Jane knew there was something going on with her 12-year-old daughter last year, but she didn’t realize the extent of it until she saw her cutting herself.
The mother of two teenagers doesn’t want her real name used in order to protect the privacy of her children.
Jane said just before that episode, she had read in her daughter’s diary that she wanted to die. At the time, she said her daughter was constantly crying and didn’t want to do anything.
She got counselling for the girl, who’s now 13, thinking it might have been typical teen issues. But it turned out to be much bigger than that, she told The Telegram Friday.
Jane said her daughter has had several medical issues over the years, and after speaking with her child’s doctor during an appointment in October 2012, he sent an urgent referral for psychiatric services to the Janeway.
It took three months to see a psychiatrist.
Jane says it would have been at least six months had it not been for the urgent referral.
It was around that time the self-mutilation began.
“That was a big thing for us at first — to walk in and see your child cut up is very scary,” Jane said.
“The psychiatrist assured us it isn’t suicide, that she’s not trying to kill herself. It’s more of a chemical release. It makes her endorphines react, makes her feel good.
“Her psychiatrist just kept telling us, ‘Don’t make a big deal of it, just let it ride, and if it continues we’ll get her to see a special nurse at the Janeway.’”
At first her daughter would cut her ribs. Then it was her hips and ankles. Now she’s cutting her arms.
“This is the most tragic for us, because she has to keep her arms covered constantly. The psychiatrist says if she cuts too deep, bring her to the Janeway and get it stitched up. That’s the recommendation on it,” she said.
A few months ago, Jane said, her daughter carved, “I’ll never be good enough,” into her skin.
In describing it, Jane begins to cry.
Three weeks ago the teen took an overdose and told Janeway emergency staff she wanted to die, and she’d do it again.
Jane said they spent seven hours talking to her and then sent her home.
“That was the worst experience I’ve ever had in my life with health care,” said the 42-year-old teacher.
She said her daughter spoke to five professionals, telling the same story over and over.
“She told them she was sorry it didn’t work and would do it again, and when the resident psychiatrist called the actual psychiatrist on duty, I thought, please be to God she’s going to have some sense and say the child has got to stay. But no, they sent her home,” Jane said.
She said her frustration hit an all-time high when staff acknowledged the girl’s medication needed to be changed, but told the family to go home and follow up with her psychiatrist.
Her daughter’s next appointment was Dec. 5 — 16 days after the night she overdosed.
“At the time, I was in such shock. I was waiting for someone to be sensible and help us. I didn’t know what to say at that point,” Jane said.
On the drive home, her daughter asked why she hadn’t gotten any help.
Jane said the next day she made calls to mental health services at Eastern Health and was told to contact outpatient psychiatry at the Janeway.
“I explained I was frustrated and asked if we could see someone while we’re waiting for her regular psychiatrist. She said, ‘No, sorry, this is the way it goes. Adolescent psychiatry has actually improved because now we have a psychiatrist, so she’s lucky that service is available, and we believe it is best for children to be home with their families rather than be hospitalized,’” Jane recalled.
While Eastern Health is unable to discuss individual cases, in an emailed statement about hospitalizing suicidal youth, the authority said a mental health nurse completes a psychiatric assessment which is shared with the emergency room physician and if necessary, the psychiatry resident is consulted. The psychiatrist will determine whether an admission to the acute care psychiatric unit is needed.
“A decision to admit is not based on policy, but rather, is based on a clinical assessment of the individual. As such, a patient who is determined to require admission to hospital will be admitted to hospital,” said the email.
“If it has been determined that a patient does not require admission, and if they already have support services set up in the community, we would encourage the patient and/or their family to follow-up with their care provider; however, we may also suggest other supplementary services, if needed,” said the statement.
Jane, who had been diagnosed with depression and anxiety in her 20s, said her daughter’s mental health was taking a toll on her, as well. She called the mental health crisis line and was told if she needed intervention after 4 p.m., a crisis team would be sent.
Jane said she told them she would call back if her daughter was in crisis, but was told the mobile unit was only for adults.
The mobile crisis response team, implemented in 2010, is undergoing a review. It is a team of mental health workers who travel within a 45-minute radius of the Waterford Hospital in St. John’s. Last year it made 242 visits.
After seeing the psychiatrist on Dec. 5, Jane’s daughter’s medication was increased. She said she told the doctor about the suicide attempt and he agreed that home is the best place for a troubled child, and not a hospital.
A few days later, she said her daughter was screaming and crying and being irrational, and they didn’t know what to do.
She said her husband heard their daughter go downstairs one night last week and they found her standing there holding a butcher’s knife.
“I said, ‘What are you doing?’ She said, ‘I was going to stab myself in the heart.’
“So the suicidal thoughts are still there and I can’t get to see her doctor until Jan. 24,” Jane said.
“I called and the secretary told us that the doctor said to reduce the dose again back to when she tried to kill herself.”
Jane said she knew what kind of reaction she would get at the Janeway emergency, so she kept her home and tried to keep her calm and safe, but she said if it happens again she’ll take a different approach.
“The child is cut up everywhere. That’s a daily thing for us,” Jane said.
“Thank God she doesn’t do it to her face — she’s a beautiful child, but if she were to take an overdose again or cut herself badly, I would do things differently — I’ll tell them to get us a psychiatrist. I’m not talking to anybody else,” she said.
On Thursday, she said she had more hope for her daughter than she has had in over a year.
The teen was referred to a psychiatric nurse who specializes in DBT — dialectical behavior therapy — a specific type of cognitive-behavioral psychotherapy developed in the late 1980s.
She will see the nurse once a week until February and they’ll go from there.
Jane said she wanted to tell her story to The Telegram after reading a letter to the editor from Lisa Tucker, a woman whose husband is struggling with depression.
Tucker later expressed her frustration in an interview, saying she hasn’t been able to get proper treatment for her husband of 18 years, Harris.
“I can totally relate to Lisa and the impact it has on the family,” said Jane.
“My older child is completely shut down. She walked in on her younger sister last year when she was cutting herself and it was very traumatic,” she said, wiping tears from her eyes.
“(The health-care system) has to do better in adolescent psychiatry and mental health. It’s not good enough, not only for my child, but for all children. I want to encourage parents to push, don’t stop, complain. It didn’t get me anywhere, but the more people who do might bring about change,” she said.