A Bedford family is with their young son at the psychiatric unit of the IWK Health Centre after failed attempts to have him admitted to hospital for violent mood swings led to a crisis.

The family's life spiralled downward after the boy began experiencing uncontrollable rages in June. The 13-year-old was diagnosed with Asperger's syndrome when he was six, but the condition isn't typically linked to violent thoughts and outbursts.

The episodes escalated until Steve, the boy's father, was forced to stay home from work to prevent his son from hurting himself or harming his mother and younger brother. CBC News is not identifying the boy because of his age and medical issues.

On Nov. 9, Steve took his son to the emergency department and the IWK Health Centre.

He wanted his son to be admitted to a hospital inpatient unit known as the Garron Centre, which has 14 intensive care beds reserved for "psychiatric emergencies."

Steve was told his son's violent behaviour did not meet the hospital's criteria for admission to the unit and the family returned home.

Boy rushed to emergency room

On Thursday night, the father rushed his child back to the IWK's emergency room. Early Friday morning, the boy was admitted to the hospital's Garron Centre.

"It is unfortunate that it took a suicide attempt to get him into the program. What I mean by that is that they did not admit him on Monday and by Thursday night, I'm back again," Steve said.

"Nothing really changed except an attempt on his life. So obviously the bar should be looked at and the criteria critiqued ... it's very unfortunate something like this has to happen before your son gets help."

Fortunately, the team at the IWK was able to save and stabilize the boy. He spent the weekend in hospital being assessed.

The family is optimistic this hospital admission — the boy had one previous stay — will result in a diagnosis of what's causing this aggressive behaviour.

The hospital's criteria for admission to the acute care psychiatric unit requires more than a display of violent behaviour or being in a crisis, the hospital says.

The youth must be at immediate risk of harming themselves or another person, as Steve's family learned this week.

Social crisis not always psychiatric disorder

"People come to the emergency department in a crisis and its not necessarily always related to a psychiatric disorder," said Dr. Ruth Carter, the IWK's director of mental health and addictions.

"In the teenage years, it often can be because of some kind of a social crisis going on in their lives. They have intense relationships with their peers and they can get in a crisis mode," she said.

"That crisis may not result in an admission. If there is anything that would suggest a risk of harm to themselves or another — then they will be admitted."

About 470 patients were admitted last year. That is nearly 100 more than just a couple of years ago.

The hospital says more than half the children it sees benefit from treatment though outpatient services or programs in the community.

Meanwhile, the troubled teen cannot attend school because of his uncontrolled rages.

Police presence is not uncommon at the family's home in a quiet Bedford neighbourhood.

'A switch goes off'

Officers were called twice two weekends ago because of the boy's violent behaviour.

"It's as if a switch goes off. He doesn't know how to control his temper," said the dad.

Posters decorate the door to the 'man cave' where the troubled teen spends time. He's not attending school because of behavioural problems.

"On Sunday, he chased a seven-year old kid in the neighbourhood with a leg from a chair and we had to call police again. It's probably the 10th time since he started to get violent last June."

CBC News spoke to the pudgy, curly-haired boy, who was smiling, tinkering happily with electronics in the garage.

But in the next moment, the young teen's face clouds over.

Swearing, pushing his mother and threatening to kill himself with a rough knife he's fashioned are some of the things that can follow.

He's on medication, but he doesn't think it is helping.

When asked why he hits other people, he shifts uneasily and says: "Sometimes I just get it without any triggers. It just happens."

Refusal to consent to treatment

The family hopes for a diagnosis were raised when the boy was referred to the IWK's Adolescent Intensive Services treatment program on Joseph Howe Drive in Halifax.

The combination day and inpatient program for 13-to-19 year olds with severe disruptive behaviour, mental health issues or substance abuse is offered in a recreation-type setting not far from home.

But the boy refused to go. According to the province's Involuntary Psychiatric Treatment Act, his parents can't force him.

That's because the Act gives patients — regardless of age — the right to consent to, or reject, treatment.

"The young person needs to be able to understand the illness or the condition for which they are being seen or recommended for treatment," says Dr. Sabina Abidi, associate chief of psychiatry at the IWK.

"They need to understand what the treatment might be and what the side effects are. They need to understand the benefits and risks of accepting treatment, and the benefits and risks of refusing treatment."

That's a position the boy's dad finds impossible to accept.

No option but to speak out

"If you have a mentally challenged individual who is 13 years old who cannot make rational decisions, the legal guardian should be able to have the authority to help him get the help that he needs," said Steve.

"A medical professional told me that my son could possibly report me to the police if I manhandle him or do anything forcibly to make him go. That's just nonsense!"

He said the boy and the family are caught in a loop that includes police, mental health services, the IWK Health Centre, and Community Services.

"We are a family in crisis," said Steve.

Community Services has assessed the boy for future placement in a group home, but that's a last resort for the family.

"Once he goes into a small options home or Waterville [the detention centre for criminal youth], we've lost him," said Steve. "And we won't be able to pull him back."

The business executive said the frustration of trying to navigate the health system and other agencies to find help for his son pushed him to share the family's experience with the public.

"I've had enough," he said. "I'm a very private person. Even my colleagues at work don't know what's happening.

"But this story has to be told, not just for my son, but the many families out there who are going through the same thing. There is a problem in the system, it has to be rectified and I have no option except to speak out."