A father calls in the middle of the night at 2 a.m. upset. They are at their wit’s end and near despair.
He and his partner have been with their autistic son for over 4 hours. He just won’t go to sleep. After dinner, there was an argument over gaming. This got so high that, although he ended up in his room, he did not calm down. He is shouting and cursing, making all sorts of curses and threats, particularly toward his parents. Some household items were not left intact in the process, but most in terms of sharp objects and what he can break is out of his reach/out of his room. By now, things have been reduced to kicking the door, although he has since locked the door. The family has been receiving assistance for some time, but they cannot reach it at this time.
After first asking for the (accessibility) details and agreeing that if it escalates to such an extent they will disconnect and call the Police, agreed to see together what the options are for calming things down. From this contact, despite the fact that emergency services are involved, it appears that there are no safety agreements in place or a safety plan. There have been previous escalations, but they were not so violent. Many times he got tired or chose “eggs for his money.”
The latter was mostly because parents managed to get his focus elsewhere. Now that didn’t work out. Fatigue and own (work) planning for tomorrow, added to parents’ tension. And then there was the concern for the safety of their infant daughter, who was sleeping downstairs on the couch.
At the beginning of the contact, emotions were high, it was indicated that they could no longer care for their son and that they could no longer keep him at home. In doing so, they were handicapped when it came to physically intervening when necessary and concerns for their infant daughter’s safety.
Emotions, feelings of helplessness are understandable and especially when you have been working for hours and it is now the middle of the night. Having all kinds of thoughts and possibly having called out all kinds of things is also part of it. The noise was already subsiding slightly, there was now only kicking at the door. Concluded (or put into perspective) with parents that their little daughter is sleeping safely on the couch, that they know where their son is (in his room), that they have made the environment as safe as possible, they do still get contact with him (they get reaction when they address him) and he is still alive c.q. is probably not doing much else (because he is constantly kicking the door).
Then parents prepared that it will probably be a rough night with little sleep. Perhaps the work will have to wait tomorrow and discussed what the options are in this.
Now that parents could fully focus on the situation, parents coached to get it done that the door was unlocked. The door was not allowed to open fully at first, it sat in front of the door and parents were not allowed in. We managed to speak to the boy (through the speaker) and father was allowed in. There appeared to have been tension signals before, but parents had missed them. Once it was worked toward bed to go to sleep, agreed to call back in half an hour.
Parents managed to put both children in their beds. The boy was almost asleep already. Parents were still not comfortable, however, what if he wakes up and then starts again. Discussed what they want to do with this. Eventually mother indicates that she is staying awake. After all, it is early in the morning. Tomorrow she will also stay home so that if going to school does not work out, it can be taken care of.
After first complimenting parents, they had pulled this off! Tomorrow, the contact with the CIT will be fed back to the relevant assistance. Requesting them to take this further, especially agreements on what to do if it gets out of hand. Concluded that should things still get out of hand tonight, CIT may of course be called again.
When I hang up, there is still a lot of work to do. The CIT also has to record and I have to make sure there is a clear transfer. Fortunately, my colleague was able to sleep through last night and this time it was possible to handle it over the phone. Once I’m done, I can already see it getting cautiously light. I decide to freshen up and have breakfast. At 9 a.m. I speak to my colleague who is starting the day shift and carry over the events of the previous evening and last night.
Tip: Always make safety agreements/a safety plan.
Usually, even with minor care issues, things have been going on for a while. After all, one couldn’t figure it out on one’s own, which is why help is requested. It is important to have in place what is possible if things go wrong, is there network to apply for support and what can be agreed upon about this now. When assistance is involved, it is always asked if there are (current) safety agreements or if there is a safety plan. Too often it appears that this is lacking and is also not a topic of conversation. Especially given the increased waiting list problems, it is important to pay attention to this already at the time of registration, this can prevent escalations and helps to increase the development of solution skills.
