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K9
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on: June 17, 2010, 01:19:37 PM

So I work as a subwarden (like a RA) in a hall of residence at a university. On wednesday we had one of our kids attempt suicide. This was a little bit out of the blue for us, we got a warning the day before from his tutor that he had been stressed and anxious about his coursework and exams, and then on wednesday he tried to kill himself (a bunch of other shitty circumstances all came to a head at the same time). He didn't make a brilliant effort of it, but it was more than just a cry for attention.

I have had to deal with a wide range of emotional and medical issues in my time as a warden, but this is a first. I'm just wondering if anyone has any advice as to how to approach him. Right now the main problem seems to be how to get him to open up and trust us, or anyone. He's being very introspective and isolating himself from everyone. I don't want to be too aggressive in getting him out of his room (to eat, or exercise or anything), but being passive doesn't feel like the right thing.

Any advice or wisdom welcomed, thanks.

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apocrypha
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Reply #1 on: June 17, 2010, 01:28:06 PM

You go straight to the University Counselling/Student Services department and you ask for help. This kid needs professional help and quickly, no question. And you need some professional guidance on what exactly your role should be in this.

Is your subwarden position a volunteer/non-professional one, i.e. are you just another student, or are you officially employed by the Uni in this role?

If you're not in official employment by the Uni then this isn't really your job *at all*. It needs referring to the people who are trained and paid to deal with this. If you are employed as a subwarden by the Uni then you need to go to your line manager or whoever's responsible for your professional role to ask for guidance.

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Stabs
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Reply #2 on: June 17, 2010, 01:33:15 PM

Who does he get on with? Any particular friends, family, who might help bring him out of it? How far from the hall of residence is his usual home?

And I'm sure you're right that being passive is not the right thing. It may be a cry for help, but it may also be something that he attempts again if he doesn't come round. It had to be done right though and really should be handled by someone professional. Surely your Uni has student counseling?
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Reply #3 on: June 17, 2010, 01:42:56 PM

I'm going to echo the "Go to the professionals" advice.  If he's making suicide attempts, this is way above your pay grade.  Your university has to have some kind of Crisis Counseling office, probably reporting to the Dean of Students (if this is an American college).  Certainly if you can't identify exactly who you should go to, that office or its equivalent is the place to find out, whoever it is in the administration that handles student issues unrelated to finances.

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Numtini
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Reply #4 on: June 17, 2010, 01:50:02 PM

I Assuming there is a professional somewhere and you're just trying to figure out how to talk to them about it. Just talk to them about it, listen, and don't be afraid to "go there."

I've been pretty shocked at just how casual kids have been about the topic. (Suicideh fwiw, freaks me out completely.) A lot of times what people need most outside of professional care, is just someone to make them feel normal about it and listen without being judgemental or overly sensitive.

But if there isn't a professional somewhere, then yeah, it needs to be sent to one.

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K9
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Reply #5 on: June 17, 2010, 01:58:13 PM

You go straight to the University Counselling/Student Services department and you ask for help. This kid needs professional help and quickly, no question. And you need some professional guidance on what exactly your role should be in this.

Is your subwarden position a volunteer/non-professional one, i.e. are you just another student, or are you officially employed by the Uni in this role?

If you're not in official employment by the Uni then this isn't really your job *at all*. It needs referring to the people who are trained and paid to deal with this. If you are employed as a subwarden by the Uni then you need to go to your line manager or whoever's responsible for your professional role to ask for guidance.

Sorry I should have clarified:

He was taken to a psychiatric hospital on the night by the duty wardens and the doctors there decided to let him go home after a long assessment (I wasn#t there, but apparently they were a bit on the fence about this). He's now home, but will be going back to the hospital again for checkups, and we'll be making sure he does this. He also has access to the counsellors and other resources, but is unlikely to make the move to go to them. I'm in this role to provide pastoral care and welfare support and I've been doing it for three years now. We are the third leg of the counselling service of the college and everyone is working to support the kid; we have two junior doctors in our mix, the rest of us are PhD students and academics. The doctors at the hospital didn't consider him a sufficient risk to section him, so we're keeping him on ice here where he lives. I haven't had a suicidal case before (although I have dealt with pretty much everything else) and my current dilemma is how to help ease him out of his depression. Before I can do that I need ideas about how best to approach him.

Given that the psychiatrists consider him not a major risk to himself, our goal now is to help him re-integrate and come to peace. I know I can meet him on a lot of his issues based on my experience, the difficulty is getting to him. He's very polite, and very smart; and he's employing those skills to be frustratingly distant, in a way which supports his doom. Given my role and responsibility to him I can't walk away or just idly direct him to unfamiliar services (a chat with the samaritans did not go down well apparently), so I'm looking for anyone with experience in breaking down people in this sort of state gently.

Who does he get on with? Any particular friends, family, who might help bring him out of it? How far from the hall of residence is his usual home?

And I'm sure you're right that being passive is not the right thing. It may be a cry for help, but it may also be something that he attempts again if he doesn't come round. It had to be done right though and really should be handled by someone professional. Surely your Uni has student counseling?

Family is not going to be any help right now, and he's in a spiral of self-isolation validating loneliness. He has plenty of people who would happily be there for him, but he's actively distancing himself. With it being exam period and given his state, social stuff is tricky, and probably needs to wait until his moods is a bit more stable.

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K9
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Reply #6 on: June 17, 2010, 02:01:53 PM

I Assuming there is a professional somewhere and you're just trying to figure out how to talk to them about it. Just talk to them about it, listen, and don't be afraid to "go there."

I've been pretty shocked at just how casual kids have been about the topic. (Suicideh fwiw, freaks me out completely.) A lot of times what people need most outside of professional care, is just someone to make them feel normal about it and listen without being judgemental or overly sensitive.

But if there isn't a professional somewhere, then yeah, it needs to be sent to one.

The professionals have placed him more in the 'cry for help' category than the genuinely going to end it category. The kid is in a very fatalistic mood, and he's too smart for his own good in this case (he'll be evasive and trying to out-think the doctors). Given that he's been placed back in our responsibility our goal is to talk him down from his depression and get him back out and mixing with other humans. As it stands he's balls-deep in online gaming and disinclined to interact with real humans.

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Stabs
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Reply #7 on: June 17, 2010, 02:08:28 PM

Is exam stress the problem? Would it help to have them postponed? It might be possible to talk to the University authorities if so.

Also which country is this in?
ghost
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Reply #8 on: June 17, 2010, 02:11:07 PM

You go straight to the University Counselling/Student Services department and you ask for help. This kid needs professional help and quickly, no question. And you need some professional guidance on what exactly your role should be in this.


This is the answer.  We had a kid hang himself on my floor in college, two doors down from my room.  We were going out to play soccer and he said he forgot something and had to run back in real quick.  He never came back out......

Depression is a tough thing to master for some folks and this one definitely needs professional help.  

Probably the best thing you can do for him is get him some sunlight and companionship.  Actually, some Vitamin D supplement probably wouldn't be bad for him either.
« Last Edit: June 17, 2010, 02:12:53 PM by ghost »
LK
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Reply #9 on: June 17, 2010, 02:18:19 PM

The professionals have placed him more in the 'cry for help' category than the genuinely going to end it category. The kid is in a very fatalistic mood, and he's too smart for his own good in this case (he'll be evasive and trying to out-think the doctors). Given that he's been placed back in our responsibility our goal is to talk him down from his depression and get him back out and mixing with other humans. As it stands he's balls-deep in online gaming and disinclined to interact with real humans.

I'm no expert, I just think this guy sounds a lot like me when I'm feeling down: distancing myself from people, trying to outsmart / avoid any help. Never went so far as to hurt myself though.

The online gaming is definitely an escape, a fantasy where the world revolves around him and other people are cold, digital entities that can be swiftly ignored / distanced from. He may feel unable to accomplish anything of worth in his life and that games provide him a focus, something to do that he cannot provide himself.

Is he a creative type? Artist, writer, etc. What are his interests? Has he had any success pursuing those interests? Maybe everything he's done up until this point is because other people told him it's what he wants rather than what he really wants.

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Reply #10 on: June 17, 2010, 02:28:43 PM

Speaking as someone who has battled depression... first thing is treat him like a human being. Be kind. Being overly sympathetic can backfire, as his self value is pretty crappy as it is, and feeling like he's a burden on others may make him spiral. It can be a fine line.

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Johny Cee
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Reply #11 on: June 17, 2010, 02:59:49 PM

I've had a couple of experiences with friends attempting or succeeding with suicide.  The ones that succeeded I'm still fucking confused about, though afterwards when you compare notes with people you can usually identify some "making peace" gestures.  A friend that really half-assed it in college, she called me first and honestly I've blocked out most of immediate aftermath stuff.

Keep the kid involved with non-threatening activities.  
- Arrange to meet for meals in the dining hall...  for breakfast on the weekends or for a lunch or dinner during the week.  Times that they may be on their own for a while plus stressed out from class or whatever.  Don't let them feel like no one gives a shit, without giving the impression you're babysitting.

- I liked to go on short walks with K, just discussing whatever or being a polite listener when she needed to bitch about something.  I remember alot of bitching about Ulysses.

- If you have a late night campus snack bar, meet up for a late night snack every once and a while.  College kids don't turn down free food, and if it's a central spot it's a good choice to socialize them a bit just because people will wander through.

- Kid's a gamer?  Maybe find someone else and head to the comp lab...  do a little gaming together where you all are in the same room.



Fuck if I know, and I went through it once.  If someone is deadset on killing themselves, and the professionals can't help, they'll do it.  If someone is just isolated and stressed and a bit depressed, all you can do is make yourself available and hope that they want to help themselves.
Mosesandstick
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Reply #12 on: June 17, 2010, 03:21:17 PM

I know it sounds weird K9, but do you know any students who are mature enough and capable to talk to this kid? Uni can really wear students down, quickly. The one thing I've always found is that it really helps to be able to talk to somebody your own age, but that can be difficult.

Are there any other conflating issues? Loneliness/home sickness/etc.?

For me, I went into a very, deep introspective stage when I was depressed. Took me a while to get out, but sometimes it's for the better. It is very hard for people on the outside to understand though.
« Last Edit: June 17, 2010, 03:55:41 PM by Mosesandstick »
K9
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Reply #13 on: June 17, 2010, 03:24:08 PM

Is exam stress the problem? Would it help to have them postponed? It might be possible to talk to the University authorities if so.

Also which country is this in?

Exams and courses we can fix easily, we're working with his tutors and re-sits and such is no problem. The main concern is getting through to him and keeping him in a more positive state so he doesn't feel tempted to harm again.

Speaking as someone who has battled depression... first thing is treat him like a human being. Be kind. Being overly sympathetic can backfire, as his self value is pretty crappy as it is, and feeling like he's a burden on others may make him spiral. It can be a fine line.

Cheers, this is sort of what I'm looking for. I've counselled plenty, but never anything quite this severe; trying to figure out how much we can lean on him before he closes up completely is challenging.

I've had a couple of experiences with friends attempting or succeeding with suicide.  The ones that succeeded I'm still fucking confused about, though afterwards when you compare notes with people you can usually identify some "making peace" gestures.  A friend that really half-assed it in college, she called me first and honestly I've blocked out most of immediate aftermath stuff.

Keep the kid involved with non-threatening activities.  
- Arrange to meet for meals in the dining hall...  for breakfast on the weekends or for a lunch or dinner during the week.  Times that they may be on their own for a while plus stressed out from class or whatever.  Don't let them feel like no one gives a shit, without giving the impression you're babysitting.

- I liked to go on short walks with K, just discussing whatever or being a polite listener when she needed to bitch about something.  I remember alot of bitching about Ulysses.

- If you have a late night campus snack bar, meet up for a late night snack every once and a while.  College kids don't turn down free food, and if it's a central spot it's a good choice to socialize them a bit just because people will wander through.

- Kid's a gamer?  Maybe find someone else and head to the comp lab...  do a little gaming together where you all are in the same room.



Fuck if I know, and I went through it once.  If someone is deadset on killing themselves, and the professionals can't help, they'll do it.  If someone is just isolated and stressed and a bit depressed, all you can do is make yourself available and hope that they want to help themselves.

Thanks for the suggestions, the last bit is what I feel it will ultimately biol down to. I just hope things can pick up. We're having some lovely weather here in the UK right now, I suspect just getting out in the sun would improve his sense of well-being.

The online gaming is definitely an escape, a fantasy where the world revolves around him and other people are cold, digital entities that can be swiftly ignored / distanced from. He may feel unable to accomplish anything of worth in his life and that games provide him a focus, something to do that he cannot provide himself.

This is my feeling. I'm debating suggesting getting him to un-sub or at least take a break. I don't know if this might be too much right now, since the only people he does seem to be communicating with are people at the other end of a vent server.

I know it sounds weird K9, but do you know any students who are mature enough and capable to talk to this kid?  can really wear students down, quickly. The one thing I've always found is that it really helps to be able to talk to somebody your own age, but that can be difficult.

Are there any other conflating issues? Loneliness/home sickness/etc.?

For me, I went into a very, deep introspective stage when I was depressed. Took me a while to get out, but sometimes it's for the better. It is very hard for people on the outside to understand though.

There's a ton of conflating issues, some pretty bad. One idea was to get people to write/record positive messages for him, but seeing as how he wants to keep this private I'm not sure if that would either backfire or just seem crass.

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Reply #14 on: June 17, 2010, 03:36:08 PM

Personally, I wanted to get away from people, and I think so do a lot of other people. If you're naturally a loner type, suddenly having an influx of attention can be a bit sickening. A bit of stability, and the opportunity to pursue the hobbies you enjoy hopefully with the people you like can do a lot. It helps take your mind off things, but also ensures that when you are thinking (which is almost certainly going to happen) you're more positive and in a better frame of mind to do it in. I spent a lot of time just walking around, including being truant and away from the parents, but I did other simple things, played pool with the friends, hit the basketball court. Also quit WoW.

It's tough trying to be proactive, especially if you don't know the kid's hobbies. Might be worth talking to his friends and finding out what else he enjoys.

The other comment is that might fizzle and go away over the summer (though that doesn't stop it from resurging). If he's from out of London, he might find living here a wee bit different from home and going back home for the summer will probably be good for him, shouldn't that be happening soon?
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Reply #15 on: June 17, 2010, 03:37:39 PM

We had a kid in my halls do something similar earlier this year (working as a warden here). He wasn't in my block so I didn't really have any direct contact with him but the main approach was meeting him at meals and staying in contact with his friends to see how he was. Fortunately he started to come out of his shell somewhat and started taking the anti-anxiety medication he had apparently stopped taking and levelled out again.

 Definitely contact the counselling services in the university, even if you can't get him to go to them they can advise you on what you should be doing. The fact that it's exam time is going to make it rougher since general student social interaction is going to be way down and it's going to be tough getting friends (or mature, stable people on his corridor who can try to keep an eye on him) to take time out of revision and work to go chat to him. Can't really give you a huge amount of advice beyond that and what's already been said in this thread, maybe just try to get him to go grab a coffee somewhere near by? Like you said the weather's looking good and you've got some nice parks around. Going for a walk isn't going to cure him but taking some time outside, if he's not deeply depressed, can be nice. Heck maybe even trying to get him to go look around the museums, just doing something slightly out of the ordinary might help. Though if he's being distant and evasive you're probably not going to have a lot of luck getting him out there.
« Last Edit: June 18, 2010, 05:49:21 AM by NowhereMan »

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Reply #16 on: June 17, 2010, 04:35:29 PM

as others have stated... this is completely above and beyond your realm.  bring in the pros asap.   

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Reply #17 on: June 17, 2010, 04:58:51 PM

Odd that he would make an attempt and be admitted to a hospital for less than 24h. Not sure where you are located in the world, but that is very questionable for that ER. Any 302 here results in a minimum 24h with a normal 48h stay in a ward here. That is usually followed immediately by a partial or wrap-around service, but that may simply be a matter of the patients here being children/under 18. I am not a counselor or LSW or anything, I jockey a computer and keep the databases manageable - but there have been many o' reports come in from our kids (bipolar clinic) making attempts and the protocol is pretty much the same across them all. I am pretty tight with the social workers and therapists as well as the docs on staff considering they are doing the data generation - I know the LSW and therapists hold group sessions involving not just the patient but the family and friends to help bridge communication gaps and deal with what has or may happen. Like has been said above, probe those people who get paid to deal with this stuff. Ask them about group sessions you can attend - understanding it, I am told, is extremely valuable in dealing with anything that jumps off.

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Lantyssa
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Reply #18 on: June 17, 2010, 05:21:22 PM

Speaking as someone who has battled depression... first thing is treat him like a human being. Be kind. Being overly sympathetic can backfire, as his self value is pretty crappy as it is, and feeling like he's a burden on others may make him spiral. It can be a fine line.

Cheers, this is sort of what I'm looking for. I've counselled plenty, but never anything quite this severe; trying to figure out how much we can lean on him before he closes up completely is challenging.
The first thing to remember is everyone is different.  And this is a tricky place to be as they're fighting a mix of emotions and probably both want someone to care and don't want to be bothered.  Nor are they in a proper state of mind to really assess what it is they need for themselves.

I have to echo sickrubik's statements though.  Letting him keep or boosting his dignity is important.  Not pushing too hard is extremely important.  Balancing the two is nearly impossible, especially since that fine line might change depending on day, energy, and how the wind is blowing.

Being direct and not dancing around things is a start, even if it's hard.  If you have someone on staff who's actually suffered from severe depression or ideation and can say a simple, "I've been in this spot and things got better.  It's tough, but if you take care of yourself it will happen" then it can help.  When I was going through this, I didn't want to be a burden, I didn't want to talk, but just knowing someone cared made a difference.  (Convincing myself someone cared was not so easy though, so there's that barrier, too.)

Hahahaha!  I'm really good at this!
LK
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Reply #19 on: June 17, 2010, 05:30:32 PM

This is all echoing a lot of shit I went through recently. Any small victory can do wonders for self esteem and disposition.

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Reply #20 on: June 17, 2010, 05:43:09 PM

...and if the kid kills himself successfully after whatever you do or do not do, it's not your responsibility. It's his life.

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Reply #21 on: June 17, 2010, 06:08:37 PM

This is definitely a job for the professionals, but...

(Convincing myself someone cared was not so easy though, so there's that barrier, too.)
This.  As someone who has been in your student's shoes but too stupid to actually succeed, I can relate to him isolating himself and not wanting to talk to anyone.  Once people find out you've done something like this, either they talk to you about how beautiful and special you are and that suicide is wrong, or that life's a bitch and you should tough it out and not quit.  Heard it all before, don't care to hear it again.  If someone wants to truly relate and get him to open up, chances are they have to convince him they genuinely give a shit about his problems, and that's not easy to do.  I'd tell you whatever you wanted to hear to get you to leave me alone and go away, but the issue was always lurking in the back of my mind anyways and I sure as hell wasn't going to tell some Joe or authority figure who heard the bad news and wanted to know what was wrong when they wouldn't give me the time of day the week before.  It's a very tricky line to walk and you being in the position you are and likely not having loads of professional training on the subject shouldn't get *too* involved.

And chances are there is a root cause to all of this that needs to be addressed, but once again, that is a job for professionals and it can take many years to get it out.  Therapy with a good therapist is a good thing in my experiences.
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Reply #22 on: June 17, 2010, 06:49:11 PM

In my experience (personal and through others in high school/university) its.. hard to really boil down what to do, other than some of the good advise already given earlier in the thread. I found what success I had in simply being there to listen, letting the other person open up gradually by letting them know I didn't regard suicide as bad in and of itself, and something I had seriously contemplated and started, and by being available whenever they felt comfortable in coming out. Too many people, in approaching someone who is suicidal (especially the "professionals" I, or those I know, saw), treat it either as a disease or close to the worst thing in existence, which either kicks in a serious guilt reflex or a general "fuck you" reflex and they shut you out if you're lucky, or try it again in part to spite you.

Loosely scheduling non-threatening meet-ups, such as a bite to eat, the night snacks, as already suggested, are great ideas. I'd avoid doing the 'record good thoughts' stuff from people he knows and giving it to him; though I've only seen that done once, the result was a guilt reflex -- especially if he wants this kept as private as possible. You don't want him to feel as though everyone knows and is pressuring him somehow (which is how he would likely see such a thing meaning). I'd have to also recommend, as suggested by another, trying to get someone who's been through a similar experience and is mature enough to talk to the kid; to give him the evidence that you can get past it, or at worst, deal with it, without having to say those words and sound like a patronizing moron.

I know everyone espouses going to the professionals as the only right thing you can do, everything else depending on the person, the day, the phase of the moon, basically, but I'd have to caution that you need to weigh the personality of the person against how good the professionals you're sending them to are. Of the three people I know who went that route, one ended up rail-roaded into a mental institution before killing herself to "escape" and the two others killed themselves within weeks of dealing with them. In each case they were well-intentioned but refused to acknowledge that depression and suicidal-tendancies in these people are normal and that they could, and must, "fix them".
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Reply #23 on: June 17, 2010, 07:07:20 PM

This is definitely a job for the professionals, but...

(Convincing myself someone cared was not so easy though, so there's that barrier, too.)
This.  As someone who has been in your student's shoes but too stupid to actually succeed, I can relate to him isolating himself and not wanting to talk to anyone.  Once people find out you've done something like this, either they talk to you about how beautiful and special you are and that suicide is wrong, or that life's a bitch and you should tough it out and not quit.  Heard it all before, don't care to hear it again.  If someone wants to truly relate and get him to open up, chances are they have to convince him they genuinely give a shit about his problems, and that's not easy to do.  I'd tell you whatever you wanted to hear to get you to leave me alone and go away, but the issue was always lurking in the back of my mind anyways and I sure as hell wasn't going to tell some Joe or authority figure who heard the bad news and wanted to know what was wrong when they wouldn't give me the time of day the week before.  It's a very tricky line to walk and you being in the position you are and likely not having loads of professional training on the subject shouldn't get *too* involved.

And chances are there is a root cause to all of this that needs to be addressed, but once again, that is a job for professionals and it can take many years to get it out.  Therapy with a good therapist is a good thing in my experiences.

This. Or you just convince them you want to listen. The worst thing that comes of this situation is that everyone feels the need to be their personal guide through the problem, shoving advice down his throat every chance they get and trying their best to "fix" them. It doesn't work, it's not what he wants. He's probably in a situation where everything is overwhelming him, but at the same time when he looks around there's no one he considers trustworthy or understanding enough to truly help him.
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Reply #24 on: June 17, 2010, 07:16:44 PM

The professional really does matter.  The guy I initially saw wasn't very good.  People I found later in life through friends, and some through my work in the GLBT community whom I had the opportunity to see interact with others, were awesome.  Getting me to any of them when I was at my worst probably wouldn't have happened.

That's the other thing.  Don't guilt yourself into doing too much.  Not just for the fear of pushing him away, but for your own psychological health.

Hahahaha!  I'm really good at this!
K9
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Reply #25 on: June 18, 2010, 04:31:10 AM

Thanks for all the help and support; the kid is seeing the doctors today, hopefully it will be a good prognosis. If he comes home again we'll work on getting him out of his room first I think.

Thanks again.

I love the smell of facepalm in the morning
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