Just found suicidal DD with knife

[HebburnPokemon]

14 year old autistic (largely non-verbal) DD has had thoughts of suicide for a few weeks but no plans to do anything - until now. She’s been self harming by cutting her arms and thighs. School are aware. GP is aware. Private psychologist is aware.

I have just noticed the largest knife was missing from the knife block in the kitchen. Daughter had locked herself in bathroom with it.

Luckily I seem to have caught her before she did anything.

I am completely out of my depth. I don’t know what to do.

I phoned 111 spoke to crisis line. They said a nurse will phone back. I have no idea when. I’m too scared to sleep in case DD does anything.

hand hold please. Any advice?

OP I’m not sure where you are but if you can escalate to requesting that your daughter is also put on the Dynamic Support Register in your area. For individuals with autism
and/or a learning disability at risk of needing admission. It’s recognised that hospital admission can be very difficult for autistic children (not saying it isn’t sometimes necessary) but this system should safeguard her and look at what support can be put in place with a system of accountability.

How are things today? If no school was a huge relief perhaps this is the issue? Can you pull her out of school for a bit if you think this would help?

As pp have said lock the knives away - a friend of mine was told to do this when her DD was in a similar situation.

If school is a problem, get her away from it. I’m an academic and believe strongly in the value of education, but there is little to be lost by taking time out and redoing a year or two, if you take a longer term view. GCSEs are important - but they do not need to be done at 16. I know a young person who had to take a year off school after a very bad accident - doing GCSEs at 17/18 and A levels at 20 have not in any way damaged her life.

Do what needs to be done to keep her safe.

Every area should have a local mental health crisis team. My sister had BPD and often threatened suicide. She is gone now but while she was still with us we had one particularly bad incident where she was standing on the edge of a bridge. We called the police and the local crisis team. They came out to the house after 11pm and gave us the option of having them come every day to help her or for us to have her admitted. We kept her home but they came to us every single day. She saw a psychiatrist the same week. That team saved her life at the time. She started therapy almost immediately and was put onto meds. Unfortunately she was successful when she we were not with her and she was on holiday 💔

Just wanted to send hugs and hope you all got some sleep... How is she today? Personally, I'd take school off the table entirely for now. If that's her trigger, it's just not worth it. Did the nurse call back?

I hope you and she are ok OP.
Yes to locking away the knives and also a h medication. We had to live like this for a year with all our shape kitchen things and medication/harmful chemicals such as household bleach locked in a big cupboard.
But I would also say an and e. It's the fastest most reliable way to get any input or help.

Lock all the knives, pencil sharpeners, razors, scissors and paracetamol etc in the car. They have to stay there now.

I've been through this and it is indeed awful. My priority was keeping DD safe. CAMHS would not help, she is purely waiting for an autism assessment. She hasn't been to school in over a year either. But self harm seems to have long stopped <<touch wood>>.

Do all the stuff people are saying about hiding blades, scissors etc. Also (sorry) consider cords, put hair dryers and straighteners out of reach.

Our first visit to A&E wasn’t that productive but a subsequent visit resulted in DD being flagged as at increased risk and the mental health crisis services kicked in at that point. You really have to stress the risk of self harm.

She needs distraction from the intrusive thoughts, they are very painful and “noisy”.
Snapping an elastic band on her wrist might help, it’s a tried and tested method that provides the relief she’s looking for without cutting. Cold water can help too, a flannel on her forehead.

DD found the MIND helpline incredibly helpful. They will just listen.

Can I ask, is she taking any medication like SSRIs and have there been any recent changes? DD’s problems all stemmed from these.

DD won’t get taken to a S136 suite, unless she was found to be suicidal or threatening to harm other people in a public place. According to OP, DD was at home.

I was in A & E majors (ambulatory chairs) with DD last week. A HCA told me, I could ask him for food and drink whenever we wanted. We both got cereal for breakfast. I had a choice of sandwiches later, and she had a menu to choose her lunch and dinner.

In the daytime, she was assigned a HCA, as a 1:1 carer (even though I was there), as were three other mental health patients. Later on, she got a bed in a side room.

The chances are OP’s DD would get sent home, unless OP felt she couldn’t keep her DD safe. In patient beds are usually rarer than hens’ teeth.

My advice to OP would be, if you can possibly afford it, pay for private mental health input. Waiting lists for counselling on the NHS are long.

I agree with the warning about SSRI's. They are risky and can make things worse. Tread carefully.

I have worked with children in hospital for many years. I’ve never seen a psychiatrist come to the ward or A&E in the first day of admission. It’s great others have but this is obviously area dependant. Many hospitals don’t have Camhs based in hospital. My last trust had a day unit that got scrapped.

In my experience it’s left to Mental health nurses to do a risk assessment (often after waiting hours) and liase with CAMHS/social services/safeguarding if needed. Mostly they go home with ‘community support’ ( whatever is available in area) and safety planning. eg an appointment with camhs/ visit at home/support workers.

If patient is deemed as really high risk and ? admission to inpatient unit then someone comes to assess them but this could be a day two three days before that happens.

These young people are left on a childrens ward that’s not suitable for their needs and often go further into crisis waiting on this. Many wait to be told not admission needed and to go home with the support i mentioned above. Or then wait days for a mental health unit bed to become available.

Mental health support for children and adults is just not there as properly as it should be.

I think this applies to all ADs. The SSRIs and SNRIs.

I'm someone with extreme sensitivity. When I started SSRIs, it was so awful I just couldn't cope. I had to have diazepam alongside it.

6 weeks later, they changed things dramatically and I could function. They made everything easier and more manageable. Anxiety was gone and I felt hope. If I could go back to my young self, I would have halfed the dose of sertraline ( ssri) and titrated up at a snails pace myself.

I have a loved one who was having a MH crisis and took their life whilst 2 weeks into Prozac. Again, the high risk window within the initial weeks of starting ( up to 6 weeks usually) are underestimated by many professionals I think.

A poster highlighted the possibility that being Autistic, this is burn out, probably from school, and not typical depression/anxiety. It's so difficult if OP works and has no choices. If a half day timetable was an option for her.

They're yet to develop a quick fix to help in a crisis mentally.

Again, a really good, ND experienced psychiatrist will cover all bases.

I do wish the school system was different as I feel this is such a contributor for all ND kids struggling.

Look into everything that is behind what has led to this, school is probably a massive thing as it is for so many ND children, also look into whether there is also infection feeding in, either current and/or history of infection which may not have had obvious symptoms such as strep, also possible deficiency issues e.g. B12 deficiency, environmental toxins e.g. living with exposure to mould at any point, be open to all these things. Once you research into why you're seeing the mental health crisis you start piecing bits of the puzzle together. If you do use an SSRI it can need to be at something like a quarter of what CAMHS might do as usual dose or not at all.

I’m so sorry to hear of your experience, which is very like my DD, also extreme sensitivity to medication. Sertraline made her suicidal. She had never had that symptom before, or since.

That is why I asked the question.

These young people are left on a childrens ward that’s not suitable for their needs and often go further into crisis waiting on this.

ITA, I was often looking after DD1, who was in the paediatric HDU for physical health reasons. Sometimes, she was in a bed, as a teenager, next to a bed with another teenager, who had attempted suicide, say with a bottle of vodka. Their parents didn’t seem to want them, and they were sofa surfing.

I worked out eventually, DD2 mostly got suicidal just before her period. IMO, no antidepressant has ever worked for her.

Only you can say whether she will cope in A&E.
In the meantime you need to do a huge sweep of your house. Knives, scissors, bleach, alcohol, nail scissors, razors, cutlery, remove glass, all medication, cords, string. Comb the whole house and lock it in the boot with your keys somewhere very safe.

We would be advising you to stay with her 247 - monitoring her. This will mean split shifts if you have someone with you, if not, make sure you sleep with her or near her with something to alert you if the bedroom door is opening.
It will require this level of care at this point, not forever, just for now.

Not unnerve you she obviously can not go out alone at all, not even in the garden.

Sellotape yourself to her until you have seen a doctor either this evening or tomorrow. They might prescribe medication, that can stabilise her, but it depends on her meds now and her age is a factor.

Stay calm op. Obviously you are going to be highly stressed but do what you can to lower the pressure with calming music and soothing routines.

If she likes massage, hugs, Indian head massage just try and regulate hee again, she may not wish for you to do this. Listening to bird song is known to lower stress levels.

Acknowledge that this must be a frightening time for her, that you are right next to her, and with you she is completely safe.

If you work, call in sick now, and plan to for the next few days, you need support too op. If you can reach out to any support networks you might have. We are here op. 247 on MN.

How are things today? We went through this with one of our children. I actually came across them lying in the bed with the knife held above them.
Im Happy to help if you need it x

Has she seen a SaLT to look at possible Selective Mutism OP?

WeWill DD's mood also goes proper haywire before her period. It seems like PMDD. The NHS are starting to recognise it now. My hunch is that girls with autism are especially affected by it, a double whammy.

That was also our experienced @Sinkintotheswamp although in our case dd became suicidal for a week a month. (She is also in the process of being assessed for inattentive ADD)

Hand hold.

In Royal Manchester Children Hospital now. My daughter took an overdose night before last.

She's fine medically but waiting for Cahms to come. Hospital is the right place. She's getting a proper rest and finally we will be a high priority for the Cahms treatment we so obviously need.

I would say go in. It's calm on the ward once admitted.

Same with ours. We think it's linked to PMDD so we decided to go for the depo injection. So far it's levelled the horrific symptoms each month.

Our 16 year old is under Manchester Children's hospital for pain management for chronic pain. They've been admitted to another hospital nearer to our home when they've been in mental health crisis but it's made them worse as they are not set up for teenagers and we were put on a paediatric ward with babies and toddlers.

Was MCC helpful to your DC? If so I will keep it in mind should we need it happen in future (I really hope not but who knows?)

Yes if they section her she may be more frightened as being an inpatient with restrictions is horrific for an autistic child. They can’t keep her any safer than you can at home either of you lock away anything that she can use for self harm

Plus if school is an issue then keep her off as long as needs be