"Lost in the Storm": Slate article about local child with suicidal depression

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I read the story. I've had some experience with my kid at an inpatient facility, and also lots of therapy and medication over the years.

I realize one of the challenges of an article like this is trying to condense a very long, complicated story into a single written piece. I also appreciate the need to leave out some details due to privacy issues.
That said... there was one part of the story that stuck out for me, and when I discussed the article with my DH, he related that he had the same reaction when he read it.

There is a point in the process where the care team is recommending an outpatient program. (This is after the second, more successful inpatient program.) The author says it sounds great, but then when the time of the program is changed to 4:30-7:30, the author makes a flat statement that is is "impossible with two other kids at home." The recommendation for this program even comes up again in the article, and author states they instead went with a virtual option. One they were doubtful would be helpful, and sure enough wasn't.

I fully appreciate that for a person with this severe level of mental health needs there will never be "one thing" can magically fixes everything. I also understand (as I said above) that I don't have all of the details.
However, while my reaction throughout reading this article had been nothing but sympathy, this part brought me up short. I just couldn't understand why this particular treatment was deemed impossible. At this point, the kid hasn't been in school, the author is taking family leave and ultimately quitting her job. There is already tremendous upheaval in their family life. I can only imagine the amount of upheaval that the siblings of this child are already experiencing. Needing to get a sitter, or arrange transport, or... something? That feels do-able based on all of the other things this family has done, and the crisis level of the suffering child. It left me scratching my head. Did anyone else have the same reaction? Am I missing something obvious?

The program is an hour away three days a week. 4:30-7:30 means she doesn't see her other kids three days a week. The parents are also divorced, so that means her kids sit by themselves three afternoons a week if those are her days

Sorry but thats exactly why it doesn't make sense. They're divorced. He should have taken the daughter 3 days a week.
Men can't fucgging pull up.

Dad is a physician. Mom is an attorney. Which one do you think has more bandwidth to be away from the office?

Mom is a special education attorney and mom complains about the district rescheduling meetings. Why is mom agreeing to meeting being rescheduled? Mom has the resources say no and then push to a due process hearing and a lawsuit.

[Anonymous]

Wow, this hits home. Having tried to navigate local programs and MCPS is a full-time job. We live in an area with so many resources, but when those resources don't work for your child, it is especially depressing. ANd unlike this family, I did not have lawyer/doctor salaries so was trying to do everything through insurance.

Like this family, my own child left a forced therapeutic hospital after 6 days feeling worse than before and scared. They were scared of hospitals for years afterward- even when it had nothing to do with mental health.

My child was an externalizer, so the school system might have been slightly more helpful, but not really. The amount of CIEP meetings I had and the amount of tears of frustration cannot be forgotten.

I feel for this family as I know how hard it is. I hope that Ash has the support she needs now.

[Anonymous]

Anonymous wrote:PP, I had the same reaction, but if the program was an hour away, she would be gone from 3:30 to 8:30. That’s a really difficult time to find child care for other children as a single parent household. If they are younger, that might be most of their waking, non-school hours. I could see decisions about trade offs going either way.

Mom of a seriously mentally I have a child with multiple hospitalizations, multiple (unsuccessful) suicide attempts, many different IOPs and PHPs, many different medications, two residential treatment stays and was in a public non mainstream in MCPS. I also have two other kids. So I know the challenges.

I found a few things that bothered me. The declination of PHP due to inconvenient hours, declining what had to have been RICA due to it not being at pretty enough, and not wanting to spent money on care - no sympathies for a neuro and a lawyer.

I get that it’s really hard. I remember crying the first time I had to leave my kid in the hospital. I couldn’t make it to work that day, I was such a mess. I remember playing the game with MC Crisis and almost losing because right after they cleared my kid, another suicide attempt. And I get that it’s extra tough because her kid is only 10. But some of their choices don’t make sense.

[Anonymous]

My oldest dc has had issues since like, 10 months old.

We have gotten SO many recommendations over the years. You are always balancing what your other two younger dc need. You never know if what they are recommending is actually going to help.Sometimes it seems like people just recommend something to get rid of you, even if they don't think it will actually help.
Is it worth the cost? The time? The emotional investment? The cost to the siblings? You never know! I can look back over the years and point to so many things that were a total waste and added extra stress for zero benefit. Who knows if one of the recomnendations we didn't follow would have been life-changing? It is maddening. You just don't know.

[Anonymous]

This part really resonated with me. Everyone is in for the cash grab. And NO one wants to help the hard patients. I'm sure they didn't take insurance!

According to them, Ash must continue with six courses of DBT group therapy, which costs $1,200 for each of the six-week courses. She must attend extra therapy with her individual therapist, at $170 for each 45-minute session. We must also have phone calls and sessions with other members of the practice, billed at $115 for 30 minutes, $170 for 45 minutes, and $225 for one hour, in order to create and maintain a safety plan for Ash. Her dad and I must sign up for weekly DBT parent therapy, at the same rates. And we must consult with one of two “placement consultants,” who no doubt charge hundreds if not thousands of dollars for their services, to find out if there are decent options for Ash for a higher level of care.

[Anonymous]

Even if MCPS had agreed to pay for residential school, there are so few that take kids that young and the waiting lists are years long.

[Anonymous]

FCPS was willing to pay for residential school for my friend's child. They looked for THREE years and couldn't find anywhere that would take him. It is really sad.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m totally out of my depth here because my kid is an externalizer, not an internalizer. But - isn’t it possible that ignoring children’s statements about death/suicide might be better than the intense reactions described here? Making suicidal statements and gestures is a good way to get a big adult reaction, which in turn can reinforce the behaviors. And then simultaneously makes it difficult to discern if the child is actually at risk because there’s no way to discern if they have a plan and ability to carry it out if all statements result in going to the ER. I don’t know, it just seems like statements made by children this young should be handled differently from
statements made by adults and teens.

The child was CUTTING WITH EVERY AVAILABLE SHARP OBJECT.

Cutting isn’t necessarily suicidal. https://childmind.org/article/how-are-self-injury-and-suicide-related/

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m totally out of my depth here because my kid is an externalizer, not an internalizer. But - isn’t it possible that ignoring children’s statements about death/suicide might be better than the intense reactions described here? Making suicidal statements and gestures is a good way to get a big adult reaction, which in turn can reinforce the behaviors. And then simultaneously makes it difficult to discern if the child is actually at risk because there’s no way to discern if they have a plan and ability to carry it out if all statements result in going to the ER. I don’t know, it just seems like statements made by children this young should be handled differently from
statements made by adults and teens.

NP here. There's actually something to this.

My teen DD experienced a lot of what's in this article. Not as extreme, but much of what's written is very familiar to me.

But let me tell you that as a parent, it's very hard to gauge what is attention-seeking behavior and what is a real threat. At least in the beginning, and even then for a LONG time. The reality is, a lot of it IS attention-seeking behavior, but you still have to take it seriously, because 1) What if it's not; and 2) What if a half-hearted attempt goes sideways? I promise you every parent with a child like this has had that thought of "Oh, she just wants attention" but it is still frightening because of 1) and 2). And so, you learn to err on the side of caution.

I will say that over time, we came to recognize certain patterns and behaviors. And what we saw was a lack of commitment to getting better. DD wasn't taking medicine she was prescribed. She was approaching therapy more as an attempt to win over the therapist to validate her long list of grievances about what a terrible life she had had (which was a fiction -- she had a fine childhood). The only thing she really seemed to relish was group -- and even then she seemed to get some kind of sick satisfaction out of watching all the other screw-ups and feel superior to them. It was REALLY strange and unsettling, and we're still dealing with that superiority complex now that she's into her 20s.

But what changed is eventually we said "enough." And stopped the intensive interventions. We pulled her out of the PHPs. We got her a personal therapist and offered group therapy so she could get that fix, but she decided not to go. But basically, we decided to stop coddling her. It was scary as hell. But the intensive therapy wasn't changing anything -- it was just bankrupting us and perpetuating the drama.

You know what happened? She stabilized. She matured. She graduated high school and went to college. And while there are still troubling mental health behaviors now and again, but they're fewer and far between. She's an adult now so I can't make her see a psychiatrist, although I've urged her to.

So, for us, at least, dropping the rope had a better outcome than continuing down the road. I'm not saying this would work for every family that finds themselves in this nightmare. But, it's worth a conversation. Sometimes if you stop coddling, it can work.

Thanks for sharing. That was enlightening.

[Anonymous]

Anonymous wrote:This part really resonated with me. Everyone is in for the cash grab. And NO one wants to help the hard patients. I'm sure they didn't take insurance!

According to them, Ash must continue with six courses of DBT group therapy, which costs $1,200 for each of the six-week courses. She must attend extra therapy with her individual therapist, at $170 for each 45-minute session. We must also have phone calls and sessions with other members of the practice, billed at $115 for 30 minutes, $170 for 45 minutes, and $225 for one hour, in order to create and maintain a safety plan for Ash. Her dad and I must sign up for weekly DBT parent therapy, at the same rates. And we must consult with one of two “placement consultants,” who no doubt charge hundreds if not thousands of dollars for their services, to find out if there are decent options for Ash for a higher level of care.

yeah this part resonated with me too … especially the “placement consultant” part.

[Anonymous]

I really don't understand turning down the 8 week intensive program in the afternoon. If your child is in crisis and that is the only option, you make it work especially with a doctor and an attorney as parents. If the child had to take her to cancer treatments or for dialysis at that time the parents would make it there.

I also don't understand the threats by the DBT program to hospitalize. Go ahead and call to report the family. There aren't many in patient treatment centers so most ER's aren't going to move forward with admitting a nine or ten year old no matter what the treating psychologist says.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m totally out of my depth here because my kid is an externalizer, not an internalizer. But - isn’t it possible that ignoring children’s statements about death/suicide might be better than the intense reactions described here? Making suicidal statements and gestures is a good way to get a big adult reaction, which in turn can reinforce the behaviors. And then simultaneously makes it difficult to discern if the child is actually at risk because there’s no way to discern if they have a plan and ability to carry it out if all statements result in going to the ER. I don’t know, it just seems like statements made by children this young should be handled differently from
statements made by adults and teens.

NP here. There's actually something to this.

My teen DD experienced a lot of what's in this article. Not as extreme, but much of what's written is very familiar to me.

But let me tell you that as a parent, it's very hard to gauge what is attention-seeking behavior and what is a real threat. At least in the beginning, and even then for a LONG time. The reality is, a lot of it IS attention-seeking behavior, but you still have to take it seriously, because 1) What if it's not; and 2) What if a half-hearted attempt goes sideways? I promise you every parent with a child like this has had that thought of "Oh, she just wants attention" but it is still frightening because of 1) and 2). And so, you learn to err on the side of caution.

I will say that over time, we came to recognize certain patterns and behaviors. And what we saw was a lack of commitment to getting better. DD wasn't taking medicine she was prescribed. She was approaching therapy more as an attempt to win over the therapist to validate her long list of grievances about what a terrible life she had had (which was a fiction -- she had a fine childhood). The only thing she really seemed to relish was group -- and even then she seemed to get some kind of sick satisfaction out of watching all the other screw-ups and feel superior to them. It was REALLY strange and unsettling, and we're still dealing with that superiority complex now that she's into her 20s.

But what changed is eventually we said "enough." And stopped the intensive interventions. We pulled her out of the PHPs. We got her a personal therapist and offered group therapy so she could get that fix, but she decided not to go. But basically, we decided to stop coddling her. It was scary as hell. But the intensive therapy wasn't changing anything -- it was just bankrupting us and perpetuating the drama.

You know what happened? She stabilized. She matured. She graduated high school and went to college. And while there are still troubling mental health behaviors now and again, but they're fewer and far between. She's an adult now so I can't make her see a psychiatrist, although I've urged her to.

So, for us, at least, dropping the rope had a better outcome than continuing down the road. I'm not saying this would work for every family that finds themselves in this nightmare. But, it's worth a conversation. Sometimes if you stop coddling, it can work.

Out of curiosity, was your child also school-avoidant? What were you doing for school and how was that affected when you dropped the intensive interventions?

[Anonymous]

I also have three kids and one who did multiple ER visits and an in patient hospitalization in 6th grade, plus multiple threats to call police or CPS on us, plus one forced trip to ER in a police car.

But my sympathy for the writer really wanted over the article. Yes the system sucks and there are insufficient resources and parents have puzzling few rights here. But the writer complains about even people that are trying to help you. DBT is all about keeping people out of the in patient hospitalization so if they all recommended hospitalization, that really says something. I was really irked at her saying “oh the evening programs don’t work for me” — clearly it’s not ideal but how do you turn that down? I was also somewhat surprised at how little discussion there was of medication she is probably under medicated for the anxiety and maybe OCD as well (I think fixation on mental health can be a form of OCD perseveration).

I also agree with PP that for some of these kids they are less suicidal and more attention seeking. I think it’s particularly true for high IQ girls who can construct very detailed narratives almost like they are writing a version of the bell jar in which they are the starring character. The DBT programs are more successful in treating that than some other modalities but it is really challenging. As our DBT therapist pointed out, if she doesn’t get the attention she is seeking from the words she is expressing, she may move on to actions. It’s a really hard line to draw. For my kid, the hospitalization was soooo boring and unpleasant that it at least convinced her that she needed to stop saying things that were going to get her out in the hospital. Then she was able to switch her focus to other things once she wasn’t caught up in that narrative. The writer’s daughter is clearly very intelligent with that poetry, so part of the issue may be that she is wildly bored in school and has constructed this alternate high drama life for herself that she is now trapped in without a clear way to break that cycle. The mental health stuff has become her whole life and as a high IQ kid, she’s knocking it out ofvtje park

I would also love to see more research on how puberty hormones affect anxiety in young teen or teen girls. I’ve seen so many that are sudden fly struck by crushing anxiety within a year or so of getting their period and who are then significantly better by 8th grade or so. Now living through perimenopause i think there is insufficient understanding of how female hormones contribute to anxiety.

[Anonymous]

Really horrifying on so many levels. I’m grateful my GTLD’r never developed a serious emotional problem. There have been many challenges to be sure, but nothing like this.

[Anonymous]

Divorce has consequences on children well being they should have thought that through first