A.
This letter is so far above my “this column is for community engagement and entertainment” pay grade that I called McLean Hospital shortly after reading.
I wound up speaking with Kirsten W. Bolton, program director of Appleton, a residential treatment program for people with psychotic disorders. (For those who don’t know, McLean is a psychiatric hospital close to Boston.)
Before I get into what Bolton told me, please know that her thoughts are general ones. She can’t diagnose a person or give specifics about a case after hearing about a letter sent to an advice column.
She said in a case like this, get a second opinion. If you need help with that (finding and affording it), we can talk more via email, but she said “there are clinicians out there who don’t really get great training when it comes to treating and identifying psychosis. … [It’s] really important to get someone really savvy – [who] knows their stuff.” It doesn’t sound like the current team is it.
She said to take very good notes about everything that happens at home. Log all thoughts and changes. You’ll be doing this for you, your kids, the medical professionals who want to help, and your wife. It’s easier to get the right assistance if you can give specifics.
You can call your wife’s care team and give them information. Bolton explained that there’s nothing wrong with letting them know when she says something concerning, upsetting, or threatening … because they need all of the information.
If you feel like you’re in an emergency situation, treat it that way, she said. Be surrounded. Bolton mentioned 911, but she also said 988 is designed to help people in crisis. This relates to her point about taking notes, by the way, because when help arrives, you’ll want records. Bolton talked about bringing a loved one to an ER “with this documentation in hand – a well drawn out kind of history to say ‘this is what’s going on. I really think my wife needs needs help.’”
I asked how to talk to a spouse about this when they might not trust the people around them. She gave an example of how to frame the conversation, centering loved ones. “I need our kids to be safe. And I would hope that you would agree that our children need to be safe, and that we need to have a healthy, happy household. And that isn’t happening right now, right? I’m worried that whatever is happening is getting in the way. How can we partner together to seek help to make this situation better?
I asked what a person could read for help. Bolton recommended a book: “I Am Not Sick I Don’t Need Help!: How to Help Someone Accept Treatment” by Xavier Amador. Bolton said there’s a method in the book designed to help loved ones communicate about all of this.
I want to add – with no expertise – that caregiving is complicated. If you’re overwhelmed by the state of things and worried about safety, make a plan for next steps. Let others in your life know you need support. Talk to your therapist about what this could look like.
As for staying vs. leaving, it sounds like getting the right help has to happen first. That’ll make it easier, I think, to make decisions you can feel OK about.
– Meredith
Readers? I know this is above all of our pay grades, but have you figured out ways to talk to loved ones about how they’re doing? How have you navigated the health system to find support you need?
