So conflicted, discharge in 2 months, already scared

[Elbry]

DD15 is still in RTC and doing well.  So well in fact that a discharge date has been set for February 28.  That is when her current insurance approval runs out.  They could try and ask for an extension if needed, but she is doing too well, it isn't justified. I miss her so much and I want her home, and for one second I'm excited she's coming home, then the fear hits me.  She has a history of doing well for months at a time, then crashing and suicide attempts.  I'm not surprised she's doing so well, she's done this well at home before.  AND she ALWAYS does well in a clinical or treatment setting. But is it just a repeat of the past?  Part of me thinks I should argue this and try to keep her in there and test it and see what happens long-term.  But I want her home.  That's the selfish part of me that just misses her.  I want her alive and healthy more though.  This is awful.  It may not matter one bit I want anyway, the almighty insurance company is the boss.  While she's in there, I can breathe.  I'm not afraid I'm going to find her dead.

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

[pessim-optimist]

I would be conflicted too, Elbry - excited and scared to be precise... . 

I seem to remember that you had a successful home visit? Is your daughter coming at all over the holidays?

What is the facility's long-term plan? Are they working on teaching her healthy coping skills for when she is home? Is she progressing in that? What is their opinion on her being able to use those skills when she comes back home?

If you and her have new tools to work with, it might be different this time around. Otherwise, I would advocate for a longer stay... .

Also, if she came home and deteriorated again, what would be their plan then?

[Elbry]

She is home for the Holiday's.  She goes back on Saturday.  Things are going well at home. 

They are working on coping skills.  I think that is their main focus, things she can do to cope instead of self-harm.  They say she is doing well, there is some resistance to treatment still but only what would be expected from someone her age.  We do see a difference in her when she is home, BUT that is only a glimpse and she is on her best behavior.  She doesn't want to jeopardize any other visits by acting out. 

Another hugely positive piece is that her mood disorder is being addressed finally.  She has been diagnosed bi-polar and her Lithium is being increased until she is at a therapeutic level.  Lithium is being used because it has an effect on suicidality. 

One other thing that is HUGE is that she got her IEP down there, and it will follow her home!  This school district would not give her one, they said her diagnosis did not support it which is a bunch of bull.  I was so angry when I went to the meeting in Rockport and it was just done so easily, and I saw how easy it was and it made me realize how it really was just the opinion of the people here.  Well, now they have to follow it for the next 3 years.  She is doing so well in school with her IEP, they are moving her into honors classes!

We haven't talked yet about what discharge will look like, I have talked to her CM about it and she will go back into HCT, and we will try to get section 28 for her which is a worker that will come X number of hours a week and take her and do stuff with her.  If she deteriorates again, it probably means back to RTC.  My heart breaks thinking this could be our life.  Institutions for her... .

[pessim-optimist]

From what you are describing, Elbry, it does look really positive and I'd be cautiously optimistic, which means being aware that things can take a bad turn and go down-hill, but that that isn't the case at the moment and that things are looking up over-all with the possibility of long-term progress towards mental health.

The fact that there is a plan in case she deteriorated must be a great relief for you, also the IEP - that's a victory in and of itself.

My heart breaks thinking this could be our life.  Institutions for her... .

That is all too early to say, Elbry.   You might be surprised at the high rate of recovery for those patients that choose to cooperate and that are motivated to get better.

We can only do our best, our children are the ones that decide whether they want to be helped and are willing to work hard for it... .