My stepson doesn't live with us because his father and grandmother believe that I have "caused" his bipolar situation.  (I think that's their mental illnesses talking) Briefly, he has had behavioral issues since age two.  He's always been incredibly smart and incredibly bent on having things his way.  As the only child of two only children, this was possible until his siblings arrived. During the same time frame, his beloved grandfather died and his mother left the marriage.  My husband obtained custody of the children.

A few years later I met and married his Dad.  I have a son who is older than stepson, and stepson had a hard time adjusting to no longer being "top dog".  His problems escalated and he was treated for ADD, depression and a whole host of things.  Stepson's teachers liked him because he was respectful in class, albeit spacey.  Sadly, stepson revealed that he has been hearing and seeing things for a long time.   Stepson dislikes me, his stepmom, because I hold him to the same rules as the other four children.  He managed to convince others that I was abusing him, and since the family is not mentally healthy, it was readily believed.  Around this time stepson went to live with mother and then grandmother after mother moved out of the country.   At this point I have nearly no contact with him, which protects me from abuse allegations. 

As you may have guessed, his problems continued even with out me.  In fact they have gotten worse as his mother has fallen apart and he has entered puberty.  Tested extensively for schizophrenia during several mental hospital stays, the doctors have come to the conclusion that he has bipolar disease.  The meds worked successfully at mitigating the bipolar symptoms, but stepson stopped taking meds because he hated the side effects.

Last week my stepson talked openly about stabbing fellow students in the stomach and he visualized the effects outloud.  He was put on probation at school.

I am becoming very afraid of him.  Do you think there is cause for concern?