I got him there (to ER) but it sure was an adventure!! He's been in before- 2 years ago, and that was difficult too. This time, local mental health couldn''t/woouldn't help because they thought he was not an immenent danger- difficult child was "shut down" in bed at time I called them. Ok, I agree I had to "stretch" that definition a bit- I went to difficult child and said I might have to call police - he said he's not going anywhere- I said what would you do if police came, would you kill them- he said yep, I might, but I'm not going anywhere. I call that a threat to do bodily harm to someone else, or at least until I knew he was being admitted. Am I bad? (Don't get me wrong, I could clearly see this was headed for a disaster if medication changes weren't made quicker and with more supervision from a psychiatrist- I just stretched the definition of "potential harm to someone else" because they don't seem to blink an eye for a difficult child making decisions that could harm themselves. Anyhoooo- I told difficult child he had to choose between detention or psychiatric hospital (like that was either of our choices- but then, his choices will determine a lot of the outcome of his life, you know?). He said he'd go to psychiatric hospital- so I JUMPED at that opportunity. I took him to ER where they have inpatient plus day treatment that I've been looking into. psychiatrist said they should admit him. Then, calls PO and finds out about current charges for going into shed and tearing up school computer. That does it for them- they WILL NOT take a child in who has current legal charges. HUH?? They were not violent acts. Well, then a couple of hours were spent with them looking into state psychiatric hospital out of this region. I start having second thoughts about that- like- how long would he be there? difficult child starts asking then if that means he would be in there with all the real violent criminals who have issues. psychiatrist says well, she's decided he should be admitted and if I don't agree, she'll tdo him. Oh, me not agreeing would look great to gal, po, and judge- so I say I'll agree. So, leave it to the agency who decides if state will pay for this- this lady says "he does not need to be sent to out of region psychiatric hospital and have state get involved in all this" and she gets difficult child in the psychiatric hospital he had been in before. OK!! YIPEE!! So, this whole process took from about 10:30 am to 8:00 pm. How's that for a full day? They cut monitor off difficult child's ankle, so he feels ok. He was shutting down so much- I think he'll appreciate this break in the long run. The people at the psychiatric hospital (once admitted) agreed that he just needed some quick medication adjustments. They did blood work though and his lithium and depakote levels were in therapuetic range- good sign I thought because regular psychiatrist was in the park with dosages, I didn't screw these medication dosages up, and difficult child must have been taking them (not hiding them in cheek). He's looking at a 3 to 7 day stay- depending on medications to be changed. I was reading a post in another thread and have a question about day treatment now. They all aren't the same are they? That post sounded like it was a place one step away from juvy. I'm looking for a place that works with bipolar issues- under the assumption that bad behavior is an effect of medications not working and difficult child not having strategies for himself and me and school district not having strategies and support systems that are currently working. Am I being too idealistic here? Are some day treatments addressing issues like this? Are those the day treatments that insurance cos. are paying for instead of school district? I don't think difficult child or I either one could take him being in a place where juvy was used as a continuous threat- he already is living with that. Thanks for reading all this!!