ADVICE: My 9 year old enjoys hurting people

I’ve posted on here a couple of times and just have no idea where to turn or what to do. My 9 year old has pushed her dad (my husband) down the stairs 3 times. She’s pushed her 1 year old sister. She’s punched, kicked, slapped, and thrown things at us too many times to count. We’ve gotten her involved in counseling (she has just been recently transferred to the home based therapy program that offers intensive therapy for children who are having the most trouble). She’s gone to day hospital twice in the past year. I hesitated to put her on medication, but decided to follow the advice of her doctor. My husband and I have taken several parenting classes and made an effort to learn new techniques. We’ve made rewards charts, point systems, and a few other reward systems as encouraged by mental health professionals. We’ve learned to regulate our emotions when she acts out, as well. She seems to get enjoyment out of hurting others, though. She’ll take toys away from my 1 year old and smile when she cries. She told me last night that she wished her sister wasn’t here anymore. I’m deeply afraid something terrible will happen. Yesterday I took her to our crisis center (it’s like an emergency room for mental health) and was turned away because they were “at capacity” for children. I was told to take her to the ER. I did, but since she wasn’t actively suicidal or homicidal, they sent us home. No resources. No phone numbers. Nothing. They did ask her to PROMISE them she wouldn’t act out. Of course, she broke that promise. The ER just didn’t seem to be very knowledgeable about mental illness. I’m not sure what to do. I’m deeply concerned she’s going to seriously injure someone and I’m broken inside knowing she’s having such a rough time. Has anyone else dealt with this or something similar? Any advice? I just want her to be happy again 😞

UPDATE: Thank you for all of your advice and support. I was finally able to get an appointment with her psychiatrist for tomorrow at 11 am. We will also meet with her therapist while we’re there. They have asked that I have someone watch my youngest daughter during the appointment and both my husband and I need to attend.

We’ve been going out of our way to try to show her we love her. 2 weeks ago just her and we had a salon day just me and her(although the next day she got violent). We’ve implemented game nights and cooking nights (she plans the meal and we cook it together). We do 1:1 activities when her sister takes a nap.

I’ve never been a fan of spanking and all the professionals advise against it, so I won’t spank her.

2ND UPDATE 4/24: can’t thank everyone enough for all of the support and advice. Last night she had another outburst, but this time said she wanted to die and that she wanted to fall asleep and never wake up. I took her back to the crisis center and this time, we weren’t sent away. She said she wanted to die because she can’t control her behavior and she wants to start over. I was told she wasn’t eligible for inpatient hospitalization, but was connected with a parent support group for parents dealing with difficult behavior. We will have a women come to our home weekly or as needed to help sort things out. I can call her when we’re dealing with a crisis and she will help walk us through the crisis or can come to our home and observe/assist with the crisis.

We’ve been dealing with these episodes since she was about 3 years old but it’s gotten worse since the birth of her sister. She was diagnosed with cyclothymic disorder about 8 months ago (her psychiatrist said she was afraid to diagnose her with bipolar being so young). Now we need to find effective medication, therapy, and parenting techniques.

3RD UPDATE 4/24: We saw her psychiatrist and therapist today. We also saw the parent support professional. Her doctor increased her meds and her therapist updated her crisis plan. The doctor also said that if she had another violent outburst that she would need to be hospitalized.

My daughter wrote me a note tonight saying she wanted to die and how she’d do it. I called her therapist (who luckily was on call) and she tried to send us to the crisis center, but they’re full. We’re now in the emergency room for a psych eval. I hope they can help her to be happy. I just want my baby to be happy.

4TH UPDATE 4/26: I was in the ER with her all night on the 24th until 4 pm yesterday because their social worker went home early and there wouldn’t be another social worker in until 9 the next morning. We tried to have her transferred to children’s hospital, but they’ll only transfer psych patients if they’re medically unstable. The social worker thought she should be hospitalized, so she had to call the crisis center- who couldn’t take her- to come assess her. For whatever reason, they determined she didn’t need to be hospitalized so they refused to admit her. The social worker at the hospital pulled me into the hall and told me to advocate for my daughter. She gave me the phone number for the boss of the woman who did the assessment. I called and was told she would need to be transported to the crisis center but they were full and it’s unknown how long it would be before they’d have room for her.

My daughter’s therapist met us in the hospital and called and talked to a supervisor at the crisis center who said we could walk in for an assessment, but if she had to be hospitalized, they didn’t have a bed for her. Why didn’t they tell us this on Tuesday??? So the ER doctor agreed to discharge her so I could take her to the crisis center to be reassessed. The crisis center AGAIN denied hospitalization but referred her to a day hospital program (she’s been to this program twice and it hasn’t helped. Plus she’s home every night and on the weekends.). I don’t feel like I can keep her safe at home. 😞

Her therapist, psychiatrist, and the social worker in the ER recommended inpatient hospitalization and the crisis center is the only one who can admit her. AND THEY’RE REFUSING! I was sent home with her and told to take her to the day hospital program in the morning. They refused to give me paperwork, too. I came home and locked everything sharp up in a safe.

Today, Thursday 2/26, my 1 year old had a check up with their pediatrician. While my 9 year old was in day hospital I took my youngest for her appointment and talked to the pediatrician about what happened. SHE ALSO RECOMMENDED INPATIENT HOSPITALIZATION. I don’t understand why it’s so difficult to get her the help she truly needs! If she had an illness that required hospitalization, any doctor with admitting privileges at the hospital would be able to admit her. Why should mental health treatment/ hospitalization be any different?

I don’t know what to do anymore 😞

5TH UPDATE 4/27: Last night we had to call 911 on our daughter. She pushed her 1 year old sister and kicked me in the back. After we called, she was trying to lock herself in the bathroom and was also trying to get into our silverware drawer. (She had also made threats of harming herself at dinner. And earlier in the day randomly started hitting herself in the head with hard plastic toys repeatedly.) Luckily, anything extremely sharp was already secured in a safe- but silverware can still be dangerous. It was extremely scary. The police were more than supportive. And one of the officers was able to get her to calm down some. I had her transported to Children’s Hospital, which is in a different county (that has different admitting practices), but because she doesn’t LIVE in that county, she still must be admitted through the crisis center in our county. We are waiting for a transport via ambulance to the crisis center, which I’m told could take DAYS. It’s been over 24 hours so far. Since she’s at Children’s Hospital, I was able to come home and shower and rest some. It’s been difficult to rest for so many reasons.

I must thank everyone for their supportive comments and suggestions. I’ve looked into quite a few of them and I will also be contacting a neurologist on Monday to make an appointment just to make sure we’re not missing something.

6TH UPDATE 4/28: We’re still waiting on a transfer to the crisis center. My husband and I have been doing a lot of research and we really think the escalation in behavior has a lot to do with the medication she she was prescribed in February (Zoloft). She wasn’t doing GREAT before then, but since being put on the medication she’s just gotten worse. We want to work with a psychiatrist to titrate her off of it and put her on something that will help more.

7TH UPDATE 4/30: after being in the hospital since Thursday night, she’s finally being transferred to the crisis center. They’ll assess her and I’m assuming they’re going to send her back home AGAIN. Trying to stay positive, but this entire experience has shown me that they’re doing more harm than good.