Have you committed your AS child to a psych hospital?

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I'm at the verge of doing this. But I'm still unsure if it's the right thing to do.

Background: DS dx'd with aspergers at age 9, 21 yr old, senior engr major, unable to cope with the idea of not being able to graduate with his year next spring because he couldn't pass req'd courses that involved team work/social interactions. Otherwise, he worked hard to get 3.6 gpa on a dual major the last 3 yr in a very tough eng'g college. He now gave up getting good grades and had been having meltdowns, screaming, crying on the phone, blaming us (parents) for all that's failed in his life.

He's not under any care of a dr, not on meds, etc. We thought we could save his academic career by pulling him out of college on medical leave, and then be given some kind of stablilization treatments for depression, and to reduce his meltdowns/agressions toward us. He's threatened to hurt us if we took him to a hospital.

He's been sent once while at student health center, for refusing to leave when the clinic was about to close. They called security. He still didn't cooperate though he wasn't violent, he just laid there on the couch at the waiting room. Security called the hospital/ambulance, and forced him to go to the emergency crisis center. He was there for observation only, and when he was proven to be not danger to anyone they released him to us and he went back to campus, finished the spring sem with good grades and in dean's list.

Now he doesn't attend classes and is failing after the dean told him once again to drop a course essential to receiving his degree. He's very tough to communicate with, does't talk to us, he just grunts. He's always had difficulty communicating, but he wants a job and wants to complete his schooling at the college he's in. But we think he could get better help if he's on meds, to be able to cooperate for language/communication therapy or what not. What is your opinion or your experience with this type of decision?

While I understand your concerns and your frustration, from what you've said, I am not at all sure that trying to commit your son to a psych hospital makes sense or is possible (legally). Committing someone to a psych hospital requires that the person be of imminent danger to himself or others. It doesn't sound like your son is. His threat to hurt you if you hospitalize him really isn't that kind of danger. The fact that you may think he should be on meds is a separate issue; the fact that you might be right is also a separate issue. Hospitalization is a drastic step and should be avoided if at all possible.

If your son is committed against his will, he will, in all probability, come out of the hospital even angrier than he goes in. It would be better if you (or someone) could persuade him to get help from a cognitive behavioral therapist, possibly working in conjunction with a psychiatrist (if medication is going to be utilized). The logic involved in cognitive therapy tends to be a good approach for working with people with Asperger's Syndrome.

^Good advise. In my experience, psych hospitals are horrible places that do nothing but medicate the patient sufficiently enough to ship them back out as soon as their insurance runs out.

Under the circumstances, maybe it's best to forget about school for now. It sounds like there's an awful lot of pressure about graduation and in the grand scheme of things, it's not that immediately important. Something's going on with him and if he's unable to communicate it effectively, then it's time for some detective work. Does he have a roommate? Could you call his professors? Does he have a friend that he confides in? Or maybe there's a professional you could talk to for some insight. In any case, you can't fix the problem until you know what the problem is.

Well, duh.

First, if he's going to be required to interact socially and work as part of a team, he's looking for a career in the wrong field. He needs to take a step back and reconsider his choices and options. I am very serious about this, at some point you have got to be honest with yourself about who you are and accept that we all have certain limitations and those of us with AS are severely handicapped in precisely those areas. Surely he has an interest in some field that would allow him the opportunity to function with some degree of independence and solitude. Working on a 'team' is only likely to make him miserable and ensure that he will never last long at any one job.

That said, depending on where you are, there may be anti discrimination laws in place that could have some influence on the requirements of the curriculum he's currently in. He does have a diagnosed handicap after all, so holding him to the same standards of social interaction as the rest of his peer group is patently unfair. Some accommodation should be made for his disability.

All engineering degrees are going to require you to take classes that include team work/social interaction because it's part of ABET certification for the degree. That doesn't actually mean all or even most engineering jobs are going to require the same level of team work that the classroom does. They kind of overblow it, making you work at the highest level of team work that engineering could require, while there are plenty of engineering jobs that aren't as heavy in it. Plus, a lot of engineers are AS or BAP, so it's people you can actually hope to work well with. Assuming he gets through this, he's not "looking for a career in the wrong field" by a long shot.

If he's having meltdowns over the stress of not graduating on schedule, this is a good indicator how he's going to cope with workplace stresses.

I would suggest family therapy. If you are willing to invest your own time and attend sessions with him it might help.

It sounds like (as others have noted) he is stressed out, which is completely normal for anyone in college and struggling. It's the way that he's handling it that is not good and he really needs to learn some effective strategies for working on that. He will never hold a job down if this is how he behaves under duress, and engineering is a high stress field.

DO NO institutionalize him. Find a reputable psychiatrist and a social worker or psychologist that can help him sort through what he's dealing with - they should work as a team to address his imbalance (if he really has one) and the root of his problem. Being hospitalized is a horrible experience and will do nothing to help this situation. They will keep him until he's medicated enough that he calms down and will release him. It will solve nothing.

My parents commited me twice and regretted it both times because the stress of being put into a new enviroment stressed me out so much I was ten times worse than when I went in. I STILL have nightmares of being in there and can't even watch movies where someone gets commited aganst their will becuase I will get short of breat and hyperventelate and have panic attacks.

However, I would NOT recommend doing nothing - your son is obviously in distress and vulnerable. DS is only 10, but I recognize that he lashes out at us most because we are the safest people for him, and that we are probably the best barometer for how he's doing, as he holds it in for most other people. I wonder if you could get the school to allow medical leave for him without an inpatient stay...he clearly needs a break.

I also wonder, since group/social situations are expressly a deficit of AS...I don't know what accommodations are available, but I'd point out to the college that he is protected by the ADA and they need to find a work around. I would guess that this particular stressor is a major part of what's happening. Might I suggest you post requests in the general board for AS engineering students' ideas for accommodation?

This question is right up my ally

I happen to be a mechanical engineer. I graduated in 2008, worked for a year, and now I am going back for my masters. I understand the pressures involved in getting your degree in engineering, because it is definitely not the easiest degree to get. But all that aside, the first thing to say is that it is unlikely that forced hospitalization will help. From your description, he seems upset, angry, and bitter that he is unable to accomplish his goals. And that is leaving him sullen and somewhat depressed. But he likely isn't a danger to himself or others.

What he needs to do is take a break from school, and accept that he will have to graduate in the summer or perhaps next fall instead of the spring. It may not be what he wants, but it is better then getting kicked out of the school for repeatedly failing a class time and time again. It is better for him to graduate a few months later then to never graduate at all.

Beyond that, he needs to find the cause of the problems that he is having, so that he can learn to deal with them effectively. As other people have said, there is some communication in engineering, but not a lot. It is mostly just the communication of information and assignment of tasks. Your son doesn't need to be a social butterfly in order to exchange notes, and information, so I doubt that is the problem he is having. I am certainly not the most outgoing and socially oriented person, but I have never had a problem with the minimum communication required in engineering.

More likely, the problem he is having is social phobia, combined with poor stress management and also a likely fear of failure. This is furthermore exacerbated with an immature mindset of 'its everybody else's fault', as evidenced by calling you up and saying that his problems are your fault. As Avengilante has said, if this is how he responds to problems, then he isn't ready to become a working engineer, regardless of his technical skills. If he is going to succeed in his career, let alone his schooling, then the first, and most important skill he needs to learn is how to deal with his stresses and anxiety.

To that end, cognitive behavioral therapy, and some soul searching are probably his best bet. Some anti-anxiety medication may help, but he first needs to address his poor stress management skills before he goes about trying to throw pills at the problem. But ultimately, this is up to him. He isn't seven years old anymore, and you can't make his decisions for him. You can encourage, help, and advise him, but it is up to him to learn, grow, adapt, and mature. So, the best you can do is help him out, but realize that he must also help himself out if he is to deal with his problems effectively.

I really can't give much further advice without knowing more about the situation, so I have to ask.
1. Have you read much about asperger's syndrome? I don't just mean reading the diagnostic stuff about what to look for, I mean the stuff like how to deal with the problems, and how to handle difficulties?
2. Have you discussed this stuff with your son?
3. Has he been receptive and proactive in dealing with his problems before they become major issues, or does he have a tendency to just ignore problems until they blow up in his face?

Prior to our diagnosis, my son was so unstable and violent that I was at a point where I had to make a tough decision - medication or hospitaliation. He was too violent to have in the house and I was worried about his and his baby brother's safety. It was really bad. I had taken him to the ER during a rage and they suggested partial hospitalization but said he was too unstable and suggested getting him on medication the partial hopitalization. These are also the same people that within 30 minutes suggested he has an ASD and recommended a neuropsych evaluation (he had already been under the care of a psychologist for a year). I obviously did not want my 9 year old child to be hospitalized, so I opted for medication. The psychiatrist prescribed him with Abilfy, starting at 1mg and working up every 4 days until we saw stability. At 3.5mg he was stable. No more violence, no more suicide threats, no more self harm. I was always 100% dead set against medication for children. Nothing could change my mind until what I experienced with my own child. I could kick myself for not starting it sooner. My son is also diagnosed with Mood Disorder-NOS, Sensory Processing Disorder. Based on the amount of Abilify he responded to, I don't think he has a mood disorder; I think it was 'agitation associated with autism'. So, that is how I dealt with the consideration of hospitalization.

My dad's friend had a daughter with autism. The woman is now around my age, 31 years old, and in full time residential care. She was too violent and unstable to function on her own. She did not respond to medications. It is not unheard of for people with autism disorders to be hospitalized.

You're dead on, Tracker, on the areas I bolded. What exactly is "cognitive behavioral therapy?" What takes place in that type of therapy as oppose to "talk therapy?" We did talk therapy but he never had anything to say, and the therapist was not good in that she didn't have anything tangible for my son to work on other than give him advice to which he ignored.

He had RDI therapy with an rdi consultant. But it went nowhere because it didn't give him information right off the bat how to talk to people. He has trouble expressing himself, and is very cynical about every advice we give him saying that' doesn't work, etc. We took him to calif for an EEG guided rTMS therapy for several months last summer. He said it didn't work. So now to him, anything that I suggest for him to improve his communication skills is going to be failure too as others were.

He was on meds when he was in high school for a few years until he begged to be taken off of them due to feeling like a zombie and finding no joy in things he used to love doing. So we relented and had his neurologist take him off of them gradually. He felt good and was looking forward to college. He encountered loneliness and isolation in his 3 years in college. This year his senior year is no different. Couple that with his outlook of not going to be able to graduate and he's in so much emotional pain that he explodes to me in grief over the phone. It's very hard to take and I sometimes wondered if he would hurt himself given the disappointments he's had in life.

So yes, it looks like he could use some lessons in life in how to handle them appropriately if he is to go out there and find work where he could utilize his academic strength.

As to your questions:
1. I have read a lot about aspergers, but I have not read how to teach my son how to deal with problems and difficulties.

2. I've always thought giving him some advice was sufficient. We stopped going to talk therapy so he doesn't get any advice from professionals that are experts in autism.

3. He has been very poor at solving problems that involve communicating with others as small talk, how to answer questions at job interviews, etc. But he can communicate about things that he needs from people he's familiar with. Otherwise, he has a lot of difficulty expressing himself in most aspects of common communications. And this is what stumps me to no end. what type of therapies are available to adults like him so he can learn basic communication skills? Because if he could have about 1/4 of a 10 yr old's communication skills I think he can be successful in whatever he is pursuing.

The irony of this problem with communication is that he hosts a 2 hour show at his college's radio station spinning records. He does his basic announcements, public service or what not, and the titles of the songs he plays. His announcements sound rote, and he stutters now and then, but he goes on air and does the shows. He does have a very monotonous voice, however. But recently, he has stopped doing the shows too. I think he might benefit from speech therapy but I'm not sure where to send him for it.

Anyway, thank you everyone for your replies. I don't want to send him to a hospital but I want him to get help to level his emotional outbursts and to sort things out about his education. And I'm afraid he will get violent with us if we told him to leave the college.

Obviously none of us have the full story, but in your description of your son I see someone reacting to a clear and obvious stress and disappointment. I realize the reaction is immature, but AS adults often are developmentally behind their peers. Consider a 12 year old faced with the pressures your son is now facing, and then consider what would be within the norms for expected reactions. If your son is within those norms, you don't have a mental health issue; you have a maturity / coping issue. If you have a maturity / coping issue, then hospitalization is absolutely the wrong answer, and medication may be as well. He has skills to learn, and he needs support that he hasn't accessed.

For some perspective, I read your description of the situation your son is in and totally empathize with the feeling of despair he must be feeling. Years of working hard to overcome your challenges, all because you believe what everyone has told you: someday it will all pay off and, despite the burdens of your AS, you will be fine. Well, guess what, he's discovered that it is not fine, and as far as he can tell it isn't going to be fine. It is probably like all he has believed in and worked towards has crashed in around him. How could he not react negatively? That isn't a mental health issue; it is a normal reaction. I think my whole spirit would have been crushed, and when my spirit has been crushed, I'm lost. Add AS onto that, and how we know our kids having trouble seeing road B when road A closes, and it becomes easier to understand why his reaction is so strong and negative. So, he needs to breath for a bit, and then he needs someone to show him the road. He needs someone to rebuild his faith in his ability to have a future. None of that will be easy, but none of it can be solved with hospitalization or medication, assuming the issue is what I'm reading. Patience, love and understanding would seem like the required road.

In my experience with my AS son, it rarely is. He has to be walked through so many things that are obvious to us, step by step, practice and repeat. Even when he's integrated the information mentally, getting to applying it is a whole new level.

I've accepted that my AS son is on an entirely different developmental path than his peers. Some things he can do years ahead, but many others he does years and years behind. The road to independence is going to be a long and slow one. I stopped listening to anyone about what he should or should not be able to do years ago; instead, I've simply listened to him. There is no, "you should be able to do this" or "it isn't hard" or "you know what I mean." It is all step by step, try this and then try that, until we move past the invisible roadblocks and he's figured out how to move forward. Each little life skill is the same process.

While input from professionals has been invaluable (speech therapy most of all, for the pragmatic issues and social skills), much more important seems to be knowing that mom and dad are listening and understanding, and are willing to provide whatever help is needed. You should know your son better than anyone else, and it is feeling supported and understood by you that he needs more than anything. I don't think he wants advice; I think he wants to be understood.

AS is not a mental illness, but a developmental and cognitive difference. When we tried to get our son counseling for stress and anxiety, the professional who did the assessment was very clear: our son was reacting to stresses in his life created by his AS, but these were not mental health issues. He told us we should be dealing with the sources of the stress, instead of the emotional fall out that resulted. Basically, he very sweetly turned us down, and pointed us in a different direction. That was a valuable turning point for us, as frustrating as it was at the time, and I think more mental health professionals should be doing the same. So, I'm hoping you will try looking at all these issues with your son from a different angle, and see if the change in perspective can help you find solutions you have not yet had the opportunity to see. Not nearly as simple as that sentence, I realize that, but hopefully you can see what I am suggesting.

After I finished the last post and stepped away, I realized I do have a suggestion.

If I was in your shoes, I would drive up the college and spend time with my son. I would assess what he needs and help him find it. And I would not leave until both of you have agreed that his feet are on a solid road. Not just one he tells you he can cope with because it is what he thinks you want to hear, but one he confidently tells you he believes can work.

Even if that means taking a leave of absence from work, paying hotel bills, and who knows what, it will be one heck of a lot cheaper than hospitalization. And probably a whole lot more effective. You will be showing him that you are there for him, truly there for him.

Wow, DW, I'm blown away by your response. I needed to hear this. My dh and I were worried that our son has developed some kind of mental illness, but I think you're right. The way he's acting is the way he copes with stress. This has always been true since he was a boy. His inability to articulate his frustrations doesn't help matters. All he can do is cry, as someone developmentally delayed folks do. The challenges of college has been the toughest challenge he's ever experienced, and because he worked very hard to get where he is, he expected a huge pay off as his dad and I had always told him. And now it has not resulted to his expectations, no job prospect, nor a diploma. He does need a higher level of understanding from us rather than throwing him into a hospital to get meds to mask his despair. He may need antidepressant to get his head cleared, as he might not be able to recover quickly enough from the reality of having to take a leave of absence from school. This is where dh and I are having so much trouble figuring out how to do, how to help him realize that what he needs is a break from the pressure of graduating next year without forcing him to take meds.



I would like to do this. Fortunately we're bringing him home for Thanksgiving break in a week, so my dh and I thought it would be the best time to talk to him about his future in college, get treatment for his depression and to receive cog behav therapy from an autism expert, and find a good speech therapist to help him with communication and social skills. I do believe that it has to come from his own desire to do all that. No amount of coercion is going to make things better for him. He deserves as much respect as anyone.

I am still concerned however, that he would not agree to leave the campus, which is 6 hours away from home, because it's where he has more social life (what little he has) and activitiesthan if he is at home. We'd have to make a different living arrangements for him off campus if he is to stay there. (he is in a dorm without a roomate, with meal a plan). Ironically, if he is to stay there to be with his "friends" he will be isolated more than ever, and will not have access to the college venues, etc, once he takes a leave of absence for medical reasons.

I suppose we could try and arrange daily activities for him if he agrees to stay home. I have called our local voc rehab office for job training for him for the winter break. Maybe that will help him get busy and have a relative social life. It won't be as fun as being with his college pals though.