RTC criteria

[Mjobpd]

Hi. I’m new here but have read the boards for a while. My dd17 has been to inpatient treatment for 5-10 days 5 times for taking action on a plan and the threats that didn’t take us to the ER are many. She’s been in DBT therapy for over a year but has yet to accept any personal responsibility for her actions. She is currently inpatient and I’m hoping to have her transferred to Timberline Knolls for rtc from there. She will be 18 in the not so distant future and I feel like this is the last big push to get her the help she needs. She told whoever would listen at the ER that she would go to this inpatient for 5 days come out and finish the job.

My question is about the criteria for TK. It appears on the website that they require a mental health dx as well as a secondary addiction disorder. She’s not an addict YET, but the text messages of late certainly make it appear that’s the direction she’s headed. Can someone please help me with this and maybe your experience with TK? She may hate me for rtc but if it saves her life that’s a risk I’m willing to take.

Thanks

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

[DharmaGate]

MjoBPD, good idea to reach out here and see if any parents have experience with Timberline Knolls criteria.  Do I have it right that from the website it looks she needs a formal diagnosis of addiction as well as the mental health diagnosis she already has? Two thoughts you may have already tried, can anyone at the inpatient help with the transfer and meeting the criteria? Is it worth a call to TK and see if they make exceptions or how strict they are on a secondary official diagnosis? Maybe what she is doing with using, along with the mental diagnosis might be enough? Anyway wanted to say hi and welcome while we wait and see if anyone else has first hand experience. 

[wendydarling]

Hi mjoBPD  

I join DharmaGate welcoming you. I'm in the UK, while no first hand experience I'm here along with other parents in support.   I agree with DG, calling KT to find out first hand the criteria and then a follow up visit by you to see and hear first hand to give you peace of mind your decision, you know your DD best.

Have you been following JustYouWait posts?

WDx

[Mjobpd]

I’m not able to search by individual person yet.

[wendydarling]

Here MjoBPD

https://bpdfamily.com/message_board/index.php?action=profile;u=104123;sa=showPosts

Can you access his journey?

WDx

[Only Human]

Hi mjoBPD,

Along with DharmaGate and wendydarling, I welcome you to BPD Family.

I'm so sorry for all you've been through with your DD and agree with you, it's worth being perceived as the "bad guy" if it saves her life!

In case you can't access the link to JustYouWait's post history that wendydarling shared, I wanted to share this link with you. Another member here, lbjnltx, has posted their experience with RTC:

Residential Treatment: Journal of 12 Month Journey

Again, welcome to BPD Family - I'm glad you found us

~ OH

[DharmaGate]

MojoBPD, how long till your daughter gets out of inpatient?

[Mjobpd]

They haven’t given me any discharge information yet. Today would be 72 hours but it sounded like it would be around Friday which would be 7 days there.

[DharmaGate]

do you know what you will do when she gets discharged?  Do you have a relationship with the staff where she is now? can they help? 

[Mjobpd]

This is the worst of inpatient facilities she’s been to. Yesterday she had no group and saw no dr or therapist. We don’t have any wrap around programs for commercial insurance in our area. The previous discharge plan has been weekly DBT and once month psychiatrist appointment. She needs to get away from our immediate area and have the opportunity to focus just on her recovery and put skills into action.

Despite my pleas she has never utilized the 24 hour access to her DBT therapist while in crisis. I am the one that calls to update and then there’s no communication between the inpatient placement and the therapist which seems crazy to me. So disjointed. I feel like all of the previous hospitalization s are not taken into account and just the most recent matters. Super frustrating.

In short I’m terrified for her to be discharged home as I feel she’s still a threat to herself. Like I’ve said she’s very charming and knows how to manipulate almost any situation and it doesn’t feel like where she’s at believes me and actually just thinks I’m the crazy controlling mother, which couldn’t be further from the truth.

[Only Human]

It's so difficult when our children are rejecting help that we know will help them! And to be faced with no wrap-around services upon discharge, it's no wonder you're feeling terrified, MjoBPD.

Have you reached out to TK to see how rigid they are about requiring "addict" status for admission? If they're real ridid, perhaps they'll have a recommendation?

They haven’t given me any discharge information yet. Today would be 72 hours but it sounded like it would be around Friday which would be 7 days there.

I take this to mean that your D is no longer saying that she'll finish the job when she's discharged?

I'm so sorry the facility she is in isn't providing her with the care she needs. Some are better than other, to be sure, but no group, no dr. and no therapist, for a whole day, seems unreasonable. I'm also so sorry you're feeling ignored when you try to collaborate with the staff. Can you go up the ladder a bit and try to get some cooperation that way?

I hope you are finding time for self-care, MjoBPD, respite for ourselves is so very important.

~ OH

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

[Mjobpd]

Some good news. DD took the call for the intake for TK and they said it went well. She does not need the addiction part and my insurance covers it.  That being said, she hasn't been approved by insurance yet. It really gets tricky because the insurance company requires at least 48 hour notice and they're not open on the weekends. I am hopeful it's all coming together.   I'll keep you posted.  Thank you all for the support.

[wendydarling]

This is great news MjoBPD, I hope it all comes together, got everything crossed for you!

Thanks for keeping us all posted.

[Mjobpd]

We've been denied before for residential treatment, but she wasn't coming off a suicide attempt. Basically they'd like me to get her there and by the time we get there they should know if insurance has authorized it. Does anyone have experience with New Directions Behavioral Health as the underwriter for BCBS Mental Health?Any tips to help get her approved. It boggles my mind that 4 inpatient stays for suicide attempts along with years of therapy don't show that a more intensive approach is necessary. 

My anxiety is through the roof. I'm nervous we'll be denied again and I honestly don't know where to turn for her if that's the case. She's coming out of the inpatient she's been in worse mentally than when she went in.  So angry.

What could I be missing that they'd deny her?  The place is in network.  The idea of driving 11 hours round trip just to get denied when we get there (again) isn't very appealing. I'll do it but I sure wish I had more information or a better hope that she'll be accepted before we make that trek.

[Only Human]

I can't imagine having to drive there before learning whether she will be approved, Mjopbd! Anxious, nervous, angry, sounds right to me  

Are there any mental health patient advocacy groups where you are?

Can you write a letter, addressed to the director of the company making a decision on whether the stay will be covered?

When I was hoping to be approved for a modification of my home loan, I was advised to write a letter explaining the human side of my request. "I love my neighborhood, want to grow old here, my kids have established relationships, etc." I know it's not remotely the same as approval for coverage, but I'm throwing it out there in case you think it might be worth a shot.

~ OH

[Mjobpd]

I’m not the most religious of people, but I’ve been crying out for help for dd17 from anywhere that could hear me. DD17 was admitted to Timberline Knolls for 7 days at this point. It’s a start. Her father and I  who’ve had no contact for a year were able to work together to make the transfer from inpatient to rtc. Which speaks to our desperation.

While on the 5.5 hour drive to rtc dd17 took the opportunity to send nasty texts to the one friend that has supported her over the past year telling them what a terrible person they are. Her ability to burn bridges is incredible.

Those that have worked with rtc can you help me understand how insurance coverage for you was doled out? I feel confident simply because she was admitted. I think it will be fairly obvious to drs and therapists there how sick she is. Just looking for someone’s experience dealing with insurance and rtc.

Thanks for everyone’s support. I took my first full breath yesterday knowing we’re not out of the woods but she’s safe.

[DharmaGate]

  great work! whew!