Anonymous
09/11/2025 21:37
Subject: When is residential placement an option?
Anonymous wrote:if school isn't going well, talk to a special ed lawyer. if it's just home going badly, talk to a lawyer from the special needs alliance in your state about medicaid waiver programs--most have waitlists and some will only work once the kid is 18 but might as well get on the list. in terms of finding new psychiatrists, again it might just be getting on waitlists at this point. My experience is that going to the ER may or may not lead to inpatient, but inpatient doesn't guarantee that you'll get followup care with practitioners from that facility. I'm sorry. The health system is so broken and especially the mental health system.
School isn't going well, but I don't think there's anything they can do either.
Anonymous
09/11/2025 21:22
Subject: When is residential placement an option?
if school isn't going well, talk to a special ed lawyer. if it's just home going badly, talk to a lawyer from the special needs alliance in your state about medicaid waiver programs--most have waitlists and some will only work once the kid is 18 but might as well get on the list. in terms of finding new psychiatrists, again it might just be getting on waitlists at this point. My experience is that going to the ER may or may not lead to inpatient, but inpatient doesn't guarantee that you'll get followup care with practitioners from that facility. I'm sorry. The health system is so broken and especially the mental health system.
Anonymous
09/11/2025 21:01
Subject: Re:When is residential placement an option?
Sending you a virtual hug OP. It’s a difficult situation. If you are in Fairfax county, I was told you can do an intake for residential placement. There’s a wait list but at least get that process started. I also recommend asking your insurance company to assign you to a case manager. You might be able to get approved through your insurance for short term placement so you can recharge and move towards getting your child stabilized. For us, the right medication was a game changer. Therapy was useless but parent training was helpful. It’s a long difficult and lonely struggle.
Anonymous
09/11/2025 20:56
Subject: When is residential placement an option?
How are things at school? Any chance you are in MCPS? For my child, it was MCPS that kept pushing for more restrictive placements and agreed to residential. The school system will only pay for the academic side of things, but combined with state and insurance help, costs were low. If things are good at school, though, that’s not an option.
Also through MCPS is RICA, but my child was too much for them. They start in 4th grade, so younger than many. But if your child gets accepted, the psychiatrists there can recommend residential right there on campus. Then you get residential and continue with an MCPS education.
Also through MCPS is RICA, but my child was too much for them. They start in 4th grade, so younger than many. But if your child gets accepted, the psychiatrists there can recommend residential right there on campus. Then you get residential and continue with an MCPS education.
Anonymous
09/11/2025 20:54
Subject: Re:When is residential placement an option?
Anonymous wrote:Two things. First therapies never worked for my child. Medications did. Residential did. But it was the structure and physical activity and consequences in addition to medication That worked.
Second, I never found any psychiatrists who knew resources. They might exist but I feel like they are a unicorn.
Unless you are very wealthy, you aren’t going to be able to private pay. Eight years ago I was paying $650 a day. And a lot of programs would not accept my child without an insurance back up. I had to either have a school commitment (which didn’t work because schools don’t have to pay for residential) or Medicaid. A private pay contract wasn’t enough for many places.
So from what I experienced, the juvenile justice system is a real option. The other step to consider is a Medicaid application, but finding a program for anyone under 14 is tough.
Good luck. FWIW, my child is now successful at home and doing well. It’s evident that they lost years - you’d think they are about 5 years younger than their age. But the outcome is good.
I appreciate the insights and I'm glad things are looking up for you, but that is incredibly disheartening to read...
Anonymous
09/11/2025 20:51
Subject: When is residential placement an option?
Anonymous wrote:OP—can you share more about what’s going? Is your child currently in crisis or quickly heading that way? What type placement are you looking for? Short term (30-60 days) or long term (60+). Is your child stable on their current meds or do you think the meds need to be adjusted? Does your child have a dx?
ASD with very high support needs. It's been a slow but steady downward slide despite the team trying to find effective medications and treatments. The long-term prognosis does not look promising.
Anonymous
09/11/2025 20:48
Subject: Re:When is residential placement an option?
Two things. First therapies never worked for my child. Medications did. Residential did. But it was the structure and physical activity and consequences in addition to medication That worked.
Second, I never found any psychiatrists who knew resources. They might exist but I feel like they are a unicorn.
Unless you are very wealthy, you aren’t going to be able to private pay. Eight years ago I was paying $650 a day. And a lot of programs would not accept my child without an insurance back up. I had to either have a school commitment (which didn’t work because schools don’t have to pay for residential) or Medicaid. A private pay contract wasn’t enough for many places.
So from what I experienced, the juvenile justice system is a real option. The other step to consider is a Medicaid application, but finding a program for anyone under 14 is tough.
Good luck. FWIW, my child is now successful at home and doing well. It’s evident that they lost years - you’d think they are about 5 years younger than their age. But the outcome is good.
Second, I never found any psychiatrists who knew resources. They might exist but I feel like they are a unicorn.
Unless you are very wealthy, you aren’t going to be able to private pay. Eight years ago I was paying $650 a day. And a lot of programs would not accept my child without an insurance back up. I had to either have a school commitment (which didn’t work because schools don’t have to pay for residential) or Medicaid. A private pay contract wasn’t enough for many places.
So from what I experienced, the juvenile justice system is a real option. The other step to consider is a Medicaid application, but finding a program for anyone under 14 is tough.
Good luck. FWIW, my child is now successful at home and doing well. It’s evident that they lost years - you’d think they are about 5 years younger than their age. But the outcome is good.
Anonymous
09/11/2025 20:41
Subject: When is residential placement an option?
OP—can you share more about what’s going? Is your child currently in crisis or quickly heading that way? What type placement are you looking for? Short term (30-60 days) or long term (60+). Is your child stable on their current meds or do you think the meds need to be adjusted? Does your child have a dx?
Anonymous
09/11/2025 20:29
Subject: When is residential placement an option?
Anonymous wrote:If your psychiatrist isn’t familiar with the options for kids with challenges like yours (which is not a criticism-it sounds like you have a really unusually tough situation) I suggest either transferring care or at least getting a second opinion with a clinician at a major teaching hospital. Your child has unique challenges and they need a real expert to understand what the landscape looks like for the future. Good luck to you and your family!
It was a year long wait to get into the current psychiatrist... I know this sounds stupid or lazy, but how do you even get in at a teaching hospital as a new patient? Is it the sort of thing where you need to wait for an emergency and then go to an ER?
Anonymous
09/11/2025 20:05
Subject: When is residential placement an option?
If your psychiatrist isn’t familiar with the options for kids with challenges like yours (which is not a criticism-it sounds like you have a really unusually tough situation) I suggest either transferring care or at least getting a second opinion with a clinician at a major teaching hospital. Your child has unique challenges and they need a real expert to understand what the landscape looks like for the future. Good luck to you and your family!
Anonymous
09/11/2025 20:01
Subject: When is residential placement an option?
Oh and I don't know about psychiatrists - we have every specialist under the sun at Children's including complex care. But if we can't even take care of kids like mine, not sure what hope there is for anyone else, unfortunately.
Anonymous
09/11/2025 20:00
Subject: When is residential placement an option?
We have a completely disabled child who needs assistance with all activities of daily living. We went through hell to get Montgomery County school placement and are working toward residential. My recommendation is get a good attorney and get ready to fight like hell. Wish we had an actual social safety net, it's such a nightmare.
Anonymous
09/11/2025 19:58
Subject: When is residential placement an option?
Anonymous wrote:Start by talking to their therapist and psych. They will need to provide recommendations to the facility.
Finding a place is dependent on age, sex, dx, and insurance vs private pay.
Thank you.
The psychiatrist has been mainly focused on medication management, perhaps in part because underlying behaviors have been sufficiently challenging that therapies haven't been effective in recent years.
We also have a developmental pediatrician, but I think we're already well beyond his comfort zone for treatment plans and management.
Is the psychiatrist still likely the main path?
Anonymous
09/11/2025 19:48
Subject: When is residential placement an option?
Start by talking to their therapist and psych. They will need to provide recommendations to the facility.
Finding a place is dependent on age, sex, dx, and insurance vs private pay.
Finding a place is dependent on age, sex, dx, and insurance vs private pay.
Anonymous
09/11/2025 19:37
Subject: When is residential placement an option?
I've had enough judgement for the day. Say what you will, but don't expect a response if you're not interested in being productive or helpful.
We have a young child that is simply too much for us to handle. Even if they're not at the stage yet, it is simply a matter of time before we'll be unable to safely care for them without putting others at substantial risk.
I imagine this will be a long process. What are the initial steps and how long do they take?
We have a young child that is simply too much for us to handle. Even if they're not at the stage yet, it is simply a matter of time before we'll be unable to safely care for them without putting others at substantial risk.
I imagine this will be a long process. What are the initial steps and how long do they take?