checked out 21 y.o.

[Anonymous]

Are there mental health providers who would work with someone in their own home? Adult DD, 21, is in such a state of mental shut-down that she refuses to engage with anything and anyone outside her home. She sometimes sees a friend or two, but even then, she seems stuck in whatever social thing that used to work when she was much younger. She managed to get some basic job interviews, and was excited about them, but refused to pick up the phone and actually speak to them. She plans to go to the gym, but pulls back last minute. We barely see her, even at home. Removing privileges (phone, car) simply means she sleeps more. She is not on drugs, just detached and depressed. School or a job is out of the question, and this is aggravated when the world is so excited about her significantly younger brother hitting these same milestones with flying colors.

Short of placing her in a structured program or having a mental health provider work with her at home, I am running out of options. She does have an ASD diagnosis that none of her other providers agree with. She refuses medicine, treatments, therapy -- anything that could mean commitment. And she is scary frail. Countless therapists have refused to continue when she has failed to show up, leaving us without good options.

[Anonymous]

OP here -- I know DCUM habituals will find unkind words to throw at this situation, my hope is that between the stereotypes and shadenfreude, there might be an overlooked nugget or recommendation that I had not considered, whatever the tone.

[Anonymous]

It does indeed sound like autism, OP. The refusals seems rooted in profound social anxiety, which is very autistic-coded.

She needs to be bribed, cajoled or somehow brought to the psychiatrist, or you need to find a provider who can do a Zoom call, to prescribe anxiety medication.

Be careful with dosage. Some autistic patients report needing a much lower dose than the standard - and if they try the standard dose, they get severe side effects. I suspect autism may overlap with metabolic disorders for that reason.

I have been able to get virtual appointments with a psychiatric nurse and a therapist for myself. I hope you can do the same for your child.

Best of luck.

[Anonymous]

Yes. She can get online ABA therapy covered by insurance with an ASD diagnosis. This person can help her break tasks into pieces, give her strategies for success and organization, etc.

[Anonymous]

It sounds like she NEEDS to be committed to a mental hospital. She is quite literally, failing to thrive in any meaningful way.

[Anonymous]

Anonymous wrote:It sounds like she NEEDS to be committed to a mental hospital. She is quite literally, failing to thrive in any meaningful way.

No, OP will ruin the trust between them and will lose any capital she had with her daughter. OP needs more gentle measures.

[Anonymous]

Anonymous wrote:Are there mental health providers who would work with someone in their own home? Adult DD, 21, is in such a state of mental shut-down that she refuses to engage with anything and anyone outside her home. She sometimes sees a friend or two, but even then, she seems stuck in whatever social thing that used to work when she was much younger. She managed to get some basic job interviews, and was excited about them, but refused to pick up the phone and actually speak to them. She plans to go to the gym, but pulls back last minute. We barely see her, even at home. Removing privileges (phone, car) simply means she sleeps more. She is not on drugs, just detached and depressed. School or a job is out of the question, and this is aggravated when the world is so excited about her significantly younger brother hitting these same milestones with flying colors.

Short of placing her in a structured program or having a mental health provider work with her at home, I am running out of options. She does have an ASD diagnosis that none of her other providers agree with. She refuses medicine, treatments, therapy -- anything that could mean commitment. And she is scary frail. Countless therapists have refused to continue when she has failed to show up, leaving us without good options.

If you are really, really concerned that her decision making is that impaired, you call the police and have them 5150 her.

[Anonymous]

She is excellent with meds and does telehealth
https://www.childadultpsychiatry.com/

[Anonymous]

Sounds like an eating disorder

[Anonymous]

Can you say more about her scary frailty? Is she eating at all?

[Anonymous]

You give her 30 days find a job or go to graduate school full time

[Anonymous]

I wouldn't dismiss a mental health clinic. My DD went into Adventist Mental Health Clinic for 1/2 day for a month and it made a world of difference. She found people her age who were just like her and felt accepted. She left with tools for coping and thriving, relative to where she'd been before.

[Anonymous]

* Fully covered by insurance.

[Anonymous]

Anonymous wrote:I wouldn't dismiss a mental health clinic. My DD went into Adventist Mental Health Clinic for 1/2 day for a month and it made a world of difference. She found people her age who were just like her and felt accepted. She left with tools for coping and thriving, relative to where she'd been before.

NP. What age was your DD and what was she being treated for? Did she go to the IoP at Shady Grove Adventist? Asking bc am facing a similar situation as the OP and trying to identify options.

[Anonymous]

Anonymous wrote:Are there mental health providers who would work with someone in their own home? Adult DD, 21, is in such a state of mental shut-down that she refuses to engage with anything and anyone outside her home. She sometimes sees a friend or two, but even then, she seems stuck in whatever social thing that used to work when she was much younger. She managed to get some basic job interviews, and was excited about them, but refused to pick up the phone and actually speak to them. She plans to go to the gym, but pulls back last minute. We barely see her, even at home. Removing privileges (phone, car) simply means she sleeps more. She is not on drugs, just detached and depressed. School or a job is out of the question, and this is aggravated when the world is so excited about her significantly younger brother hitting these same milestones with flying colors.

Short of placing her in a structured program or having a mental health provider work with her at home, I am running out of options. She does have an ASD diagnosis that none of her other providers agree with. She refuses medicine, treatments, therapy -- anything that could mean commitment. And she is scary frail. Countless therapists have refused to continue when she has failed to show up, leaving us without good options.

Someone who refuses to leave the house needs to be in a structured program, but it sounds like you will have to convince her. She can't be committed, based on your description. If you have the money, a residential program (not a hospital program) might sound more appealing.