Type 1 diabetic with mental health issues

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Casual scribe

Type 1 diabetic with mental health issues

Hi, I am looking for strategies to try and help mitigate our current situation which I have described below.

 

Our 14 year old daughter is a type 1 diabetic with mental health issues.

 

She self-harms and engages in risk-taking behaviours.

 

Overdosing had been going on for about 18 months but only identified as such since August 2017 when the other behaviours also surfaced.

 

She was under medication  but this was quickly abandoned and community engagement given preference as the best way to achieve a balanced outcome.

 

She is currently with AMYOS for community-based care and treatment and LCCH for in-patient episodes.

 

There has been no identified reason (apart from the obvious stress of being diabetic) for any of the above issues, or rather they may have been identified to health professionals however in the interests of ensuring her privacy we are not privy to them.

 

She has been admitted to a number of hospitals.

 

Her admittances to hospital are now weekly and usually involve both QAS and QPS to be in attendance.

 

She will abscond without hesitation if she is not at home and hide, so far last week this has happened twice once from a sporting acivity and once from a scheduled diabetes-related appointment, the last time required two shifts of QPS and a SAR heli.

 

She will then walk up to a stranger and say she can't go home because she isn't safe. So far she has been fortunate with this approach however sooner or later her luck will run out.

 

This absconding has happened around 15 times during the past 6 months.

 

Her home is now a safe zone where unsafe items are at least two locked doors away from her at any time.

 

We have a 6 ft fence and all external doors are either locked 24x7 and/or have push button access to exit to which she does not know the code.

 

We don't particularly like doing this but we have no real choice in the matter.

 

She no longer has access to phones because she uses them to hassle and complain to friends in order to garner attention and sympathy.

 

She has low self-esteem and body image and appears to have alienated most of her school friends.

 

She says we do not 'allow her to do anything'. The last time we 'allowed her to do something' by herself she met a girl 3 years older than her who had befriended her in the adolescent mental health unit and as a result she indulged in further risk-taking behaviours. 

 

We have had to toss her room in order to remove unsafe items.

 

She comes with all the usual teenage traits of being selfish, self-absorbed, self-centred, attention-seeking and impervious to any reasonable request, and of course loved unconditionally.

 

 

If she is admitted to hospital under an EA (examination authority) she will have a security guard in attendance; she will attempt to abscond anyway. If she is not under an EA she will walk out
of the hospital and security will use CCTV to tell police in which direction she ran off.

 

We have had to carry out CPR on her when despite checking on her every 10 minutes she still managed to get into a situation where this was necessary.

 

She has excellent spatial awareness. I have seen her in a room at the hospital with four police and she easily evaded them all. She will bide her time and pick the best opportunity for escape; and she can keep up this level of awareness for hours.

 

When she is discharged from hospital she will attempt to unlock the child-locks on the car doors, if we do not monitor this or forget to do so due to a combination of tiredness and/or stress she will attempt to exit the moving vehicle at speed on the way home from the hospital. She will attempt a similar action via windows in police cars unless handcuffed.

 

Local QAS and QPS know all of us by name, as do most of the hospital staff. We are on a first name basis with hospital security guards and know some of their life stories.

 

Thinking about joining the hospital's loyalty card program, after 10 admissions we apparently are entitled to a free gift of a small carton of diazepam.

 

That last one was a joke as obviously if it were true we'd be able to start our own pharmacy.

 

We have now reached the point where our daughter's needs are all covered.

 

Now its ours (but still with a focus on our daughter), for example my wife has recently seriously considered just leaving and I don't blame her.

 

There is no way she can continue to stay awake 18x7. She doesn't need pastoral care or people telling her what a great job she is doing or how hard it must be for us.

 

We've had that. We are over it. We need some practical non-medical assistance.

 

We are now at the stage where Child Safety will be getting involved because we can't continue to provide the level of care that our daughter requires and still remain as a viable family unit.

 

Does anyone else have similar issues and what strategies do you use to combat them? I'm not talking about the medical side, that's covered.

 

I'm referring specifically to what happens at home once all the medical professionals have exited the scene.

1) How do you handle absconding?
2) What, if any parenting strategies do you use to try and get a child to keep safe, i.e. acknowledge her diabetes and make some attempt to help us (or herself) deal with it?
3) What do you do about respite care? We've tried FACC who gave us DSQ and some other support links we don't need. Diabetes isn't a disability and mental health is medically treatable so we aren't eligible for respite via them. DSQ gave me some numbers of respite care to call and I was about to do that, all of them appear to be for aged care or people with a disability.

 

thanks

ujb

Community Manager

Re: Type 1 diabetic with mental health issues

Hi @unclejimbob thank you for sharing your story.

 

This is just a quick note to let you know that I've edited some content out of your post in line with our community guidelines (link here). I hope you don't mind, we just try to be mindful of sharing information that may be considered graphic, triggering or have any identifiable details.

 

It sounds like you and your wife are going through a particularly difficult and stressful time and hopefully our community have some helpful strategies and support for you.

Casual scribe

Re: Type 1 diabetic with mental health issues

Yes that's fine, I did try to edit out identifying information to follow community guidelines, I can see the content  you have removed and am happy you have picked up on it as its removal doesn't materially change the post.

Community Manager

Re: Type 1 diabetic with mental health issues

Thank you @unclejimbob, I really appreciate that and look sometimes its a but of a grey area but that's where we're here to help.

Community Manager

Re: Type 1 diabetic with mental health issues

Hi there @unclejimbob and welcome to the ReachOut forums - thanks so much for sharing your story and the background of where your family is at.

 

I know that you specifically have asked in your post for practical advice and are not looking for support and pats on the back, but you are going to have to indulge me one time because every bone in my body wants to let you know how amazingly your coping through all of this.

 

OK - with that out of the way, I wanted to summarise and address the specific questions you ask in your post:

 

1. How to handle absconding

2. How to keep your teen safe

3. How can you access respite care.

 

 

I was wondering if you had considered speaking to anyone at Parentline?  They offer an over-the-phone service where you can speak to someone about the specifics of your situation and who will offer you personal, practical and tailored advice around the issues you are dealing with.  I really think that they might have some good practical advice around how to keep your daughter safe and how to address the issues around her running away.

 

You can call them on 1300 30 1300 or you can find out more about what they offer by following this link.

 

In addition to this, I would also like to tag @motherbear and @LovingThruBlue who have spoken really intelligently about related experiences.

Casual scribe

Re: Type 1 diabetic with mental health issues

That sounds like a very good idea, we met with a Child Safety Officer this morning and went to the hospital to see our daughter 'S' (not her real name and not an initial) in the afternoon. They won't be letting her out and frankly we wouldn't take her even if they did. We can't provide a safer environment at our house than she would get at hospital and loathe though I am to keep her there without a good medical reason (its not good for her) at least there she has security to ensure basic compliance with her safety needs. I will give ParentLine a call tomorrow. Without any false modesty my wife truly is the one who is doing all the hard yards on this, she's the Formula 1 GP driver, I just keep the windows clean and stop the wheels from coming off.

Highlighted
Parent Peer Supporter

Re: Type 1 diabetic with mental health issues

Hi @unclejimbob, welcome to the forum. It sounds like you guys have pulled out all the stops to try and help your daughter. I really feel for you all as our story was quite similar. In saying that, I also understand the point where you're at, where hearing how hard you're doing it or what a great job you're doing is not what you need. It doesn't alleviate the situation or change our kids behaviour, and at crisis point change is what we need. 

 

My daughter was super sensitive and quite volatile and aggressive, which created problems in all areas of her life. She didn't know how to cope with her big emotions, and didn't cope for a number of years. She has mental health issues too and our safety plan included calling the police to take her to hospital when needed. They got to know us very well, and when my daughter ran away, if they found her first she'd be taken to hospital and sectioned under the mental health act.

 

My daughter refused to engage with services back then, which made things really difficult. I had a caseworker who helped me change the way I interacted with my daughter, which in turn taught her new ways. I did the Triple P parenting course which was also fantastic in learning about the teenage brain, and how to communicate to get a better outcome. You'll find it doesn't go into situations like ours, but what you learn still really helps in crisis situations. I highly recommend it! 

 

My girl's nearly 16 and I still put out her medication and make sure she takes it each night. She has refused it on many occasions in the past and ended up sick, so she's pretty good these days. Does your daughter say why she won't take it? For my daughter, it was when she didn't value herself that she wouldn't take it. So that was something we could work with. 

 

I'm hoping others may have suggestions for respite. Things have hopefully changed, but when I was desperate for a break there was nothing around. I've done loads of crying and lots of fist shaking at the universe. 

 

I've been where you're at, believing you can't do this any longer. It's a heartbreaking place to be, and I really encourage you to find some support for you and your wife. It's what got me through those times, and I'm so grateful today.

 

I love your words "she's the Formula 1 GP driver, I just keep the windows clean and stop the wheels from coming off."  You guys sound like a truly amazing team! I hope you get to something special for Valentine's day, even if it's little.

 

 

Casual scribe

Re: Type 1 diabetic with mental health issues

Yes, I started the online version of the Triple P Parenting program last week. Cue spooky Twilight Zone music. I'm working full time but I see there are some evening classes nearby we will sign up for them once the current round of hospital admissions has ceased. S always says that she has told someone else why she doesn't do certain things so for example when she didn't eat for 4 days she gave the reason to a CNC nurse; and then of course we don't get to find out why. Frankly I don't think she knows herself half the time, there appears to be no particular trigger apart from when  someone chastises her over something minor - its not just us, if she has a bad session with the medicos that'll do the trick. Being a diabetic comes with its own set of problems as you can imagine, there is essentially no 'leverage' and the possibilities for self harm are multiplied. I'm confident that the support links supplied so far will at least give us a shot at reopening a communication channel - and that's half the battle right there, so many thanks to you and Nick.

Active scribe

Re: Type 1 diabetic with mental health issues

Hi UJB,

 

Thank you for sharing your story.

 

Try and take a break if you can. Do you have any family who would be able and willing to come to the house when your daughter stabilises to care for her overnight? Just so you and your beloved can get some time together away from tension and crisis.

 

Teens with mental health problems really test the whole family to say the least! I am now divorced due to all the conflict having a teen with mental health issues presented itself with. I don't wish the same thing to happen to you. 

 

So my suggestions are to 1. HAVE TIME TOGETHER

                                           2.ASK FOR HELP

                                           3. USE FORUMS SUCH AS THESE TO VENTILATE

                                           4. SEEK OUT AS MUCH SUPPORT AS POSSIBLE

                                           5.PRACTICE MEDITATION.......DAILY AND NOT DURING THE TIME OF CRISIS BUT AS A REGULAR PRACTICE.......5-10 minutes can help in your reactions and responses to the situation at hand.

                                            In regards to strategies to assist with the absconding.....stay calm, no matter what. Panicking will just accentuate the matter. If your daughter is a danger to herself or others then calmly do what you probably already have done.....call the police. Importantly, UJB don't give up. Behaviours CAN change with lots of therapy and although the process is so draining on the entire family, there can be a light for you all.

 

In regards to the diabetes.....do you have a Diabetic Educator onboard? A good GP? A naturopath or dietician could assist with management and take you away from the medical model but not too drastically.

 

The respite care needs to be snapped up by you. Your daughter is not aged but she does have a (dis)ability! No matter what your age, ability or state of health.....if you are struggling with your daughter then accept the care.....the organisation you looked into will hopefully have a mental health worker.

 

Don't give up! Importantly, enjoy some calm times through the storms......I highly recommend the meditation.

 

TAKE CARE

                     .

Parent Peer Supporter

Re: Type 1 diabetic with mental health issues

Haha! Some things are just meant to be! That'd be great if you could get to the evening classes, although it's good to know there's an online version as well. I must check it out. I really hope you get a lot out of it. 

 

That must be so frustrating not finding out those kinds of things about your daughter. It makes it difficult for you to work on things as a family unit or to know what to help her with at home. However, as you open those communication channels, hopefully she will share more with you. 

 

It sounds strange but teens like ours who come across big and tough, often have little resilience to any kind of negativity from others. Although the behaviours can be really difficult to deal with, it shows how much they're actually struggling. 

 

My daughter's friend is type 1 diabetic too, and she now has the new insulin pump, but it's still a lot for her. At least now she doesn't need to be woken in the night for a test though. I can imagine how worrying it must be for you when your daughter's not looking after diabetes. That must affect her moods as well. 

 

I absolutely agree with you, that if you can have open communication, that's half the battle won. Communcation is a superpower! It's amazing what it can do.