Dear Meghan: What do you do with a 14-year-old boy who has mental illness (anxiety, oppositional defiant disorder, etc.), is refusing school, and won’t take his meds or see a professional for help?
- Struggling Son
Struggling Son: Thanks for writing in. Since the coronavirus pandemic, the spike of mental illnesses in teens has wreaked havoc on families’ lives, and it’s important to know that you are not alone. My therapist, psychologist and psychiatrist friends (and my own coaching practice) are all still seeing waves of suffering in teens who just cannot seem to recover. I badly want to give you an answer for what you should do with this complicated young man, but there is no simple solution.
To start, I would suggest sitting with your partner, your co-parent or just yourself and making a list of what has happened so far. Write a short history of your son: When did the symptoms begin? Was there a precipitating event? Is there a family history? When did the symptoms worsen? And, most importantly, what has been your reaction to the behaviors? Be as honest with yourself as humanly possible. This isn’t to shame you; rather, it can help you find the patterns that are either helping or hindering your son’s growth. These notes are also excellent in case you obtain a full neuropsychological exam or go back for another one.
Try to completely change your outlook on your son. Instead of focusing on all of his behaviors (getting to school, taking meds, seeing a therapist), ask yourself, “What is standing in the way of my son wanting to go to school, take meds or see a professional?” This may sound painfully basic, but have you asked him? Has he tried medications and doesn’t like how he feels on them? Is he afraid of them? Does he feel too hopeless to try? Does he not want to go to school because he does poorly or can’t keep up? Is he bored? Too hopeless or anxious? Does opening up to a therapist make him feel too vulnerable? What he thinks and feels could astonish you. Adults are so accustomed to the diagnosing and fixing model that we can skip right over the actual teen. Most teens are dying for someone to simply ask them what they want or need. Do I know that your son will open up to you? No. That depends on your relationship, but that doesn’t change that that’s what needs to happen. Without his buy-in, you will not get him into school, on meds or to a good therapist, period.
An excellent blueprint to figure out how to talk to your son is Ross Greene’s collaborative and proactive solutions approach. Yes, it focuses on behaviors, but the magic of it is that, when used properly, it is a tool based on relationships and connections. Going to school, taking meds and seeing a professional can be too much to tackle all at once; this approach slows everything down and focuses on one issue at a time. And although your parenting needs matter, the beauty of this approach is that your son’s needs matter just as much. The Lives in the Balance website (livesinthebalance.org) has everything you need to start this approach, but you can also work with a professional who can guide you and hold you responsible for not falling into old (and unsuccessful) habits.
You will need to make room for the possibility that your son may not be attending school (the way you thought) right away. I would contact his high school, talk to the needed people (school counselor, learning specialists, principals or head of the grade) and describe the situation. Get information about home schooling, unschooling or online options for school, and make sure that you are in compliance with your state. If his diagnoses aren’t on the record, please take the steps to establish 504s and IEPs.
I know the panic parents feel when they watch their children miss school. But we have to deal with reality, and the reality is that your son is really suffering. His mental health comes before school. Plenty of teens use alternative learning methods on their own schedules, and they end up quite happy and successful. Again, I strongly recommend finding a parent coach or therapist who works with families going through similar struggles. You need all the support you can get. Good luck.