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]"The practice head, who has never once met Ash and has not had a single helpful thing to say to us since Ash started group DBT therapy in September, tells us that based on the therapist’s assessment, Ash is not safe at home and we must take her to the emergency room immediately, or else they will sign an emergency petition to have her removed by the police from our care."

This section really stood out for me. It's so wretched for a provider to do this. When we were researching providers a mom told me this nightmare story about how this type of thing happened to her. The head of the practice apparently has done this to several patients accusing the parents of abuse. The provider is crazy as they parents cleared but caused huge trauma for kids who were already in a mental health crisis. We left the practice very quickly after hearing that.[/quote]

That’s not fair to the practice.  The therapists are often in their 20s.  They all have regular check ins with the practice head especially on difficult cases and when something this serious is going on, it would be weird not to have the more senior practitioner involved to deliver the bad news.  If a DBT provider is telling you that you need to go to the ER, it’s bad.  And unfortunately, the whole system is set up to create a fear of liability.  They have a legal obligation to report siotuations of imminent harm.  So if the kid is articulating a concrete plan for serious self harm and is not participating in therapy (which it sounds like she was not, as the author said she hated it), the practice has to report it.

There aren’t easy answers here.  If the author was told something like — look, there is a 20% chance she kills herself in the next week.  You can eliminate that by putting her in patient but it’s unclear whether that placement will make her somewhat better or somewhat worse.  What is the right choice?  I don’t know but that is essentially the choice facing these parents.  In some ways, her story is less about the lack of resources (as she was offered a ton of resources) but more about how we don’t have great treatments for some types of mental illness.  It’s like having a treatment resistant cancer but then getting mad at the doctors because the existing treatment methods are ineffective or have side effects.

I do think the author’s child case is complicated by the fact that she is so verbal and high IQ—she is running circles around these providers (to her own detriment) and is able to express/articulate things in a way that most kids that age can’t.  My number one advice for the author would be that she has to find something else that this kid can spend her mental energy on rather than turning it all inwards.  At this point she sounds like a caged tiger who is turning all her energy inward.  [/quote]

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