Finding the right psychiatric help in Memphis or Birmingham
November 11, 2015 8:17 AM   Subscribe

A sibling of mine is in crisis. Possible bipolar disorder, definite prescription pill abuse, possible suicide risk. We need to find them help immediately. But my family being my family, there are some requirements that have to be met. More details inside.

My sibling has struggled with MH issues their whole life. The problem is that I come from a deeply religious family who are big proponents of prayer solving everything and that quote-unquote mental issues often are the result of demonic influence. I wish I were kidding. Oh, and my mother was a psych major in college back in the 60s and her opinions of medication used to treat behavioral issues were both formed and calcified in that decade, so she assumes that 99% of all mood stabilizing meds "turn people into zombies."

As a result of these two things, my sibling's fairly significant MH issues have been "treated" by a parade of family therapists and church pastors. They have never seen an actual licensed medical professional who is trained to handle the bigger brain deals. We have no formal diagnosis, but given my sibling's actions and how they interact with the world, a lot of it points to bipolar disorder, and certainly a hefty dose of depression. They also have an addictive personality, and self-medicate with pain pills to a really troubling degree -- as in, they will sometimes be so completely checked out and incoherent and won't wake up from sleep.

Yesterday, the family learned that my sibling has been engaging in a serious (as in felony) criminal activity at their job for at least the last couple of years. The *only* reason why the cops weren't called is because my sibling has been fortunate to be employed by another family member, who views this as an opportunity to effectively coerce my sibling into getting the MH help they so desperately need.

When I leaned about all of this yesterday, I immediately became worried for my sibling's safety, because all too often you hear about someone making a staggeringly terrible choice and then deciding to kill themselves rather than deal with the fallout. And knowing my sibling has obvious self-destructive tendencies, I raised the alarm with my mom and my sister, who then also contacted my sibling's spouse. As of right now, my sibling is still alive, although last night the extent of the help they got was more pastoral counseling. They have an appointment to see a therapist next week, but I'm still terribly afraid, because a) that's a week of unemployment and sitting in the house by themselves, and b) there's nothing to suggest this therapist is any more qualified to do anything other than more prayer sessions.

The big positive about all of this is that my mom seems to have come around to the idea that my sibling does need actual medical help right now, so mom (working with my sibling's spouse, who is admittedly dazed and unsure how to proceed) has said she wants to pull out all the stops in finding THE BEST person to help.

Mom, sibling, and sibling's spouse all live in a smallish MS town, but Memphis and Birmingham are drivable options. Yes, my sibling is a grown-assed adult, and yes, they are asking for help with this. They are not in the condition to be able to take this on themselves, and their spouse, while being a lovely person, is also maddeningly passive and is not willing/able to be the point person here. And so that duty is falling to my mom, and she's asked for my assistance in finding THE BEST.

Here's where I'm hoping AskMe can help:

- we need a kickass psychiatrist who specializes in dealing with people who have bipolar/suicidal issues, with prescription pill addiction as a comorbidity.

- they can be anywhere within a 2-3 hour drive (each way) of northeast Mississippi; logically it seems Memphis or Birmingham would have the most options.

- they must be an MD who can prescribe medicine, and/or have the affiliations to be able to get scripts issued.

- we recognize that there's a real possibility my sibling might have to be in an actual rehab facility, as an inpatient. There is a facility in their town, but my mother has ruled it out because she "used to preach there on Sundays and all the inpatients are just zombies" (see above re psych opinions calcified in the 60s).

- VERY IMPORTANT: the professional must be a Christian / have a Christian aspect to their approach, BUT NOT sacrifice the medications my sibling almost certainly needs. I cannot stress this last point enough. It's taken a life-threatening crisis to get my mom to agree to actual doctor care, and she will not agree to send my sibling to someone who isn't a Christian. This makes me nuts, of course, but it's not about me and at this point I'm just grateful for any positive movement towards the "science over faith" approach to MH treatment.

I'm a thousand miles away, so I'm limited in my ability to help, but I'm trying. I just want to keep my sibling alive and get them the professional help they so badly need in this time of crisis.
posted by shiu mai baby to Health & Fitness (11 answers total)
 
What does your sibling think and want? You've talked a lot about what your mom wants (and what she is refusing on behalf of her adult daughter who has the right to make all of her own medical decisions, unless there is a guardianship in play that you haven't mentioned here) and about what you think is best. But what does your sibling want? Does she want to see a doctor? Does she want to check into an inpatient hospital? Does she want to try medication or therapy? Does she want to receive religious treatment, or secular treatment, or does she not care what her doctors do in their free time?

You're describing a situation in which your mom is permitted to make all of the decisions for other adults. And she doesn't get to do that. Neither do you. Not unless there are some very unusual extenuating circumstances that have rendered your adult sibling legally a ward of your mother. So I think you need to find out what your sibling wants to do, and then you can figure out how to support those choices. If you want to help your sibling, the first step is to find out what kind of help your sibling wants and/or is willing to accept.
posted by decathecting at 8:33 AM on November 11, 2015 [2 favorites]


(and yes, I realize that your sibling isn't in a position to do the legwork herself. But presumably she can answer simple questions like, "do you want to check into a hospital?" and "do you care whether your doctor believes in Jesus?" that will help to guide the decisions you can help her make going forward. But I think the most helpful thing you can do, even from so far away, is to tell your mom to shove it, because she has withheld medical treatment from her serious ill child for decades, and so she has forfeited the right to veto needed and wanted treatment now.)
posted by decathecting at 8:35 AM on November 11, 2015 [1 favorite]


Honestly, I'm not completely sure. I think they want help; based on the conversation they had with my mom yesterday, and my sister's conversation with my sibling's spouse, it would certainly point that way. But I'm not completely certain.

At this point, the main reason I posted this is to be able to say something like, "ok, look, here are three hugely respected psychiatrists who happen to specialize in this kind of thing, here are their numbers" and pass that info along to my sibling and their spouse.

I hate my mother's involvement in this for obvious reasons, but she's the only non-passive local person here, and she will most likely be footing all of the medical costs.

I'm limiting my involvement to research, because my sibling and I have our own separate set of issues, and I don't want to trigger a fight when they're in such a delicate place. I left them a voicemail this morning telling them that I loved them and I am here for them in any way they need.

Given both the actual and metaphorical distance, I don't know that I can do much else outside of helping locate a resource.
posted by shiu mai baby at 8:48 AM on November 11, 2015 [1 favorite]


I will cut through a bunch of details and say contact the University of Alabama hospital system (looks like you should start with UAB HealthFinder - 800.822.8816).

Your sibling probably does not have a choice about hospital stay, they will need to do what the trained medical staff says they need to do. They should be prepared to engage in a voluntary 5-day hold, possibly longer. Medication onboarding (and modifications) require supervision until it is determined that it doesn't (I know several people who've never had to overnight for medication reasons, and I know several people who schedule their hospital stays for med changes because it's too dangerous not to).

They also appear to have an emergency department specific to mental health, but call them and find out how that works.

I imagine they can find at least one Christian on the staff, it's Alabama.

If you want to do more shopping, you can call NAMI but it honestly does look like TN doesn't have much to offer in well-rated (or at-all-rated) comprehensive medical mental health care besides Vanderbilt's medical school hospital. The Baptist Hospital system in Memphis (which I imagine would satisfy your mother) doesn't seem to offer any mental health services, unfortunately.

Yes, ultimately your mom needs to cram a sock in it, but just get your sibling through a door, whatever it takes. Psychiatric professionals are highly experienced in dealing with manipulative parents, so just get your sibling in a door and then let them handle all that bullshit.
posted by Lyn Never at 8:49 AM on November 11, 2015 [6 favorites]


If you are truly worried about your sibling's safety--ie, might they be a danger to themselves?--don't rule out the possibility of an involuntary hospital stay.
posted by the_blizz at 8:55 AM on November 11, 2015


I have been a patient in the UAB system, but not in mental health. They are certainly premiere in Alabama, and have a great reputation southeast-wide. They took great care of me when I suffered severe orthopedic trauma.

Funny enough, I just recently answered an Ask Me question in which the beliefs of a practitioner is discussed - is that important or not important, and cited counselors as an area where matching beliefs is worthwhile. However, I think while it's a nice thing to have, it should not be a deciding factor in a crisis like this. Not to denigrate marriage counseling, but this ain't marriage counseling. This is brain chemistry, and a crisis. Philosophical and religious beliefs aren't much of a factor, IMO (and FWIW, I'm a Christian).

While I am not keen on dishonesty, I think it's a point at which you placate your mother while getting your sibling the help they need. You might talk in terms of getting your sibling connected with a faith-appropriate counseler AFTER they're out of crisis.

It might be helpful to point out that UAB is in an alliance (at least for my part of the state) with BAPTIST Health System, which is most assuredly strongly affiliated with that church.
posted by randomkeystrike at 9:17 AM on November 11, 2015 [2 favorites]


Memphis has a church-affliated place called the Christian Psychological Center that doesn't (I don't think) prescribe medication but will certainly refer you to someone who will, and help you find an inpatient or outpatient treatment facility that fits your needs. They are not against medication ro hospitalization, they just don't have MDs on staff. Probably not the best option for a crisis situation, but might be the most alluring option to your mom.
posted by raspberrE at 12:58 PM on November 11, 2015 [1 favorite]


A lot of times people don't differentiate between a psychiatrist/prescriber and a therapist. I can't imagine how it could be at all relevant if a prescriber is Christian--the appts are often brief and infrequent and focused very narrowly on meds. In terms of a therapist, I can see that making a bit more sense. If your mom can appreciate the reasons for doing this, I'd let go of needing a Christian psychiatrist and say that's more of an issue when it comes to a therapist.
posted by mermaidcafe at 2:13 PM on November 11, 2015 [3 favorites]


Follow-up: I had high aspirations for UAB that have since been dashed. Firstly, their website sucks. Not a huge deal, but frustrating when you (meaning I) are trying to convince the family that this is an excellent option for my sibling.

In particular, their page under patients > treatment is this one, which lists Electric Convulsion Treatment (ECT, aka shock treatments) as the only thing on the page. I know ECT has made enormous strides, and is hugely effective for people suffering with severe depression, but having that and just that on the page was irritating, especially since I know my mom well enough to know that will make her and my sibling NOPE out right away.

And lastly: they don't answer their damned phone. I called five different times today, letting the phone ring and ring (20 times during one of my attempts), but nothing. No answer, no voicemail, no answering service, no redirect to another department.

I feel like I'm back at square one, so any additional suggestions would be so welcome. Thanks, everyone, I'm grateful for all the help so far.
posted by shiu mai baby at 2:04 PM on November 13, 2015


Shit, I'm sorry. Maybe do start with NAMI, though apparently they only staff their helpline during business hours.
posted by Lyn Never at 5:11 PM on November 13, 2015 [1 favorite]


As I'm in Canada, this isn't a specific suggestion but more one of approach:

1) Try looking up "christian mental health services" and location (I googled and got a bunch of results with Memphis and Birmingham) and then once you have the names of facilities, look for reviews.

2) Try contacting actual church organizations (you don't mention what denomination, if any, your mother is concerned with, but for example the Southern Baptist Convention has a Mental Health Advisory Group)--they might be able to refer you to affiliated medical practitioners or hospitals.

Good luck!
posted by sarahkeebs at 8:17 AM on November 15, 2015


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