Vent about psych admit of 12 yo boy

2 ***VENT*** ***Kind of long***
I work in an equivilant to a pysch ER, we do assessments, then reccommend the patient to the correct level of care (therapist, psyciatrist, in-patient, ect...)
Anyways.... I did an assessment on a 12 yr old boy, accompanied by his bio mom and her boyfriend. The boy was making threats to hurt himself, cut his throat, ect. Very defiant, rude, obnoxious, continued to deny that he was ever suicidal, not very cooperative.
After the assessment I called our on call doctor (per protocal) and it was reccommended that this boy go to either day program (if parents felt safe taking him home), or in-patient on our unit.
I go back to the assessment room to inform the boy and his mother of the decision. I basically say "Ok...I talked with our doctor on call, and we have two options. 1. (talking to the boy) You can go to day hospital, or 2, you can go in-patient."
The immediate response from the boy was "My mom has a third option. She can just take me home. I am not ever coming back here. I don't have to!"
I inform mom that yes, that is an option, but we also have a fourth option, mom and mom's bf could file for commitment. The three of them begin to discuss this, and it became heated. I opted to leave the room so that the three of them could discuss the options.
While I was waiting, I noticed the boy attemting to leave the premisis, with mom yelling at him to come back. Luckily he did go back to the room, and our security guard had to stand by to help monitor him. I go back to the room and mom tells me that she wants me to start filing for court committal.
I go back to the nurses station to page our doctor yet again. Not five minutes pass, and I am called back into the room, yet again. Mom has decided that she will take him home, AMA. I let her know that before we can go that route, the doctor must be informed.
Get a hold of the doctor, and the doctor reluctantly agrees to do this. Go back to the room, have them sign AMA. They leave.

NEXT DAY
I get a frantic call from the same mom about the same boy. He went to school and made threats that he wanted to die. She was headed over to the school to pick him up and bring him there. I inform her that if she wants to bring him in, and he was unwilling to come voluentarily, that they (mom and mom's bf) needed to go to the clerk of courts office and have him committed.
Few hours later they stroll in with the court committment papers... and he is promptly admitted (be me).
The entire time the boy is abrasive, rude, and continues to deny any suicidal ideations, he claims that what he said at school was "This (who knows what "this" means) is what makes me feel like killing myself."
Anyways, he is admitted to the unit, and mom still isn't sure that she wants him there. (AFTER obtaning the court order)

Some days I just don't understand people.
If he's only 12 why do they need a court order to admit him or bring him in?SOrry you had a bad night tho *hugs*

Per our policy if the child does not sign in voluntarily, then a court order is required. (Not sure if this is statewide or just our specific hospital.) It's parents like these that show me how NOT to parent my children (whenver they come along)...

I think that as parents there is fear and guilt. This 12 yr old with that "third option" comment shows he is probably a little more intelligent and possibly dangerous than you yet know. His parents regardless if they contributed to his being, are most likely fearful of later retaliation, or of acknowledging some kind of real or not real failure.

I feel you! We have to Section-12 people (that's what we call the psych commitment in MA- not sure if it's the same where you live) all the time from my facility (court mandated drug detox) ...and then once they get to the hospital they become the perfect patient and adamantly deny any SI/HI, which makes us look stupid for sending them out. Then once they're brought back to us and learn that no, we will not be continuing the Ativan they received in the hospital, they start with the threats all over again. It doesn't end, but what can you do :/

Quote from netglowI think that as parents there is fear and guilt. This 12 yr old with that "third option" comment shows he is probably a little more intelligent and possibly dangerous than you yet know. His parents regardless if they contributed to his being, are most likely fearful of later retaliation, or of acknowledging some kind of real or not real failure.

Totally agree with you there.But I'll add that the Mom is not really aware of your presence entirely... do you know what I mean? You were there, speaking with them, and she hears and sees you but there is probably so much acute stress that you weren't really registering so much. You are a peripheral vision sort of status for now. She needs to get some MD support for herself ASAP. She won't be able to see things and make decisions at all without it.

Quote from elizabeth8503RNIt's parents like these that show me how NOT to parent my children (whenver they come along)...

Ahh, the future of America....Kids who have been parented by doormats. VERY sad.

Quote from KateRN1You'll be amazed how often you end up eating words like these once you become a parent.

Why can you not involuntarily commit him if he is making threats at school? In our state the school psychologist, or in an emergencya police officer can sign the request for evaluation for involuntaryhospitalization. Police officer then transports to Psych emergencydepartment for evaluation. The situation that you describe seems a recipe for danger, theboy is escalating and running the show. It is clear to me thathe is asking for a time out from Mom and esp boyfriend.Each time she rescues him, he will escalate more...I am confused why your MD on call did not come in toevaluate him directly...by the time he does, the boy maybe now carrying a knife or other weapon as this escalates in intensity.He then may go into the court system directly depending on thecircumstances.

This is my take. At the point where he is stating he has a problem, and won't accept help with it (threatening suicide, declining treatment) he gets taken out of the decision making process. Parents are in charge, you state that in front of him, and state it repeatedly to his parents when you take them out of the room. Tell him they are going to make the decision, then give them a spot to discuss their options. Then go back to him, with a security guard and tell him what he is going to do, and the consequences if he doesn't cooperate. Security will keep him in the room, or if he leaves the police will be called to bring him back.There was another option. If the boy is threatening to harm himself and the parents can't take control, CPS certainly can.

Quote from jahraI am confused why your MD on call did not come in to evaluate him directly...