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?

The post doesn't indicate difficulties beyond neurodiversity- I wouldn't make a diagnosis based on the information but first concerns age 6 (when school tends to funnel to more structured learning after the early years), self harm in primary school, increasing anxiety absolutely screams neurodiversity. If this was a vignette in a teaching session it would be first on my list of differential diagnoses. Bipolar would not be- it is rare to present before early 20s, if it does it has a worse course and prognosis so would expect a kid with bipolar in their teens to be completely florid (not making sense, stripping naked, bizarre behaviour) and needing hospital. Often there is a prodromal anxiety or depression prior to first episode of mania but this course of illness does not fit that picture.
Having a brain that is not designed for the world we live in (or rather, when the world you live in isn't designed for you and your needs) can be incredibly stressful, anxiety inducing and isolating.

I'm not anti -psychiatry or against medical solutions... I'm a psychiatrist! I prescribe all the time! I've prescribed and administered electroconvulsive therapy! However the right diagnosis directs the right treatment.
I for one am not going to sedate autistic/ND kids with antipsychotics, shortening their natural lives. Services are shite but kids deserve more therapeutic options than that.

Hi op sorry you're going through this you all must be distraught! As soon as I read this I said ADHD. I have ADHD and was late diagnosed at 29 last year. My entire life I was angry as I couldn't understand why I wasn't like / couldn't function like everyone else. Very impulsive emotionally to the point the feelings are so intense I just want to die. I have put my poor mum and husband through hell with outbursts that I just couldn't control. After years fighting with the NHS I gave up and went private. The medication has changed my life. It's a long process finding the right medication and dosage with a lot of emotional ups and downs but once you get it right, for me personally things have fell into place. I also went to a and e suicidal and they also discharged me saying to wait 7 days for psychiatry to be on touch, I felt the same as you. Just to note, ADHD isn't actually a mental health condition it's a developmental condition, the problem is when it's unmanaged/ unsupported that distress then causes anxiety and depression etc which makes everything so much worse. A lot of people who have ADHD are misdiagnosed with bipolar as well.

Oh, I do feel for you. We were in a somewhat similar situation last year with two suicide attempts and an utterly useless CAMHS - and, with ASD and ADHD diagnoses, my boy was already on their books.

We paid for a private psychiatrist who prescribed an anti-depressant and an anti-psychotic. There really was no NHS alternative - or not fast enough. I think he’d have been sectioned (or dead) before they treated him.

I see you’ve already received a private psychiatrist recommendation but do let me know if you want any others (SE England). Ours saw us as a weekend emergency - over Zoom initially. The relief of someone taking the situation seriously was immeasurable. Fingers crossed, knock on wood etc, we are in a much better place now. I am hoping for the same for you.

I'm dismissing unqualified scaremongering irresponsible people telling the OP her child has a severe psychiatric disorder or personality disorder and needs anti psychotic medication on the basis of no evidence of psychosis whatsoever. You seem to have a minimal understanding of ADHD and the impacts it can have on the mental health and behaviour of an adolescent.

@PenguinLover24 can I ask if it's ADHD medication specifically ( a form of methylphenidate for example) that has helped you with these struggles.

Your story offers hope to OP and people reading this ( including me). I have heard similar comments from others who found an ADHD medication that worked for them to be life changing.

It's not scaremongering at all. The right diagnosis is a massive weight lifted off, not scary.

In the case of my relative they got diagnosed with ADHD after and in addition to the initial diagnosis.

If we'd started by addressing the ADHD it would have had no impact at all, or taken far too long to make a meaningful difference.
The OP knows her son and she's had contrasting suggestions here.

I just wanted her to know that actually not shying away from more serious diagnoses if applicable can be incredibly positive and life changing, whilst flailing around with small adjustments that have minimal impact can be soul destroying.

Since the son will likely see a psychiatrist at some stage they will be able to assess what the condition is. I hope OP you get a good one and whatever treatment you get is mightily effective.

If something beyond ADHD is found, please don't be scared. It's the beginning of the solution. Hugs to you.

Hey! Feel free to ask anything at all, same for the OP.

I'm on 60mg of elvanse which is the stimulant Lisdexamfetamine.

I started on 30mg which worked straight away but wore off within a week, upped to 50mg which was good but something felt missing like I wasn't quite there yet so they tried me with 70mg. This transition was hard for me as I felt like I got the taste of a "normal" life and it felt like it was taken away and I was back to square one. My depression reared it's ugly head and I was suicidal. That's why I always warn people that finding the right dose can be really challenging. The 70mg was wayyyy to high and I felt like I was dying. Settled now on 60mg.

My son's issues were different from yours but, like you, I had a terrible time getting suitable help. The thing that made the difference and opened so many doors was obtaining a private assessment with a consultant child psychiatrist. He came highly recommended and he took such pains with my boy.

The report and letter he wrote made CAMHS, our GP and the school sit up and take notice. I couldn't afford it but my parents did - I am so grateful. I very strongly recommend a private assessment.

I just want to say how utterly traumatic this must be for you and I can hear the desperation in your post. It sounds as if he needs mood stabilizers as a matter of urgency if this is tipping into mania? Can you get him to A&E? I would take him and refuse to leave until they give him some help! Extreme PDA? He needs an urgent psychiatric assessment. unless there is something else triggering this such as county lines involvement? Sudden anxiety triggered by illness by any chance? PANS/PANDAS?

Hi all, apologies for the lack of update this afternoon. It's been a day.

Just to be clear on a few things from everyone:

• I am not a medical or mental health professional. He is showing signs of everything mentioned, but I'm not pigeon holing him, because that doesn't help anyone. As with my OP - I am in direct need of help, and everyone who has responded here has been extremely helpful, offering suggestions and giving me options to dive into so I can discuss these things with professionals.
• I am open to medication, so is my DC - unfortunately I feel like I've made this all about me, but I really want him to feel comfortable in his own skin and head and start to get answers he needs. We're all in pain for him.
• CAMHS tried to shove me off, but i have pushed back today. We are finally getting minimal movement, but i have reached out to recommendations. For the poster who said that are in SE - please send me those details. We are also SE UK.

DS is turning somewhat - hes become more reclusive and we have had more outbursts. He so low, and we're all trying to create a calm and relaxed atmosphere - we have someone visiting tomorrow because we reported him missing so many times over the weekend, and he does not want to talk to them or any professional.

I took him to A&E yesterday, and they will not do anything. They dent us MH professionals, who are not psychological professionals, and they wrote their report and have sent it off to CAMHS and the school. They will not do anything without CAMHS. GP is the same.

No county lines involvement, no drugs, no physical illness - the local police are very aware of who he is - as we reported him missing so often - and they know the full layout of our house now. We are doing all of the safeguarding that we can, but at the end of the day, could I really say that during his hype cycle - would he say no to doing those things? No, I can't. But we would notice if something like that was going on. He has no sense of hygiene in his personal space, so I do clean his room (clean space, clear mind) and get rid of rubbish and just put it back to order for him - so I also use this as an opportunity to check for anything suspicious

Id look for a private psychiatrist who specialises in teenagers.

I was thinking this sounds more like bipolar disorder that has florid mania and cycles rapidly through the stages.

OP - Can you talk to the GP or even the Psych Team at A&E about an urgent psychiatric appt - he may need lithium rather than counselling as a first step?

It's a very difficult medication but better than jumping off a bridge at the worst stages of his illness. And I don't agree with the first poster POV that he hasn't attempted if he was standing on a bridge and luckily members of public talked to him until your DH got there. That's far beyond a merely preparatory act and just talking about it.

So sorry for what you are all going through OP.

@3Blues I’m a MH nurse. A question, does he ever say anything particularly strange, have any unusual beliefs or seem to respond to things you can’t hear or see? Like PP, I’m concerned that ADHD may be muddying the water but, as the psychiatrist poster said, teenage onset bipolar is usually particularly severe and 14 is very young indeed. Weirdly, my spider senses were set of by the messy room comment. Yes, all teenagers are messy but mental illness mess is another thing entirely. If he was left alone would be care for himself at all, do you think? It does sound like you need much more input. Diagnosis is impossible over the internet and, to be frank, there could be lots of different things going on. Right now he just needs to be safe.

Same thing happened to my nephew when he was 15. Took a shed load of tablets because he wanted to die.

Went to A&E, My Dsis was told it was a cry for help and to speak to Camhs. This is apparently the highest level of support via the NHS.

Camhs were useless, told him to go for a walk and get a colouring book!

He has had OCD for years, since he was about 11 and sometimes his head gets too much, this was his first suicide attempt and he tried again just before he turned 16.
Camhs wouldn’t help as he’d stopped going to school, he only got one GCSE.

Dsis pushed his GP for help and we managed to get him to self refer at a local wellbeing clinic. He ended up in a mental hospital for 3 months but they didn’t help him there either.
The problem is, it’s almost impossible to help someone who won’t help themselves and my nephew wouldn’t engage in any discussions or try exposure therapy or CBT.

Following all this with my nephew, I trained as a counsellor and have been doing the job for 4 years.

My nephew is now 23 and I’ve been his counsellor since I qualified and he talks to me about things and over time things have improved. He still has OCD but he doesn’t obsessively wash his hands until they’re red raw any more. He hasn’t tried to hurt himself since he was 18.

If your son is kicking off at the hospital, it doesn’t sound like he’d engage with any professional help at the moment.
May I ask, as these are common causes for boys in need of help:
Is his older brother the ‘golden child’ he can’t live up to? Is he being bullied at school?
Has he split up from anyone?

Has he said why he wants to die?
I recommend you try and have a non emotional talk with him and say, we love you and don’t want you to die but we need to know why you don’t want to live any more. It’s hard but it needs to be brave, factual with no pleading or tears.

Has your GP given a reason they won't prescribe anything? We had an extreme event in our family when my oldest was 7yo and he was just beserk and he prescribed him some tablets immediately. Would your GP consider a mild anti-depressant? Can you buy some melatoniin over the counter? Where I live you just have to say it's for yourself? Is that an option?
Def get a child/adolescent psychiatrist appt asap. They can prescribe what they want. Put it on the credit card. And worry about the price later. You've got years to pay it off.
My second son was very similar to yours. It's a nightmare and to add to the fun his gf was diagnosed BPD at 18yo (we'd been putting up with her straight out insanity for 3 years by then). I could fill pages with shit we went through, so similar, the police, the screaming the broken doors, the abuse, the school suspensions it's relentless. Left school at 15 and the drama continued until at 18 I finally cracked and said he had to leave. He ended up arrested and thankfully was given a suspended sentence but had to come back to us.
He has improved. He got a job, just KFC but it's money, then joined with a friend and they have a little business doing gardening. I bought all his tools for him and it seems to slowly be working. He finally got rid of the gf , has a new one and seems to be working hard.
OP - I think I made 3 mistakes ( probably hundreds really) one was not believing the ADHD diagnosis because I took him to 2 psychs and the other said he wasn't. I think the first guy was right but too late now, though I'm thinking of talking him into a late diagnosis ( he's 26yo now)
The second was letting him rule our house. For a few years we were all just waiting for the explosion, or the gf's( should never have let her in but she came through the window at 2am most nights ,again I should have fixed that).Or the police turning up. My youngest ( at 5yo) was like "oh look the policemen are here again".
The third is not doing what someone has already mentioned upthread, and that is taking him out of the situation, away from the druggie friends, and the school he hated for a month or more. I looked into camps and heaps of places and could not find a spot but I should have just done it myself.
Regrets.
You are doing brilliantly OP but book that Psychiatrist appointment now , definitely one who specialises in adolescents. ( Be warned some of them are wankers so if you don't like them try another) Best wishes.
Hopefully I haven't offended anyone .

With the missing episodes, has anyone from the local authority been in touch to complete return home interviews as a debrief with him afterwards? It might be worth requesting that those are completed by the same return home practitioner each time so that there is a professional who can start to build a relationship with your son and a picture of the missing episodes to feed into the team around the child meetings. It might add an extra layer of understanding to the triggers and his perception of what’s happening for him at those times when he’s particularly heightened.

Also - if a child is reported missing 3 separate times within a 42 day period then the local authority have a duty to have a strategy discussion regarding the child to explore what needs to be done/is in place to safeguard. In my area, this would include the return home practitioner. It sounds like you’d have hit the criteria for that so I’d be asking social services if a strat has happened and what the outcome was if you haven’t already had it communicated to you. It takes a village OP and it’s a shame that you have to shout loudly to build one, but keep asking the questions and building the safety net for your boy.

My other suggestion in the interim whilst you wait for mental health services is to look at mentoring - if your local authority has a targeted youth service, or a prevention strand of the youth offending team then this could be an option. There’s a lot of benefit in children having safe and trusted professional relationships and a mentor through those types of service is well placed to start to explore and understand what it feels like for your child to navigate life, as well as being able to feed back into the network around him to contribute to planning going forwards.

Good luck.

Hi op I was looking for advice regarding my son and was just wondering how your coming along did u get any help how is your son