Explaining Inpatient Psychiatric Treatment to Mentally Ill Child

February 10, 2012 Angela McClanahan

This time of year, I am always reminded of the first half of 2008--the year I admitted Bob to inpatient psychiatric treatment not once, but twice. I suppose it's because this is the same time of year, or because it's the season when Bob experiences more manic-type symptoms. Apparently, it's on Bob's mind, too.

He's mentioned it at least four times over the past two weeks. "Mom, remember that time when I had to go to the hospital because I was bad?"

It crushes me to hear him say that. I usually respond the way most parents do when put on the spot with no idea how to formulate a response: with annoyed dismissal. "Oh, Bob," I scold. "You weren't there because you were bad. You were there because you were sick."

Then I promptly change the subject.

When he was hospitalized four years ago, Bob was six. I'm not at all sure how much he remembers, or how clear his memory is. I'm not sure what he was told by the hospital staff about the when or why of his admission. I barely remember what I told him.

Even though I know he's ten and probably old enough to start participating in his own health, I'm still hesitant to give him the nitty-gritty of Spring 2008. His comprehension and understanding of social and behavioral norms is still substantially limited. I don't know that he would understand if I said, "You were there because you were out of control and I was afraid you were going to hurt yourself or someone else."

I don't know how much awareness Bob has of himself, his moods and his impulse control. I can sometimes recognize behavior patterns in myself and understand why I'm doing something and even know it's not the best choice (and do it anyway); other times, I have no idea I'm behaving in an unacceptable manner unless (or until) it's pointed out to me. Does Bob truly believe he was simply locked up in a kid prison because he was "being bad?"

I don't want him to think I just shipped him off because I didn't agree with his behavior. I don't want him to think he's a "bad" kid for having been there. I want him to understand the purpose behind his hospitalization--to help him, not to punish him.

I obviously need to come up with some sort of explanation that doesn't just dismiss his recollection; one that tells him the truth in terms he can understand. And whatever I tell him, it needs to be sooner than later.

APA Reference
McClanahan, A. (2012, February 10). Explaining Inpatient Psychiatric Treatment to Mentally Ill Child, HealthyPlace. Retrieved on 2024, May 25 from

Author: Angela McClanahan

February, 26 2012 at 3:40 pm

If you had a broken arm, you would go to the hospital to get well. Similarly, when you have a mental illness, you also may need to get well. You need help. The hospital helps you to get better. I wouldn't say anything else. There is way too much stigma related to mental illness. Kids should not have to bear that awful burden. They need to name it, accept it and be able to discuss it if asked. Hospital staff need to do more to eliminate the stigma and work towards acceptance. Similar to an addiction, the individual should be encouraged to confront illness during therapy. Too often meds are adjusted, group therapy is provided, but the illness itself is the elephant in the room.

AllUCanBe (Barb)
February, 13 2012 at 11:27 am

Hi Angela,
Such an interesting and insightful post! I did a few google searches to see what was out there to support parents on how to talk to their mentally ill child(ren) and found very little!
Breaks my heart too reading that your son described his behaviour as bad and that's why he was hospitalized. Your response was perfect!
It is difficult enough for adults to be able to "talk" about mental illness, even harder with children and the challenges you as a parent are faced with to be able to relay what is happening with your own child's mental illness is something most would not even consider.
More help needs to be available to parents of mentally ill children, especially on how to talk to them about their own mental illness in an age appropriate way keeping in mind the challenges of the illness.
I've read Chrisa's posts many times and loved her "safe" and "unsafe" explanation.
Thank you for doing this post and educating me and others. I'll be sharing this on my FB page as well.

February, 11 2012 at 1:06 pm

I hate that too. Tim often expresses his times when unstable as him being bad, less now that he's older than he did younger. Somewhere around his 9th inpatient stay (out of 12 to date) he understood better than when he is struggling with his symptoms, the hospital is a place to be safe, and work on stability. We talk about it in terms of his ability to be safe or unsafe, instead of good or bad, since Tim's instability often comes with a hefty dose of rage.

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