With mental illness in the family, you don’t get lasagna.

It has been said that mental illness is not a casserole sickness. You won’t get showers of gifts or offers to bring dinner.

Your friends and family don’t quite know what to say, so often don’t say anything. Should they ask if you are okay or pretend everything is fine?

That’s just one aspect of when your child is inpatient for mental health care.

Parents might also be confused about what comes next. When an appendix is diseased, the doctor takes it out. How does treatment work for mental health conditions? How long will your child stay, what will the treatment be like, and what will your role be?

As I have written about in my Still Standing blog series, we have children who have received inpatient mental health care. We have experience with both short term and long term care in a number of facilities, in more than one state.

Below are details I wish someone had told me before we began walking this road. Here is what it's like when your child needs hospital mental health care.

When our child was first hospitalized, I didn’t really know of anyone who had taken a child for inpatient mental health care. Mental health hospital stays are not the type of thing people discuss at dinner parties. But the more we have opened up about our family, the more we have talked with other families who have had similar experiences.

Inpatient Treatment for Mental Health Care

I am not a doctor or therapist, and this blog is not intended to give medical advice. This is a parent perspective only.

Insurance is a huge factor in the type of care your child will receive. Inpatient mental health care is very expensive, and your insurance company wants proof that your child needs it, that it’s working, and that your child is getting the lowest level of care that is still effective.

I’m not saying this to knock insurance companies. This is just reality.

Where you live is also a factor in the type of care options that are available to your child. States vary quite a bit in what they have available for mental health services, and in rural areas you will not have the options that a bigger city has available. Sometimes the need is great and there are simply not enough spots. (Called “beds” by people who work in the system.)

I know this is all scary. You might have pictures in your mind of an old fashioned psych ward where people are locked in rooms and in straight jackets.

Or maybe you child has been running wild and you are hoping this stay will scare your child straight. (Hey, I get that.)

Perhaps you are hoping for a quiet, restful place with a team of experts who will treat your child with optimal care and bring about healing.

Well, it’s not going to be exactly like any of those things, but probably somewhere in the middle of all of them.

We’ve had experience with a wide range of facilities for our kids. Some were really nice and some were, let’s face it, kind of awful.

We’ve been in a few nicer-looking facilities but the majority are kind of run down and not in the best of shape. This is a reality of mental health care.

We’ve dealt with staff that were amazing and some staff members that left something to be desired. They are doing a tough job.

As with any type of medical treatment, don’t be afraid to speak your mind. You are still the parent and you know your child best. Keep in mind every facility has rules, and you and your child will be expected to abide by the rules, but you are allowed to request what you feel is in the best interests of your child.

A psychiatric hospital stay is not a punishment. No matter what your child did that landed her here, if your child is in a mental health facility, the goal is treatment and stabilization. (If there are legal repercussions to your child’s behavior, those need to be dealt with separately.)

That being said, being away from family is serious and can be an important wake-up call for your child that it’s time to make certain life changes, but don’t count on that.

Types of Care

Short-Term Facilities

After going to an emergency room or crisis center, children are generally placed at some type of short-term treatment center for further evaluation or stabilization. These centers vary in the level of strictness, types of rules, amount of therapy, and if there is school available.

Insurance companies play a huge role in how long your child is able to stay, but generally the goal is for the child to stay 1-7 days at this type of facility (or wing of a hospital or other facility), and either return home or to a more long-term facility.

These facilities are usually locked and children are not allowed to leave. They are allowed to bring several changes of clothing from home (no strings) and a blanket and stuffed animal. Their belongings will be checked by a staff member.

Typically in a short-term facility they do not go on outings, but they might play outside at a small playground at the facility.

The facility usually looks somewhat similar to a hospital, but with more of a common-house type of feel. Kids might have a roommate or might have their own room, depending on their level of need. There is usually a main room where they watch TV and do group activities. Often they attend group therapy daily, and most times they also meet with a therapist or social worker individually every day.

The days are structured, with a schedule and routine for each day. The children are carefully monitored and someone is always awake and watching them. A nurse is either on duty or or call, and a psychiatrist is on call.

Parents might be allowed to visit daily or maybe less often. Typically at a short-term facility parents are allowed to visit more often than at longer-term facilities. (See the next post in the series for more about visits.)

Long-Term Facilities

A long term facility is a group or residential treatment center where the child lives for one month to one year while receiving treatment. These facilities are for children with serious issues who are not safe to live in their home situation.

Contrary to what many people think, parents cannot simply choose to place a child in residential treatment and be done. The process for getting a child this type of care is much more complex and difficult.

Insurance companies do not want to pay for children to be placed in residential treatment, and even if you have insurance, it eventually runs out. The department of human services does not want to pay for residential treatment because they want children to live with families or they want the insurance company to pay.

Parents who are already exhausted are now caught in the middle of a battle to try to get their child the treatment he or she needs. They might have their doubts about placing their child outside of their home in the first place, then are forced to advocate for the treatment with the insurance company, social services, and often in court.

If you know of a family who has considered placing their child in residential treatment, never EVER judge them, because you have no clue the type of hell that family has been through. Trust me, if they are at this point, they have been to depths of emotional pain that are about the worst a person can experience.

Offer them love, hugs, and for heaven’s sake bring them a casserole.