Anonymous wrote:
I get your frustration with locating providers and finding a good fit. I also understand what it’s like to have a suicidal child - coming up to the sixth anniversary of the first attempt and there is no end in sight. The pain and the fear are intense. And the pain in the a** that it is to find providers is real.

But your focus on having 5 years of experience seems misplaced. Fit, accessibility, success with your kid are what matters and that can happen with someone in their first year or their 45th year.

I kind of see your point. I am in fact more worried about the quality and fit of the future therapist, more than that of future psychiatrist. However, we would only know for sure a psych MD or NP is a good fit, after using them for a while. Before starting with somebody, there is rudimentary vetting we want to do. It can not be the very next random provider we can get. In that vetting, experience is of course big on the list.

I might make more sense to you, if you knew the full story. After years of struggle, our kid is not stable and could be having SI any time. We really don't want to take any chances and want somebody with reasonable experience to help on the medication front.

We feel like we may not have a third chance to keep her safe, so everything counts. If she was just now starting to have some issues, I would be less worried, but the sense I and my wife have is that we may be running out of time to keep her safe, as we navigate and stumble around this crazy world of mental health.

Anonymous wrote:You sound super difficult to me. I think you should show this thread to your therapist. There's a lot for her to work with here.

You sound super defensive to me. Like you’re an unqualified provider.

-DP

Anonymous wrote:I think you'll have to bite the bullet and go with who's available instead of trying to find someone who meets all of your criteria.

This, especially if OP wants in network and close by.

Anonymous wrote:

Anonymous wrote:You sound super difficult to me. I think you should show this thread to your therapist. There's a lot for her to work with here.

Not op.

SUPER ! You sound dumb.


Op I’ve noticed the same thing when looking for help for my teen. Places were evasive about their staff’s experience. I definitely was more interested after one practice offered someone who was attending Liberty and unlicensed but they said would have some supervision. Nope.

I am not surprised that you had that experience.

Providers of all kinds in training have always been around. They could work fine for you. Or not. What I am seeing in psych is a bit different There is a severe shortage and lots of money to be made. Earlier medical providers have rushed in. Long term, patients will benefit as most of them will mature and be effective providers. In the interim, you are on your own to figure out who you can trust. For patients who are not stable and at severe risk, it's a nightmare.

Anonymous wrote:Dr. Selassie in Bethesda or Chevy Chase takes insurance, not sure about new patients.

Also, because it sounds like standard antidepressants aren't working, is there any reason to suspect type II bipolar, which is where the manic phases aren't dramatic?

Thank you for the tip. Will look into it.
What is the right diagnosis? That is a loaded question. Kid just went through a neuropsych eval. Got bunch of diagnoses, none new. The psychologist wasn't too sure which are the root causes that triggered or worsened other diagnoses. Clear as mud. Kid was not impressed with the level of due diligence by the doctor. She is super smart and she was right. She wrote a long email to the doc. The doc essentially said insurance pays for only so much due diligence!!

During my search, there was another psychologist I liked with good reputation and a comprehensive approach for neuropsych eval. Couldn't afford her. She doesn't take insurance. I tried to figure out how much the insurance would cover the out of network doc. It was a struggle for a month. Repeated answer from the insurance - they will assess after I file a claim. Is there another world than mental health care that is more bizzarro?

Anonymous wrote:
...
Hi OP, I'm sorry my comment sounded flippant. I just meant that given the shortage of experienced mental health providers, you probably won't be able to find someone who has the experience your daughter deserves and takes insurance, unfortunately. It sounds like that's kind of where you ended up at.

I will say that we didn't find Children's helpful because their psychiatrists are a rotation of psychiatric fellows learning to be psychiatrists.
I'm so sorry your family is going through this.

Thanks for understanding. My post was directed towards unhelpful, dismissive and accusatory posts from others. Sorry I put that in reply to you.

We've had one in-patient experience with Children's. They appeared fine, but they were of course focused on short term recovery. You have to deal with providers-in-training at any teaching hospital.

Given what is at stake, the very life of our child, we want to get her the best providers of the right kind, soonest possible. It's just sooooooooo hard to even figure out for sure what kind of provider that would be (e.g. what kind of therapy, after one year of DBT), then to identify the really good ones in that area, then worry about affordability and availability.

Physical illnesses tend to be black and white with definitive tests and exams, so mediocre providers might just work out. With mental health, the quality, suitability of the provider and your child's rapport with them makes all the difference. With rapid influx of newly minted psych providers, especially NPs and therapists of all kinds, it's a scary world out there.

We took out loan for intensive one year long, out patient therapy. Just after they said kid was good to reduce the schedule, is when she attempted. After that, they don't want to touch her at all. She was practically kicked out. We have nobody to guide us, like a primary care provider. Now weighing out patient vs residential care. Figuring out residential care is a whole another story.

Thanks for being kind.

Anonymous wrote:OP, I think your frustration is justified. The reality is, there is a shortage of child psych providers, and the need surged after the pandemic. So people are stepping in to fill these roles without years of experience. If your child is already on a stable medication regimen, and you just need refills or slight tweaks in dosage, I wouldnt obsess over provider experience level. The psychiatrists I've dealt with personally have usually just prescribed whatever I asked for.

I hear you. The problem is the kid is not stable. We fear losing her. See my next reply.

Please ignore this reply.

OP, I think your frustration is justified. The reality is, there is a shortage of child psych providers, and the need surged after the pandemic. So people are stepping in to fill these roles without years of experience. If your child is already on a stable medication regimen, and you just need refills or slight tweaks in dosage, I wouldnt obsess over provider experience level. The psychiatrists I've dealt with personally have usually just prescribed whatever I asked for.

tabira wrote:

Anonymous wrote:I think you'll have to bite the bullet and go with who's available instead of trying to find someone who meets all of your criteria.

Sure. If your kid hasn't suffered a lot for years and hasn't been through many providers. And has not attempted suicide recently. Just grab a random provider and hope for the best.

I and my wife are grasping at straws just to make sure we can maximize chances of our kid surviving, until she turns a corner. Trying new providers because she didn't click with existing ones with no progress in more than a year, only to have her try to kill herself.

Nobody in this world is going to take days off looking for right help for her, other than me and my spouse. We don't have the luxury of rolling the dice trying a random available provider.

If you have been fortunate not to have a kid suffering mental illness, I am glad for you and that's just awesome. But please don't post dismissive comments on this topic (not so much you, talking about other posters). I hope you have heard of kids suffering from severe mental health issues in general, and lack of quality providers especially since covid.

If you have faced such issues, and have tons of money to get any top and reputed providers for your kid without worrying about cost from your pocket, yes, please have some empathy, give me some benefit of doubt and don't post dismissive comments.

If you have a child with significant mental health issues, fear losing your kid, and have to rely on insurance, I am all ears.

I get your frustration with locating providers and finding a good fit. I also understand what it’s like to have a suicidal child - coming up to the sixth anniversary of the first attempt and there is no end in sight. The pain and the fear are intense. And the pain in the a** that it is to find providers is real.

But your focus on having 5 years of experience seems misplaced. Fit, accessibility, success with your kid are what matters and that can happen with someone in their first year or their 45th year.

Anonymous wrote:You sound super difficult to me. I think you should show this thread to your therapist. There's a lot for her to work with here.

Not op.

SUPER ! You sound dumb.


Op I’ve noticed the same thing when looking for help for my teen. Places were evasive about their staff’s experience. I definitely was more interested after one practice offered someone who was attending Liberty and unlicensed but they said would have some supervision. Nope.

Dr. Selassie in Bethesda or Chevy Chase takes insurance, not sure about new patients.

Also, because it sounds like standard antidepressants aren't working, is there any reason to suspect type II bipolar, which is where the manic phases aren't dramatic?

tabira wrote:

Anonymous wrote:I think you'll have to bite the bullet and go with who's available instead of trying to find someone who meets all of your criteria.

Sure. If your kid hasn't suffered a lot for years and hasn't been through many providers. And has not attempted suicide recently. Just grab a random provider and hope for the best.

I and my wife are grasping at straws just to make sure we can maximize chances of our kid surviving, until she turns a corner. Trying new providers because she didn't click with existing ones with no progress in more than a year, only to have her try to kill herself.

Nobody in this world is going to take days off looking for right help for her, other than me and my spouse. We don't have the luxury of rolling the dice trying a random available provider.

If you have been fortunate not to have a kid suffering mental illness, I am glad for you and that's just awesome. But please don't post dismissive comments on this topic (not so much you, talking about other posters). I hope you have heard of kids suffering from severe mental health issues in general, and lack of quality providers especially since covid.

If you have faced such issues, and have tons of money to get any top and reputed providers for your kid without worrying about cost from your pocket, yes, please have some empathy, give me some benefit of doubt and don't post dismissive comments.

If you have a child with significant mental health issues, fear losing your kid, and have to rely on insurance, I am all ears.

Hi OP, I'm sorry my comment sounded flippant. I just meant that given the shortage of experienced mental health providers, you probably won't be able to find someone who has the experience your daughter deserves and takes insurance, unfortunately. It sounds like that's kind of where you ended up at.

I will say that we didn't find Children's helpful because their psychiatrists are a rotation of psychiatric fellows learning to be psychiatrists.
I'm so sorry your family is going through this.

Anonymous wrote:Skip the NPs they don’t note their experience because it’s little to none. I’m a nurse who does not use NPs for the care of my children or myself.

You're right. If they withhold that information, that pretty much answers my question.

It's just that when I find a group and a NP that works for us and our kid other ways (not easy feat), I start having wishful thinking that they have at least 4-5 years of psych experience, out of 20 years they tend to list that includes being RN, Family NP etc. I do first look for MDs, but there are less of them.

Very late today, I found a psych NP in Arlington with 7 years experience and booked an appointment. I will however cancel that, if I hear back from some MDs I contacted today that are closer home, have more experience, and focus exclusively on children/adolescents.

I have nothing against using NPs per se, ones with good experience and reputation. They tend to me more attentive. My wife has had competent NP providers for ob-gyn.

Skip the NPs they don’t note their experience because it’s little to none. I’m a nurse who does not use NPs for the care of my children or myself.