Some treatment programs have never worked with someone who gives their own bleeding-disorder medication by IV (infusion) or under the skin (injection). Because it’s unfamiliar, they might feel nervous or assume it’s unsafe in a behavioral-health setting.

If you or your family member normally self-infuse or self-inject, your bleeding disorder treatment team can help explain the process and reassure the facility. They can also send a letter confirming that you—or your loved one—are trained and capable of doing infusions safely from a bleeding-disorder perspective.

Before this happens, your treatment team will need to confirm that self-infusion is still safe right now, given the person’s mental-health or substance-use situation. This decision is made together by:

• The person with the bleeding disorder,

• The bleeding disorder treatment team, and

• The behavioral-health provider or facility.

If the treatment team agrees that self-infusion is appropriate, the facility will simply need to provide:

• Staff supervision during medication time, and

• A safe, private space for the infusion.

However, some states or facilities do not allow any self-administration of medication, even when a person is capable and prefers to do it themselves.
In these situations, if you wish to move forward with admission, you may need to agree to let a nurse, trained staff member, or visiting nurse administer your medication instead.
Your bleeding disorder treatment team can work with the facility to help identify someone qualified to give the medication safely.

Here are some examples you can use when talking with a facility:

• “I understand this might be new for your team, but I’ve been giving myself my bleeding-disorder medication since I was [age]. I do this safely and independently at home and in the community.”

• “My bleeding disorder treatment team can send a letter confirming that I’m trained and able to self-infuse safely.”

• “If it would be helpful, my treatment team can also share a short video showing what an infusion looks like and how it’s done safely.”

• “I understand your team may need to consider whether it’s safe for me to self-infuse right now. My treatment team can talk with you directly about that.”

• “If your policy doesn’t allow self-administration, I’m willing to have a nurse or trained staff person give the medication instead, as long as it’s done according to my treatment plan.”

• “If I’m not permitted to self-infuse, my treatment team can help identify someone who can administer the medication while I’m here.”

If you’re a parent or caregiver, you could say:

• “My child has been self-infusing since age [age]. They’re capable and comfortable doing it safely. Their bleeding disorder treatment team can confirm this and help plan for how infusions can happen while they’re here.”

When talking with your treatment team:

• Ask them to send a letter confirming stability and self-infusion competency, and

• Offer to connect them directly with the facility’s nurse, medical director, or admissions team to discuss what the facility’s policies allow.

If you’re following up by email, you can personalize this message:

Subject: Self-Infusion Information for [Your / Patient’s Name]

Dear [Name or Admissions Team],

Thank you for speaking with me about [my / my family member’s] admission. Because bleeding-disorder medications are given by IV or injection, I wanted to share some helpful national guidance and resources from the National Bleeding Disorders Foundation’s Medical and Scientific Advisory Council (MASAC), Recommendation #289 (attached).

MASAC explains that many people with bleeding disorders safely give their own medication. When appropriate, the facility can simply provide staff oversight during medication time and a private space for the infusion.

My bleeding disorder treatment team at [name of clinic or provider] can send a letter confirming that I am medically stable and trained to self-infuse, and they are happy to speak directly with your team if that would help.

If your state regulations or facility policy don’t allow self-administration, I’m open to having a trained nurse or staff member administer my medication, as long as it follows my treatment plan. My treatment team can work with you to make sure everything is done safely and correctly.

I’ve also included optional resources you may find helpful:

• MASAC Document #289 (excerpt on infusions)

• Sample self-administration policy

• Video: “How to Give Factor by Peripheral Infusion” (Children’s Minnesota)

• Video: “How to Give a Subcutaneous Injection” (Children’s Minnesota)

Please let me know what additional information would be most helpful.

Warm regards,
[Your Name]
[Your Phone / Email]
(optional) [Name and contact of your bleeding disorder treatment-team provider]