Apologies if this has been suggested, and it sounds extreme, but given the risk to himself and others, have you looked into Level 2 sectioning, to provide an emergency short term assessment of his mental health needs? I say this because we're currently in a similar situation with my nephew, but it's not straightforward as he's now 18 (12-13 mental age), and refusing help from anyone including his mum, my dsis (who doesn't have a health power of attorney in place for him, sadly).

If you need any advice on getting an ehcpna, there is lots out there (we got one in place for our dd despite no formal diagnosis and her heavily masking at school).

You don't need a diagnosis for an ehcpna and you can apply for it yourself.

@3Blues This sounds horribly familiar and my heart goes out to you. My grandson is the same but much younger, (saying he would be better off dead at 7 years old) and violent destructive behaviour towards his siblings and parents. His parents have been ripping their hair out and jumping through countless hoops to try and get help. The game changer was medication. It took three attempts to find the right one, it isn't the total answer but the extremes in behaviour are far less. They have paid privately for everything, his first appointment on the NHS isn't until the end of this year. And anti-depressants, his anxiety was through the roof.
I am so sorry that you (and anyone else in this situation) are going through this. It literally destroys families.
My very best wishes for speedy, effective help.

Private psychiatry apts are so much better than what the NHS provides. I hope your recommendation can fit you in. The other thing that is calming is weight training. See if there is a local powerlifting or weightlifting club. The graduated improvements are specific and measurable and there are a lot of Neurodivergent participants.