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?

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.

Anonymous wrote:We've been close to hospitalization a few times. This one hits home.

(And, PP, psychiatrists are medical doctors, ERs have medical doctors, the kid's dad is a medical doctor. I suspect their kid had a medical eval but mom didn't include it in her story.)

Having been through this myself I highly doubt that any of those professionals have tracked her bloodwork to rule out metabolic disorders or genetic causes.
And therein lies the problem. "You would think" but you would be incorrect.

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?

I had exactly the same reaction. I also disagree with some of the responses you've received in this thread. 3:30-8:30 is actually a relatively easy time to find care for school-aged children. If one of my kids' friends' families had this happening in their life, I would take a sibling that was a similar/compatible age to one of my children in a heartbeat. But also, this program is only 2 months, right? Isn't the worst case scenario that she takes the two siblings with her? Picks them up afterschool and brings them back for bedtime? They can sit in a car for 5 hours for 2 months to save their sister's life, no? And that's absolute worst case, I'm sure there is something else you can do with them for some of that time... Some care you can get for them on some days. She also mentions a grandpa and a boyfriend, in addition to the dad. I totally get that not everyone has a village, and maybe they are cutting a lot of the explanation out, but the decision not to take that outpatient program seemed genuinely baffling to me.

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.

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.

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.

It sounds like they turned down Bridges or the RICA program?

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.

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

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?

We've been close to hospitalization a few times. This one hits home.

(And, PP, psychiatrists are medical doctors, ERs have medical doctors, the kid's dad is a medical doctor. I suspect their kid had a medical eval but mom didn't include it in her story.)

The standout, to me, is the lack of national or state standards for psychiatric care----- which should BEGIN _ not end_ with medical evaluation. Medical evaluation isn't mentioned once in the article and I bet not one of the many "professionals " she and her daughter have seen, including the inpatient hospitals, did any medical evaluation. She should be tested for the known biological causes of anxiety and depression, first.
But no one in the psychiatric community has any long term benefit from doing so.

After, and ruling out biology, there needs to basic standards of care of psychiatric patients. There are none.
Same for education. There are none.

It is a heartbreaking story- heartbreaking for the family involved and heartbreaking for the many families I know who have experienced elements of this story. My child hasn’t needed hospitalization (yet?) but has been in crisis with no good options. And the failure of schools to address kids that don’t fit into round holes is very familiar.

It's heartbreaking. This family used the GTLD program of MCPS, where my son did so well in middle school (and then not so well in high school, but that was also due to the pandemic).

https://slate.com/technology/2023/06/child-teen-mental-health-crisis-therapy-help.html