Residential treatment... question please read.

[njva4]

how many times was your child hospitalized before residential placement became an option? How long were they having problems?   is it normal for a doctor to want a child to be placed in residential  when she was only hospitalized once before?   


My daughter was put in a hospital in August and then again in September She was admitted at 8 pm and by 11  the next morning they were calling to recommend residential treatment. I asked nurses and doctors about her behavior  at said hospital and everyone of them said she had cooperated   even after they recommended residential treatment my daughter was in that hospital for 8 days she only got in trouble 1 time, for coming out of her room during "room time".  She never had to be restrained or anything.  She was put in the hospital by her psychiatrist, (she disrespected him and told him just because he had degree's on the wall didn't mean he knew everything) The hospital she was admitted to... .her psychiatrist was the administrator. He was Also the one who recommended residential.   The residential hospital she is in now... .She was placed in the most violent and aggressive wing... .No other beds were available yesterday she witnessed a girl wrap a cord around her neck and pull it so tight she turned purple. I know this is true because I was on the phone with my daughter and her therapist when I was told about it.  The therapist even admitted she hated going to that wing when she had to get my daughter for therapy. My daughter is not aggressive, She is not violent yet she is in there with the most violent in the hospital. I want to know How long it took for you guys to get your kids in residential because this whole situation does not sit right with me. thanks for answering.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Elbry]

I have a somewhat unusual story with residential.  We started talking about a RTC for my DD15 many months ago when in home therapy was not working because she was not engaged enough.  She was cutting, truant from school, drinking, smoking weed and having risky sexual behaviors.  Then she started to do better.  She was discharged from home treatment and sent back into individual T.  The T ended up quitting on her.  The T called me into her office, handed me a printout on BPD said 'this is what your daughter has, I can't help her, I recommend residential treatment, good luck".  This was in February. 

Up to this point DD had been in the hospital twice and the crisis unit twice and had had 2 suicide attempts, one by cutting and one by overdose.  February 27 she took a lethal dose of Tylenol, ended up in the ICU, then went back to the Psych hospital.  They did NOT recommend residential.  But her treatment team at home did.  I struggled with the decision and by the time I gave them the go ahead it was a couple weeks, and she was doing so well and was so stable at home that she wouldn't pass the IT/RT (insurance approval process).  But we decided as a team that the next time she became unstable we were not going to waste any time she was going to residential and that was it.

She remained stable for 5 months and then started to show signs.  There was a missing bottle of Tylenol I posted about. And then on August 31 she took another overdose of Tylenol.  Back to the ICU and back to the Psych hospital. At first the hospital and her team here disagreed about the RTC, the hospital said no, we said yes, then a new P came on service and he agreed with it, then he changed his mind because once again DD started "doing so good".  She was in the hospital over 3 weeks and was discharged last week. 

Even though the P at the hospital changed his mind, I told DD's CM to submit the IT/RT anyway, and she did and DD passed the IT/RT and it is good for 60 days.  So we have to find her placement now.  So this is my story.  It was very long and drawn out. 

Even after the decision to do RTC, for us, it takes weeks to gather all the information, submit it to insurance, get approval then actually do the applications to the facilities.  I'm quite shocked at how fast it seemed to go for you njva4.  I'm so sorry you and your DD are going through this.  It was such a difficult decision for me to make, I agonized over it, and I have peace now that it is the right thing to do.  I can't imagine if she were in a place that I did not approve of and where I felt she were unsafe. Is it possible for you to have her moved? 

[njva4]

I have been exhausting my resources trying to find out about why she was sent to this particular facility,  I know there are hospitals closer to home my DD is 250 miles away from us at this time. I too am concerned why all this happened so fast. She only started receiving any kind of help in August and the problems we had before that was minor. I am worried that when she got smart with this psychiatrist he decided she needed to learn a lesson and pulled strings to have her put at this hospital. He had only 1 real session with her (about an hour) and the second session is when he decided she needed to put in inpatient. (about 30 minutes) and the following day is when residential was recommended. The social worker at the hospital said they had a 45 min. session with my daughter And then her and the psychiatrist talked for another 30 minutes after the session. HOw can a psychiatrist decide that someone needs residential after only speaking to  someone for 2hours and 15 minutes?

[breathofheaven]

I see you have another thread concerning the actual residential place, Harbor Point.  If this is the one in VA then I would really try to remove her as soon as you can.  I researched this facility for my D15 when it seemed she had no other options.  I was not pleased with the poster board in the dining room which had a running tally of the number of restraints used in each unit.  I was told the unit with the least number of restraints got a "party' at the end of the month. The admission person stated to me that if my daughter "showed her true colors there" they would be quick to get her on the right track whatever it would take.  My D15 at the time was completely in the depths of BPD traits.  She was not doing any of her behaviors maliciously or willfully.  I knew they could not give her the real help she needed.   As you can imagine this residential  did not impress me.  It really scared me.  I felt they did not know how to take care of children suffering from a mental illness.   Unfortunately, my experience with residential facilities reaffirms that prior statement. 

I still can't believe the circumstances surrounding your daughter's admission.  If she was voluntary then I would think you could pull her out anytime provided she is not actively suicidal or a danger to others.  I can sense the helplessness in your writing and I can say I know that feeling all too well. It is so frustrating trying to navigate the mental health world.   

[pessim-optimist]

We are not professionals and can only give you our opinions, njva4... .

That being said, this whole situation doesn't sound right. As others have said, usually it is a longer and sometimes difficult process to get a child into an RTC, and the process of looking for and researching the facilities takes some time too.

Also, this decision usually comes when the child is not safe or danger to others and after all other options have been exhausted... .

Did anyone consult you or talk with you about her treatment plan and what the goals would be/reasoning behind sending her to an RTC?

[njva4]

We are not professionals and can only give you our opinions, njva4... .

That being said, this whole situation doesn't sound right. As others have said, usually it is a longer and sometimes difficult process to get a child into an RTC, and the process of looking for and researching the facilities takes some time too.

Also, this decision usually comes when the child is not safe or danger to others and after all other options have been exhausted... .

Did anyone consult you or talk with you about her treatment plan and what the goals would be/reasoning behind sending her to an RTC?

All I know is when she was admitted to the local hospital, for something that was said out of context it was 8 pm and then at around 11 the next morning they called to tell me my daughter needed residential. At that time I had to ask what residential was because I had never heard of it before. The social worker told me that Harbor point did the therapy my daughter needed including DBT.  At the same time they are telling my daughter if she doesn't go willingly that she may be taken from me and put in Foster care. My daughter also told me if i go get her AMA they could get me for child neglect.  yesterday I called a facility an hour away from home and told them of the situation even he said something was strange about it. My daughter tried to overdose once and she was hospitalized ... .once. I do know that the facility i called yesterday said they were pretty sure there was a bed there so first thing Monday morning I will be calling harbor point and finding out all of the information I can about having my daughter Transferred. I know a woman who had her son at this other facility and she said it helped tremendously.  I dont understand why they would send my daughter 250 miles form home when there were facilities an hour away. I am contacting a lawyer tomorrow and seeing if I have a legal case. The Psychiatrist that sent her away has done something and I do not know why he signaled my daughter out.

[heronbird]

Hi Njva4

I read all the posts, haven't read any previous ones from you, what is the problem with yoiur dd being In Residential care?

Is it because it is too soon after diagnosis? Sorry if I haven't read properly.

I have a dd who is 20 now. When she was 16 she was hospitalized about 13 times in one year, they would take her in on a Friday night, then by Monday, she was better they would discharge her.

This last time, things in her life had gone so terrible, she was put in our local hospital for safety and that's all, they don't do anything in that unit. She was 19 by the way. She had had a baby and this tipped her over the edge, she was so terribly ill, her husband kicked her out so she lost everything, her home, husband and baby.

Anyway, after 7 months they wanted to put her in a horrible hostel where there would be all the worse of the worse sort of people. I said I didn't want her there, but the psychiatrist said they haven't got anywhere else for her.

But they refused to take her, said she was too bad. So he was forced to put her in a residential unit. It is a high secure unit, but she does proper DBT every day and they are at last addressing her needs.

She needed this years ago, so I am happy with it.

It is an hours drive away from us, and that's not a good thing.

Yours is so far, that's not ok, she will miss you and how is that going to help anyone. I always feel they need to be nearer to aid recovery.

It was fast, too,  can you get her transferred or anything, is she undergoing DBT there, what are they doing to help her?

[BamBams_Dad]

My daughter was hospitalized four times before RTC was requested. During her 2nd and 4th hospitalization we were going through an IOP, and it ended up causing more problems than it solved. About 3 weeks into the IOP my daughter was suicidal and we had to place her back into the hospital for the 3rd time.  She claimed it was emotional abuse from her mother, and everyone at the time believed her, however we now know that she was just manipulating us into sending her back to the hospital. After the 3rd stay she was out for about 4 days before she insisted on going back in. Its the only place she felt safe, and that she would do anything, including harming herself to get back. We didn't send her back for several weeks, until I started to stick to my guns and put up boundaries regarding rules. She called the police saying that she was going to kill me and herself. At that time I sent her to her moms to live for a while, but her mom found her self-harming within 2 days, and re-admitted her back into the hospital. This is when RTC became a reality for us.

I'm going to visit with my daughter today, and we have hopes that she is going to be released this week. Were not sure how well she really is, but phase 2 of RTC is partial hospitalization (PHP). During that time, she spends her days at the hospital, and nights at home. We hope that between RTC and PHP that she is stable enough to live in reality with the rest of us.

[pessim-optimist]

I do know that the facility i called yesterday said they were pretty sure there was a bed there so first thing Monday morning I will be calling harbor point and finding out all of the information I can about having my daughter Transferred. I know a woman who had her son at this other facility and she said it helped tremendously.  I dont understand why they would send my daughter 250 miles form home when there were facilities an hour away. I am contacting a lawyer tomorrow and seeing if I have a legal case. The Psychiatrist that sent her away has done something and I do not know why he signaled my daughter out.

One thing to consider is that the facility she's at right now might have a stake in keeping her (they get the insurance money for another patient). It may not turn out to be a problem, but just in case perhaps talking to the lawyer and having enough information from the other facility that is willing/able to take her may be a safe route.

At the same time they are telling my daughter if she doesn't go willingly that she may be taken from me and put in Foster care. My daughter also told me if i go get her AMA they could get me for child neglect. 

This would also be something I'd discuss with a lawyer... .(especially because you are actively trying to get her help.)

[njva4]

I actually got a hold of the psychiatrist that is treating my daughter at Harbor Point yesterday, I asked her straight out if she thought my daughter needed to be in residential. she told me no. she said those who are placed in residential are very suicidal or they are not safe to be around people (in case they attack them) she said at  what she has seen my Daughter did not meet that criteria. She also advised me that my daughter is in the system now and it would be better to let her finish the treatment  than to pull her out, because if i pulled her out it would look bad on me. I mentioned there may be a facility closer to us that does residential and she told me that yes it would be beneficial to try to get her moved because my daughter needs family support along with family counseling, and as long as she is 250 miles away we would rarely be able to go see her (maybe once a month) and can only talk to her for 15 minutes  3 times a week. Family counseling is big on her treatment list because my daughter holds anger and grudges against her father for drinking, so it is imperative we are able to do the counseling with her. Please just pray for me that I am able to get her in the other facility, it is only an hour away instead of 4.5 hours like she is now.

[theplotthickens]

I strongly suggest that you follow your gut instinct.  It does not matter if you "look bad." The insurance is not going to pay if she does not meet criteria... .you may want to start by talking to your insurance company.  The RTC will be happy to discharge her when the money stops flowing.

Usually day treatment is tried first.  My dd has been hospitalized 4 times and attended 3 day treatments before RTC was put on the table.

The literature I read on RTC's leans toward the idea that they don't work long term, and often make teen pick up and take on new behaviors of others.  All home-based options should be exhausted first.

It does not sound like your daughter has tried day treatments, or out patient DBT, so it is a mystery why she is there.  She is learning and picking up things every minute she is there.  I would say the sooner you can get her home, the better.  Home-based treatments are the most effective, anyway. 

Hugs!

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[tinkerbellsmom]

I wish something like that had been available to me when my daughter was a teen and she really did need something but my insurance at the time would not have covered it and it is just stupidly expensive.  Now she is 24 and has a really messed up life with not a thing anyone can do.  Once they hit 18 you lose all rights, and you can't force them to any treatment.  I would recommend doing research to find one that is good and take advantage of everything you can right now.

[inkling16]

Our daughter (16 at the time, now 19) was recommended for RT during her first hospitalization, which I now realize was unusual. I consider that we lucked out, since it was the RTC that gave us the diagnosis that finally made sense. The social worker at the hospital pushed us to consider a particular RTC that was nearby (he said it would save her life and he was right, at least so far), and got her a spot within a couple of days. Though she fought just about every aspect of their program at the time, she also finally recognized that she needed help, which was huge, and the psychiatrist there put her on a drug regimen that actually was effective (and which, with some tweaks, she is still on two years later). She was there for three months (the whole summer, pretty much). She did not go through all the stages that they required for an official graduation from the program, but we took her out because school was starting and she thought (mistakenly) that she was ready to go back. If we had it to do over, we would have left her there until she went through the stages or our insurance wouldn't pay any more, whichever came first. Even so, she considers it a transformative experience, and she has the logo of the place tattooed on her wrist.

She is not out of the woods by any means, but things have been much better since. We learned a lot in family therapy there that has made us more effective at dealing with her difficulties and moderating our expectations.

However, if the place had been anything like you describe, I think we would have taken her out or not allowed her to be admitted to begin with. As far as I know, there was never anything preventing us from taking her home at any point in the process.