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We have had a very hectic month with my daughter.  She was admitted to this facility on Feb 1st and was mistakenly placed into the wrong cottage based on some information that was reviewed prior to her being offered a bed.  As we all know the amount of paperwork is astronomical and creates too many opportunities for the most crucial elements in a recommendation to go unnoticed.  After a very difficult period of two months, the administration revisited the paperwork and realized they had made a grave mistake and approved my daughter to be placed into the cottage that was specified in the report written by a diagnostic team at a level 5 psychiatric facility.  They also acknowledged that their own psychiatrist had changed her dx so she was now under-diagnosed.  I had been fighting this from day one and I was ecstatic when she made the transition, so were her therapist who fought just as hard as I did,and her case manager who did not back down once my daughters behaviors escalated and her behaviors continued to decline.

I thought all was well.  She transitioned okay, but was the new kid on the block and feeling out of place.  She started to involve herself and show improvement to the point that her sister and I were in tears during our family session.  Not even a week later something changed that caused the staff to become alarmed by her conversations and behaviors.  She started to become suicidal and was hysterical every time I spoke to her.  She never wanted to tell me what was wrong and I had no idea how to help her.  And then out of the blue she said that the reason why she wants to kill herself for the last two years is because she has intrusive thoughts about murdering us in our home and the visions are gruesome and they make her want to die because she has felt at times that she needed to follow through and actually prepared a plan.  Recently she had been mentioning a dark figure with no face that comes to her in her dreams and that when this starts up she feels compelled to act on these thoughts.

I heard what she was saying but my brain wasn't able to grasp it.  I figured this was another attempt to get back at us for having her committed or that she was attention seeking in her cottage.  It didn't really hit me until I processed the conversation with her therapist who was very concerned about this shift in thoughts and actions.  He believed that she was not acting but finally able to come out and say what she had been dealing with.  I am devastated and half of my family doesn't even know because they would recoil from her.

So here was are about almost two weeks after that disclosure and I get a call from a staff member informing me that she had attacked another staff member and beat her badly enough for her to have to be rushed to the hospital.  The attack was unprovoked as most of her past attacks have been as well.

The staff member has now decided to press charges which she has been charged with simple assault.  I have to make the 5 hour drive to find out what will happen now that this has become a criminal matter and if this will interfere with her treatment.  Ironically I had just finished my research paper that was about the mentally ill juveniles in the juvenile justice system.  And here we are a part of the worst possible scenario a family with a child with a mental illness can find themselves in.  I am going to attach my paper just so you can get a taste of what I learned and why I am scared to death for her more than I ever thought possible.

Has anyone ever had to go through the juvenile system based on an assault at a PRTF?  I need advice on what questions to ask and how hard to I fight to make her dx (which is still not accurate) an issue.  i don't want to make it worse for her, but I can not travel back and forth as they require me to do.  I read the disclosure letter which was basically three paragraphs naming the charge, confirming it a criminal act and mandating parental involvement in all court actions and when there is a disciplinary plan, the parent is required to provided transportation and supervision at every court ordered program that is included in the order.  

5 hours each way, financial mess just paying for gas, and the classes.  I don't even known if the victim is seeking medical restitution and punitive damages.  What do we do as parents when our children's mental health issues are not being dealt with appropriately to the point that something like this occurs and they act as though its out of character.  She has been doing this to us for over 2 years now and almost killed a girl at school.  The dx given to her at Central Regional was dead on and the facility psychiatrist (who has never returned any of my calls or the calls from her therapist) downgrades and even adds ADHD which was definitively ruled out by the Vanderbuilt Scale.  Her results did not even indicate there was any issue with ADHD at all, so why is it there?  I have made these concerns known to every staff member I come in contact with.  I am backed up by her therapist who is perplexed as to why the psychiatrist is refusing to revisit her documented history.  he wants a more detailed biological history.  Well, here's another problem, my daughter's entire immediate family less her sister, are all dead from unnatural causes and untreated mental illness.  There is no name to the mental illness, just mental illness.  I gave them my side and there is no reason to believe that based on the info he has that his current dx is inaccurate.

I guess I will be doing a lot more research than I had intended.  I will update as I find out more info.  They are not so forthcoming with info these days so whatever it is I will post so I can get some guidance and wisdom.  I am so angry I can't see past the first mistake they made on the date of her admittance.  UGH, but even with all this, I believe her therapist can help her and I believe that her first case manager can help get us through this.  So my goals for this week are to get the first case manager back on board (he used to be a juvenile court counselor) and get my daughter reassessed outside of this facility at a center that is unbiased and has no reason to cover their butts by refusing to see the conflict and problems related to the current dx.  If I knew I could loss my job by downgrading a dx and limiting treatment options, I'd most definitely try to convince everyone that I was right.  I have his number and I am going to prepare a history for the court counselor to see these obvious inconstantcies and provide statistics of children such as my daughter's statistical probability of completing her next suicide attempt unless we get this straightened out.   She would have less than a 10% chance of living past her eighteenth birthday. She'll be 16 in August.

Please pray we can make this happen.  I asked why us and I know its because I will fight to change the way these technicalities are more detrimental to our children's lives and cause parents to prepare themselves for their worst nightmare... . all because certain professionals that have the final say in what gets written in a box are too ignorant to entertain the possibility that they made a mistake.  That is all this is about... .  

I still believe in the staff at this facility and would like to see my daughter complete her therapy there.  But my mission at this moment is to make these technicalities tell the story of what my daughter has been suffering with for two years and there was a plan with the box filled in with accurate and appropriate dx that with proper treatment and medication could allow her to forgive herself for thoughts she has no control over and let herself feel how much we love her and always will.

Sorry for the ramble... .  I had to vent and let it all out.  I will post my report after this.

Googie, it sounds like a terrible mess. I am so sorry it is so hard for you and your family. I can understand why you would feel angry and fearful for the future.

I just want to be here for you, I doubt there is much I can suggest. I do have one thing for you though. In Aust this month was published the National Clinical Guidelines for the Management of BPD. On pg 126 there is information on risk assessment and risk management etc. The figure on pg 128 is especially helpful. In fact there is much there that you may find helpful in your 'research'. There is though nothing about rtc's and such like and while it is based on the current and international research, the recommendations are targeted for Australia clinicians.

National Clinical Guidelines for the Management of BPD (Aust) (http://www.nhmrc.gov.au/guidelines/publications/mh25)

good luck Googie, praying for you all tonight,

Vivek      

Oh Googie,

Sounds like a jumble of concerns and uncertainty!  So sorry that this has occurred and hope that you get cooperation from the facility to increase the protection around your d17 to keep her safe and others safe from her. 

Regarding the legalities:

Upon reviewing the admissions policies for the facility what is their liability for improper security? 

What affect did their mistake of placing your d under the wrong level of care have on your d17?  How might this relate to their liability?

Did a change in medication occur that carries a side affect that came into play here?

Does your d17 need an attorney to represent her and your family's best interest?

What prior charges are on your d17's juvenile record?  Is this her first offense?


How are you taking care of self during this extremely trying time Googie?  How can we help support you?

 

lbj

Hi LBJ,

You summed the last 3 1/2 months up perfectly... .  jumble of concerns and uncertainty.  Right at this moment she has gotten off of all her restrictions so there are no special protective plans in place.

The facility's paperwork states that safety comes above all else and staff is trained to impose immediate safety protocols that includes all clients and staff.  As far as my d15, the last two attacks have been unprovoked leaving no time to react and protect that staff member.  They were 2 to1 with her for 48 hours and then 1 to 1 for the last 24.  She was cottage bound and kept somewhat separated from the rest of the unit, but I was told that the girls did that on their own.  Liability will be decided by a judge if charges are filed which they were.  I am assuming that she had insurance and that hopefully the insurance company did not refuse to pay due to my d15 attacking her unprovoked.  I have been hearing more and more of these cases popping up.  If she had paid or will be billed any amount due to my d's action's, I am not quite sure how that would play out since she was receiving psychological treatment for her mental illness and had already set the precedence of being aggressive.  Thats why she is there, and I am not a rich woman.  My first thought is to absolutely make her whole and pay the damages, but I can't pay my own bills as it is.  If she requests punitive damages which would be her right if she wishes, then I am really screwed.  

It seems that I will have to pick the most important pieces of this situation and ask for a reduced rate for a consultation from random lawyers.

I would assume that they would be liable for eating the expense of losing more than half of her approved time frame.  The LME is still saying August 1 and there is no way she'll be ready to come home.  Thats what her therapist said and is still saying.

The medication change is the strangest part of this past week or two.  I am sure that had something to do with her aggressiveness, but then again she was aggressive when she was on it as well.

Minors are always given a court appointed attorney and a Guardian ad Litem.  Part of that paper that I posted I had written about the lack of care and repulsion of the juvenile system by the public defenders (not all but most) puts them at risk for not receiving community based support services because the attorneys make a plea deal look like gold and lie to them and tell them there will be no long term consequences.  Felonies cancel out a few of your constitutional rights and forever bars you from receiving emergency aid the way it was intended to be used, disqualifies scholarships and basically keeps them from becoming champions and heros to other kids later on in the future.  I had to cut that entire piece out because it threw off the flow of the paper.

Sorry, long again.  I do not trust the juvenile system especially the lawyers.  They remind me of used car salesmen.

Luckily d15 has no official prior petitions filed against her however, she has plenty of suspensions and an expulsion.  There are police reports for at least 5 assaults but we were working with intensive in home services and had her hospitalized when she needed to be so they just fell to the side.

I am trying to stay calm but its very difficult.  We are all angry and disgusted about everything going on and I am hoping to get out of the house for a few hours to get away from one family member that had said some very hurtful things to me and my kids.  i guess he has off today so i will have to find quiet outside of here.  I have a therapy appointment at 10:15, but I am soo exhausted that I don't really want to go and bring this up for 45 minutes and then have to find the energy to come back here to hear some stupid comments about being sad and scared from all of this.

I usually talk to my friends but i can't when he is here.  The less that is said the better off we all are.

I am angry that this is happening just as much as anyone else.  I just can't wait until Friday comes and I can get the answers I need in order to process  whatever the outcome may turn out to be.  I'm the last to know and that is not okay with me.

I actually have to go get ready.  I will update when i can

googie

I just wanted to tell you I am thinking of you... . I was wondering what happened with you and your dd. Please keep us updated. I wish I had some words of wisdom for you but I am a bit overwhelmed by your story and I bet you are too but you seem to be doing well and are trying to put the peices together... . sending a hug to you