Ok, I'm playing phone tag with- pediatrician to set up sleep study. I called the place that Crazy recommended, which is also one the super mentioned, and am waiting for someone from intake to call me back. I called a second place that accepts county funding and is licensed, etc., and has a wide array of services and told this lady the issues. Her response was that this was ridiculous. She said there is no way that this could be dealt with on an out-patient setting. She said this kid needs to be in a more structured setting getting stabilized because he is living on the edge of an acute crisis. The very fact that difficult child has had to acute stays since mid-Dec then acted that way the first night he was home indicates that he is not stable. "What does it take for people to realize that these kids need more help".She said she thought this was all about funding and budget cuts and processes. She said she knew difficult child's psychiatrist and that since I had updated him yesterday but difficult child was sitting right there and the appointment was over before we discussed his recommendations in detail, that I should call him right away and discuss this with him and see if he would right a letter stating specificly that difficult child needed to be in a place. She said she thought the best thing would be for difficult child to go in to have medications stabilized, then get in-home to help him transition back into a functioning lifestyle. I have a call into psychiatrist now and have a third place on my list to call. Then, I had missed a call from PO while on the phone with someone else, so I returned her call. It went like this: PO: I have a code of conduct form that you and difficult child need to come in and sign. It is required because I am putting in refferal for in-home services. Me: I'm confused- I spoke with Mr X yesterday- he told me I could call places and find a provider and discuss several areas where services are needed so I've been sitting here starting on that process. PO: Well, I spoke with him, too, and he told you we were going ahead with the referral but if you wanted to call places, you can, and if you find other services you want, you can come back and asked for them. But I'm putting this referral in. Me: Well, I want to ask, just to make sure we are all on the same page and that I interpreted things correctly, If I find a place that is acceptable as far as funding, licensing, so forth and they have all these sesrvices, could they be changed to a different provider. PO: Well, maybe, but you are going to get this assessment that I have put in for and I'm going ahead with it and you and difficult child need to sign these papers. Me: Ok. But, I am going ahead and talking with psychiatrist, too, based on what this lady I just spoke with told me. PO: What did she tell you? Do they even have services for difficult child? This type of service? ME: Yes, they have all kinds of in home, but she said she didn't think in home was what difficult child needed right now- she feels he needs to be in a more secure environment. PO: So, she said they couldn't help you, they don't have what difficult child needs. Me: No, she said they ahve inhome that can be accessed and used but she doesn't think any in home can help difficult child right now. PO: Why? Me: Because things transpired over the last two weeks that are very serious and even psychiatrist only became aware of all these things yesterday and I didn't even have a chance to discuss his specific recommendations about them yesterday because his next appointment had arrived and our time was up. You need to keep in mind that the letters you have from therapist and psychiatrist were written prior to difficult child's last psychiatric hospital visit and some things have happened since those letters were written. PO: Things like what. Me: Well, for one, the very night difficult child came home and I was making sure that I kept things relaxed and encouraged everything to stay on a regular schedule so he could sleep well and go to school the next day, he was pulling his hair out, saying he could not stand his life, it was too overwhelming, he did want to live, he was sorry for everything, and nothing helped him- not tdocs, psychiatric hospital, nothing. PO: Oh, he's just frustrated. He's a 14yo boy. They all get frustrated. You know, think about how you feel when you've had a hard day and you are worried about bills and so forth and you get frustrated. And I can see where he would be frustrated and it might seem a little harder for him to deal with, given his age, and the fact that he sees other kids being allowed to go out and do things that you don't let him do because...well, you keep a highly structured environment for him...but hee doesn't get to do what other kids can so he is frustrated. But you need to not let everything he says get to you so much. I think he's just feeling a little overwhelmedd, and he wasn't hurting himself and didn't say he was going to so I don't see it as anything to be concerned about. All teens say things like that. ME (maintaining calmness): Well, I think I will leave that up to the professionals. I am going to do what this lady suggested and talk with psychiatrist and see what he says. There are some other things that have happened that appear pretty serious to me and I do need to get psychiatrist's recommendations about them. PO: Well, you just saw him yesterday, why didn't you get them then? If he thought you should do anything any differently, he would have told you. Me: We didn't really have a chance to discuss specifc recs. yesterday. We discussed what had transpired over the last couple of weeks, difficult child's sleep issues and medications and blood work done by psychiatric hospital. He wants a sleep study done by the way, and made another medication change. PO: What's wrong with difficult child's sleeping? Where is he now anyway? ME: He's sleeping. PO: Why isn't he at school? What did he do yesterday? I thought he was rested up. He went to school the other day. So, you didn't get him up to go to school today? ME: He stayed up all Monday night, went to school on Tues., went to sleep Tues early evening, slept until Wed. late afternoon, stayed awake thru the night, went tos chool yesterday, went out to play with T and A for a while yesterday, went to sleep early evening. Yesterday was quite successful all in all and I did think he was moving toward normal sleeping patterns and would be able to get up and go to school today, but he didn't and he's still asleep. psychiatrist does not think this is normal and that is why he wants a sleep study. But, some of it could be the medications he's on and all the medication changes recently trying to get him stabilized, I don't know. But, I am pursuing arrangements for a sleep study. PO: Well, if he could sleep regular hours wouldn't that help things? ME: Yes, most definitely. PO: Well, you need to sign these papers. Are you going to work Monday so you can come by and sign them on your way? Or is there a time you'll be out running an errand? Me: I don't know when I'm going back to work yet, I can't determine that just yet and commit to it because I don't know what I'll be dealing with re. difficult child from day to day. Could I call you later today and leave a message about a good time to come in, after I've made a couple of more phone calls and figure out what I need to do on Monday? PO: I'll just mail them to you. You can fax them back or drop them off either one. You guys have an appointment on Feb, YY, you need to be here then and I'd like the therapist from this place to be here so you can meet and cover the rules then. ME: Could I have the name of the place you are ordering services from? It might be a place I have on my list. PO: The name is YYYY. ME: Ok, I didn't have that name- I'll check them out. Mr X gave me the name of YY and I have a call into them now. PO: Well, I'm ordering this so you WILL have this assessment by this place. If they say they can't handle anything or provide any services, then we will deal with that. Me: Oooookaaayy I have to mention here- the way she introduced mst guy was to bring him and me and difficult child in her office and say "this is Mr ZZ," then, looking at me "You ARE to do this and this and anything else he says or else you will be non-compliant and I WILL have to take you before the judge and YOU will have to answer for it". Now, given that I have never refused an order she's given, had never said I didn't want mst at that point (I didn't know what it was), been late to an appointment, etc., I really do not think that approach is called for and it really does not lead to a pleasant attitude in me. And I really do not see what I am doing to antagonize her- it really appears more that she's antagonizing me. Then, when mst guy showed up giving me same kind of "I'm telling you what you have to do or else" attitude, I knew it wasn't going to go well. If I'm overlooking something obvious that is causing this in her, please point it out to me.