First timer advice with residential and what comes after

[deardaughter]

Hello, this is my first post in this forum.

My 17 yo DD was diagnosed BPD traits her first time inpatient 4 years ago after a suicide attempt. Four years later, 3 overdoses, 2 inpatient, 1 partial hosp., DBT, group therapy, family therapy, CBT and meds, and she is now in residential for the first time. She was turned down by two places - one for violent fantasies and one due to substance abuse. I was not allowed to transport her where she is now, and am only allowed to visit for a few hours on the weekends. It is a very restrictive DBT facility. At first I was really worried about her safety there, but on her last night inpatient before being transferred, the nurse found that she had been stockpiling her nightly sleeping meds (planning to take them all her last night inpatient) so I then decided that she really needed to do the residential thing. The psych called today and said they are going to try Effexor XR. She has previously been on Celexa, Prozac and Wellbutrin. None have helped in the slightest.

Here's what I'm wondering - insurance will only pay for residential for so long... Does anyone have experience where insurance paid for a longer time period than 30-60 days? We have BCBS. Anyone know of a therapeutic boarding school that bills insurance for the medical portion? She will still need to complete her senior year of high school and honestly, the situation has escalated with drugs and violent thoughts that we (the fam and the psychiatrists) feel longer term help is needed, but we aren't rolling in the dough. Thanks so much for your advice

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

[Bright Day Mom]

Hi dd... .Welcome to BPD Fam.  

Our family has been thru much of the same turmoil as yours w/our now D17 too!  

We had reservations about residential and only used as a last resort. Do you have a CMO (care manager)?  We have one from our county and she spearheaded the residential tours, enrollment, etc. You are fortunate that your insurance will cover the cost as ours does not provide ANY residential treatment.  My D's residential home didn't cost us at all; it was provided by the state.  I have to say there are good and bad, so it was best to look at multiple to determine the best match.  Her stay was 8 months.  

It is a long road with many bumps, but good things can come.  We had limited visits too in the beginning and they slowly increased as she earned the time.  

Unfortunately my knowledge with insurance is a bit limited, talk with the residence and see if they could handle an appeal to the insurance company on your behalf.  I think if your D needs more time as she may not be ready to leave in 60 days and is not stable enough to step down into a Partial Hospitalization Program safely then an exception and extension may be granted.

In terms of what comes after... .that all depends.  Our "team" (residential staff, CMO, parents, child) worked on the discharge planning together. We were matched up for in-home therapist 1x/wk, mentoring 1x/wk, and our D returned to her therapeutic high school where she has social worker access as needed.  I followed the lead of the "professionals"; however, recently learned she probably would have benefited to stepping down either into a PHP or IOP program too for additional support during the transition back home.

Keep posting, knowing you aren't alone helps!

Have a Bright Day!