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

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

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=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.

[b]I also don't understand the threats by the DBT program to hospitalize[/b]. 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. [/quote]

You didn't understand what they were doing there? They wanted to dump her as a patient. Hence the demand for a treatment contract that was totally unreasonable. Child's issues were too difficult. Private practices like EASY patients.[/quote]

As someone whose kid went through DBT, I don't think this is right.  The DBT program--by definition--is typically a year long program that involves a weekly group session, a weekly individual session, and, for minors, a parent group.  You can't just do a little bit of DBT because it would be like doing a little bit of calculus class -- it's a skills based program and all the skills need to work together.  It really demands a fair amount of commitment, and it's definitely a much harder modality for the practicioners beause they are typically available for check-ins with the patients througout the week to help them use the skills.  But like all practicioners, they need to do certain things to maintain their liability coverage and comply with mandated reporting laws -- and if a child is repeatedly stating a suicidal ideation that is concrete enough, they really don't have much choice about reporting it.  (Reading between the lines, I also really wonder if the DBT professionals thought the parents were not being realistic, and that requiring the in-person consultant was a way to get them more educated about options.)  If they wanted to dump her as a patient, they could have just said "We can't meet her needs."

On the reporting, this is where the system is totally f-ed up.  The mandated reporters have to report.  If you refuse to take them to an ER for assessment, they may have to call CPS and report you for medical neglect.  Regardless of the fact that there aren't available beds and the treatment doesn't actually cure anything (but will keep the child safe for a brief moment while they are inside).  So if the school counsel or the therapist or whoever tells you they are going to call, you have to go to the ER and hope you can talk the ER person out of commiting the child.  IME, the ERs that actually have a juvenile unit are more likely to send you home -- they know they need to save those beds for the really serious cases and are better able to suss out the kids that are just attention seeking.  The ERs that do NOT have a juvenile unit are worried about their liability, aren't skilled in interviewing kids/teens so won't ask the right questions, and will keep you sitting in a random ER bed indefinitely while they wait for a bed to open up God-knows-where.   So the worse case scenario is some therapist or counselor who doesn't know much forces you to take the kid to an ER where they don't know much, and then you end up stuck going to the worst option for in-patient, just because that's where there's an open bed.   [/quote]

yikes. I’m going to put that one in my back pocket in case I ever need it (hope not). [/quote]

Don't forget being required to pay the ER bill every time. My dc was in a placement that sent him to the ER in an ambulance multiple times in one year. The cost was astronomical and he was always discharged from the ER once he calmed down.[/quote]

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