klmno
Active Member
Those of you who have been reading my threads- what do you think about this draft letter to judge to file with another request for a hearing tomorrow morning?
difficult child was hospitalized at xxx, an acute care facility, after being TDOd on December 18, 2008, for self-harming behavior and again on January 13th, willingly, after I called the police due to difficult child becoming aggressive. His difficulties the past few months began with signs of serious depression last October and worsened with medication changes to address the depression and a physical illness that could have lead to asthmatic wheezing. He has experienced increasing instability and has missed over 20 days of school this school year.
I am requesting that my son be released from probation so that I may access more mental health services for him and pursue FAPT involvement myself, if the court cannot order it. Attached are copies of letters from my sons psychologist and psychiatrist. I am also attaching the recommendations from the staff at xxx where he is currently hospitalized but about to get discharged from due to a removal from acute status and subsequent lack of insurance coverage of the hospitalization.
I filed a request for an emergency hearing due to a Child in Need of Services on Thursday, January 8, 2009. I have since learned from the clerk that this was denied because I needed to speak with CSA and DSS. I had spoken to Ms. yyy, the countys CSA coordinator, in December, 2008, and was told that any services requested and needed must go through FAPT, which can be referred by either Children Services Board (CSB), DSS, the school system, or Department of Juvenile Justice.
According to zzz County Mental Health, Children Services Board (CSB) is not accessible to me without changing difficult child's private mental health care providers to the countys providers and allowing them to start over with evaluation and treatment first. If their treatment is not successful, they would determine if Children Services Board (CSB) and ultimately, FAPT should be recommended. Due to the length of time involved to go through that process and the urgency of difficult childs needs, I have sought other avenues.
I have spoken to three social workers from DSS. One was regarding obtaining a waiver for difficult child to receive Medicaid, which funds more services and relieves me from paying for his high cost of medical insurance out of pocket, which I can no longer afford because I have not been able to work full time hours in almost two years. Apparently, difficult child cannot get this waiver. The second social worker stated that DSS cannot get involved in referring services because I do not abuse or neglect my child. The third stated that I could pursue a temporary parental placement into a more therapeutic environment and/or family preservations services if difficult child was not on probation, but that I do not have control over his placement as long as he is on probation.
The social worker also indicated that the FAPT team would more than likely follow any recommendation from difficult child's probation officer and that the probation officer would be difficult childs case manager, instead of getting a mental health case manager. Given the nature of the problems, the fact that the probation officer is not a mental health professional, the difficulty reaching the probation officer by phone, and the fact that she has been aware of difficulties and has not pursued additional services to date, this concerns me greatly, as I am held accountable if difficult childs needs and recommended services are not provided.
The principal at difficult childs school is pursuing whether or not the school can and will help us access additional services. However, that appears to be a lengthy process, as well, since I asked for her assistance in December and they are still going through their determination process.
I have been trying to look for other options since November of 2008. I pursued an opportunity to get services for difficult child through the National Institute for Mental Health but he was disqualified due to the fact that he is on probation.
As you can see from the attached letters, difficult childs individual therapist recommends placement at home with additional services provided through FAPT. The hospital staff recommends pursuing either more extensive services at home or medication stabilization at a Residential Treatment Facility.
As difficult child's sole care-giver and mother, I am concerned that during this period of instability, I cannot provide everything needed in order to keep him supervised at all hours of every day, attend all appointments and meetings necessary, prevent a crisis or illegal actions, and work enough hours to financially cover household expenses and private insurance costs. Please note that when my son is manic, he might stay awake for two days straight and it requires staff who are awake to supervise his actions during those periods. In home therapy alone will not solve all these problems and can only be so helpful until mood lability is stabilized through medications. For these reasons, I personally believe a temporary placement with full time psychiatric and therapeutic staff is in his best interest.
The following definition of mood lability as listed on the Bipolar Information website is most helpful in describing our current situation:
Mood lability is a classic symptom of bipolar disorder. In very simplified terms, mood lability refers to mood swings, to the changeability of a persons overall mood state. The intensity and frequency of these swings varies from person to person and also varies over time so it can look a bit different in each child/teen. Mood lability can include things such as: your child has been of a normal mood in the morning, overly happy in the afternoon, and then irritable in the evening; your child is quiet and withdrawn all day but when a frustrating situation arises, he/she blows up, suddenly showing notable agitation or maybe even aggression; your teens mood switches from happy and laughing to crying to irritable and swearing in the course of the six hours between the end of the school day and bedtime.
Often when moods are very labile, especially if some the swings include intense irritability and agitation, life can feel unpredictable and parents can feel as if they spend all day walking on eggshells or waiting for the other shoe to drop. Significant mood lability is a sign that the bipolar disorder is in an unstable phase. It can be addressed (as can most bipolar symptoms) by adjusting your childs/teens medications under his/her doctors guidance.
If an immediate placement into a psychiatric Residential Treatment Center (RTC) is not an option, I am happy to have my son at home if necessary crisis prevention and intervention, supervision, financial, and other therapeutic assistance is provided until stabilization can be established on an out-patient basis. Either way, it is my understanding that FAPT is the avenue for making those determinations and funding whatever services are deemed appropriate.
I respectfully request that you hear this case at your earliest convenience. It is my sincere hope that you can and will help us obtain more appropriate services for my son.
Thank you for your consideration in this matter,
