Hello, I am Rafael. Thanks for asking your question - I'm here to support you. (Information posted here is not private or confidential but public).
I am very sorry to know about your serious and overwhelming situation. I understand what you describe in your message but only you know how tough it is, how it feels to be in your shoes. Your situation appears hopeless because of everything you have tried so far without any improvement, but I wanted to say that whoever has stated that your son does not have mental health issues has no idea about basic psychology and mental health.
Should we continue down the mental health route
The behaviors you described show your son has serious mental health and behavioral problems, what we call oppositional defiant behavior, poor anger control and for sure personality problems affecting from mood, to functioning, socialization and other aspects ion his life.
Anybody who said he has no mental health issues was very irresponsible, neglectful and ignorant. Your son requires intensive psychotherapeutic and behavioral treatment; and you need support to learn how to better cope with this serious situation.
How can I find information to enable us to cope with this situation. We have our second meeting with mental health care professional this week after insisting the GP re-refers us, his case would've been closed if we hadn't persisted.
Your son is a minor but all enough to have to take full responsibility for his choices and actions. You need to find out what's the source of these serious problems in order to address them and for him to get all necessary support - treatment.
He has had an assault from peers sexually a few years ago, although this had been mentioned to the mental health professional.
No way, if people in the NHS system try or close his case, you should push them filing a complaint in writing making it clear how much you have done looking for support, and how it's been denied, so for them to hold full accountability for any neglectful or abusive decision.
It is unacceptable, they are going against basic ethics and standards of good health practice, that's why you need to push them and make it clear you would not give up
If these serious problems started after that abuse episode, then it could be the very root of them, it would make perfect sense.
A child does not get this way from nothing, but it is very common for victims of abuse to get traumatized, feel overwhelmed and from there develop serious behavioral and mood problems, using anger since unable to effectively cope with painful feelings.
Does fear manifest itself as anger? His anger towards us as his family is tremendous and towards other mostly female authority figures, unless they are no threat to him, or not becoming angry with him for something he has done. He has cornet lessons and his female teacher poses no threat and therefore he has no problems with her.
For how long has he been like this, and did these behaviors developed gradually or you noticed a sudden change, specially after the abuse episode he suffered?
He has been like this for exactly six months, almost as though a switch has been turned on. But the abuse was a further 12 months earlier, around eighteen months prior. He has been a keen footballer but sustained an injury which prevented him from joining a high ranking club, which didn't help his self esteem, and after that he didn't care about anything, some substance abuse, self harm etc
Then each one of this serious stressors could have led to this anger-violence problem, and all together could become overwhelming for most people in his shoes. I truly believe his anger-violence, defiance problems are deeply rooted in all these issues fueling each other, his frustration and any other destructive behavior.
Unhappily many drugs could also create serious mental health disorders like these, so ti is essential for "competent" mental health professionals to assess drug use - abuse history in order to identify what substances he has used and how they could have impacted him.
Your son could present what we known in the mental health filed as dual-diagnoses disorders, which are cases where the person suffers of mental health problems and disorders related to the use or abuse of drugs, which require professional and multidisciplinary support.
How as parents do we cope with his problems, we feel we are walking on egg shells continually, and we actually need some form of parenting strategies. I f we are open and come clean regarding his ad-hoc substance miss-use, what impact would this have on any future career, or possible army career plans?
He was described as presenting extremely well during his mental health initial assessment, and he engaged but didn't want any further intervention, and it was at that stage they decided there was no mental health issue.
There is no doubt that there is no way to work on his rehabilitation process without you playing a leading role in it, that's why his treatment must include you. You should get collateral sessions to work on how to better cope and support him, and refer to parenting classes. Therapist and social worker must work with you and school staff in order to work as a team promoting his rehabilitation.
As parents of a minor you have the right and responsibility to take good care of him and to get necessary professional support. Nobody better than you know about his reality, thus please do not stop pushing the system until you get the support he and you need. What I know is that is these serious issues-disorders are not addressed right away with therapeutic support, he would get worse and it would be unrealistic to even expect a healthy and fulfilling life taking good care of his basic needs, even less about career and family, then please do reassess and set your priorities an dfocus on what you can and need to do right now to support him and yourselves.
Please remember that without addressing and treating the substance abuse problems, any mental health intervention - treatment would not be effective. Both, substance abuse disorders and mental health problems must be treated as a whole for him to get good chances for rehabilitation.
If he won't engage further, he has refused in the past, are there any parenting strategies we can seek help/advice from that have aided parents like us, really don't know where to look, or read up or classes to attend.
Absolutely, please look for counseling for you and your spouse on parenting, request referrals for parenting classes and join support groups for parents coping with children with mental-substance abuse disorders. Asks for these referrals at local clinic. They must provide information and refer you to these free support groups as well as mental health programs providing counseling for parents supporting children with these disorders.
You could also consider getting direct private psychotherapy through independent provider or clinic in order to ensure you get the support you need without delay.
Here you can find a directory of professionals who could support you:
This is from the BPS directory: http://www.cbtregisteruk.com/Default.aspx
And this is another good source of professional support providers:
Finally, here you would find information and several useful resources:
Is psychotherapy more advantageous than counselling. I did a counselling session but felt she didn't comprehend the severity of the situation, and became more interested in the enabling side of our parenting, rather than helping us to cope/deal with the frightening side that we have to endure.
This link is specifically for parenting: Parenting: Family Lives - Phone: 0808(NNN) NNN-NNNN Website: http://familylives.org.uk
Yes I have called Family Lives frequently this last six months.
Psychotherapy is the best therapeutic form of support, necessary for most mental health disorders, while counselling is the "light" version of psychotherapy, adequate for not too serious mental health problems. Psychotherapy is a higher level of treatment - interventions.
YoungMinds could be very useful too. They provide Information on child and adolescent mental health. Services for parents and professionals.Their parents' helpline is 0808(NNN) NNN-NNNNand their website: www.youngminds.org.uk
Ok thank you so if he won't engage we should at least try and engage ourselves with a psychotherapist. It was one of the qualified therapists who can call back for a one-to-one from Young Minds who insisted I go back to the GP for re-referral.
Especially once I mentioned the abuse even though it was a while back.
Yes, please do everything in your power to assertively support him, not to allow any further abuse or violence, which is never acceptable, and if you have to call the police again, do so, and also get all the support you can for you to take good care of yourselves and better cope with this serious and overwhelming situation. All close family and close friends who happen to care must be taken into account. Finally, please consider reviewing codependency support groups, they could be very useful and supportive too.
You're welcome. Thank you for being this open and honest here, for your trust. I truly hope your situation improves with necessary support.
Can I thank you for your detailed and informative response.