what would you have in a mental health facility?

[Jena]

Hi, I think this is difficult child related, so i figured i'd put thread here. I've been thinking a little lately.

So, if you, the parent could have whatever you want in mental health facility or could create one in your town what would it have in it?? What type of facility to cover your needs?

For me, I think it would be licensed pyshdoc's on staff, who were well versed on different diagnosis's and mental health issues. Ranging from add to bipolar. Behavioral specialist, and therapists on board there as well. A main center or bldg. mainly for neurological testing as well as evaluations. This center would also have facility for families to stay over night with-difficult child's when evaluations were performed. I, as the parent would like there to be a trained therapist to assist me the parent to handle various behaviors displayed by difficult child.

whose next?? any thoughts??

 

[Jena]

oh and a nutrionist as well on staff, a small corner dedicated mainly to healthful living, diet, exercise.

 

[klmno]

My son. Temporarily.

 

[BusynMember]

A neuropsychologist evaluation for every child who passed through the doors. Even in hospitals (I've been on psychiatric wards three times) they never test you. Well, sometimes you get the 500 question MMPI test, but they don't really do enough evaluating in my opinion. A psychiatrist and neuropsychologist should work together on every patient to get a correct diagnosis. and plan.

 

[trinityroyal]

Here's what I would have:

1:1 staff who show a great aptitude for dealing with difficult children and their issues. Not necessarily those with a SW background, but those who show good instincts in dealing with difficult child behaviour.

A therapeutic advisory team that includes: psychiatrist, therapist, pediatrician doctor, chiro, endocrinologist. Other therapies as they show benefit, including RMT, accupuncture, etc.

Small units that house no more than 3 residents at a time. Client-to-staff ratio of 2:1 max.

Useful work that difficult children in residence can do, including learning life skills, vocational skills, academic and self care, and whatever interests them. High degree of supervision and structure. Trips into the community, guided by staff, in small groups.

Active involvement from parents, and open communication between staff and parents. Access to daily logs, so that parents know exactly what's going on with their children day by day.

That's all I can think of for now. More will come to me...

Trinity

 

[trinityroyal]

And Yes, MWM, I second the full evaluation and correct diagnosis, before any sort of treatment plan is put in place.

Trinity

 

[Jena]

klmno your so cute if i had one of my own he'd be in it and getting all the care he needs

((hugs))

Midwest mom - so you mean in other words no hey go to the neuropysch guy he'll send the report i'll read it and call you to diagnosis??? a more comprehensive approach that would include a team??

 

[Jena]

Trinity that's a great thought, that could be included within the unit that would be mainly to house healthful living, a nutrionist, along with those other approaches you listed that would be of help as well in treating and long term care once a plan is in place.

by the way i loved that you wrote ppl who get difficult child's, not necessarily those with a degree behind them. there's alot to be said for experience, and "gut" feelings and intuition, as opposed to textbook answers and diagnosis's. Afterall mental health is a "grey" area and especially that of children's mental health, which Dreamer reminded me of today. so true.

 

[Andy]

Coming from the non-direct, support staff side: A person to work with the financial side. Almost every patient we had was on a state health care program or needed to apply upon admission. One person is needed to help get this medical coverage set up and remain open. It takes an enormous amount of time to find the financial worker, ask about review dates, and help the patient fill out the forms needed to open or keep open.

Before the mental health division moved off campus, I was the one to help patients complete the application. It can take up to 1/2 hour or more to ask the questions and write the answers - you can imagine how long it would take the patient to read and understand each question. This was an adult facility. Try asking an unhappy patient financial questions! Not fun! The staff would let me know if someone was not open to this task. I think finances are very private and when a committed patient is not happy to be at the facility, he/she will not be willing to share this. I can understand and always waited until the patient was comfortable with giving the info.

Those with private insurance are a special challenge. Insurance companies are not fun to work with. You need someone to call for benefits, obtain preauthorizations, do reviews, ect. (NOT ME!!!)

Coming from a non-direct support staff job in which my new office I hear will be way too small (no one understands archiving and hard copy files), I would ask for a large enough office for every single worker. Also a break room (we no longer have that either - I doubt the new facility will have one).

A great IT department. We have the best. Our guys are so great! Maybe they would be willing to leave their jobs and come to this new facility?

A billing system that makes sense. Ask the medical records person AND the biller what they need in this system. It has to be user friendly to retrieve information. The system I a using is very difficult to get information out of.

Make sure the biller and the medical records staff work as a team (all our staff members will get along wonderfully - no fighting at this facility).

I know the direct care is the most important, but believe me, if the support staff isn't working well, the facility will not be able to meet all needs.

 

[Jena]

I agree with you Andy that's a great point. I'd wish for a center in which would be accessible to all, regardless of their finances. Something that would perhaps run mainly off grants and contributions. It would upset me if a place like this, that we are all creating on our forum lol, would turn ppl away......... i've experienced that first hand as many here have. You find a great dr. who is in high demand and who wont' see you because you dont' have the sufficient funds. What's that all about?? wow. right??

 

[Jena]

ok i'm going to go off on one of my ramblings lol.... i remember last year all too well sitting in my broken down truck hysterical crying over difficult child, with Rosalie Greenbergs book in my hand that i had just finished reading. I felt desperate, at a total loss difficult child was all over the place. Each day was torment, each night was endless. I called information got her number and called her. I tried to sound normal on the phone she actually answered her own phone!! I explained my situation briefly and said how I was desperate for help, that I had read her book and would love just an evaluation by her of difficult child, etc. that i'd pay anything i could manage to get together. I asked what her fee was, she said some insane amt. stated she did not accept insurance and abruptly hung up the phone wishing me luck with finding difficult child help. I wasn't hysterical on the phone i was obviously distressed yet that was her response.

ok just wanted to share that

 

[Jena]

i just thought of one more thing when i woke up, a library. filled with tons of books on various diagnosis's by great authors, a visitors center thing maybe library could be there. maybe one could bring the extended family there once the diagnosis and plan is in place to enlighten them, show them, etc.

 

[Nancy423]

I'd add in:
*behavior therapist staff
*play therapy
*EMDR specialists
*family classes (for some parents who need to learn how to deal more effectively with- their difficult child and diagnosis's - and for siblings who need to know how to handle home life)
*what about a massage therapy section? seriously, it can be quite calming! (or the parent can make use of them quite easily ROFL)

by the way, how are we funding this facility??? I could win the lottery!

 

[totoro]

I just had to say I can't believe that about Dr.Rosalie Greenberg... I love her book!!! I may just throw it in the trash!!! I don't know if I can recommend her book now! Hmmmph.

I will think of some things to add, I just had to say that. I am miffed now.

 

[Jena]

Toto wasn't that book amazing and so so insightful?? i couldn't stop reading it and referring back to it. It was like my ah ha moment so much more than pappolos to be honest. she was so detailed and it was written so well i thought.

boy i can't tell you how put off i was to hear her be that way on the phone with me, no heart, no compassion just all about the bottom line, the money.

shocking when you build someone up in your head and turn to them and get so disappointed at their response or lack thereof.

 

[Rotsne]

It seems that the really small group homes or health care facilities with only 10 persons in a dorm seem to function best.

When I had an relative hospitalized (severe depression - 450 mg effexor) the last time I was asked to reduce the wire to a mobile phone charger to under 5 cm so it could not be used for suicide. Access to mobile phone outside therapy and other treatment should be mandatory so the hospitalized person maintain the network. We were told not to phone the individual but text only. If the individual was ready to talk to anyone, we would receive a call.

Visitation hours on daily basis if wanted by the comitted. The dorm was semi-closed. It meant that the door was closed all night and when they had patients they wanted to keep inside. The dorm was build so the patients could go outside in a small garden and smoke if they wanted (See Google map).

Last but not least. Single room. The patients was even given a key, but of course the staff did also have some.

In the family we were quite afraid before the hospitalization because it was regardless of the risk of suicide voluntary and we would not have asked for the court for an involuntary hospitalization, but the department treated the individual with respect and it was ended within 3 weeks. The out-patient treatment which should have followed did not work, so they offered to push the system from inside and while it took a couple of months where we were on the edge of a return, they found an out-patient solution in the end and gave out-patient treatment without being obligated. Without them I wouldn't know whether we would have been at a funeral.

 

[trinityroyal]

Andy, I agree that having a dedicated team of staff to manage the business details (IT, books, administration, fund raising, etc.) is also a big key to success. Someone needs to keep the lights on, otherwise the whole thing falls apart.

I also like the idea of a library. Not just of expert books on dxes, but also just novels, comic books, fun things to read that the residents can enjoy whenever they want to. Also board games, a collection of good DVDs, jigsaw puzzles, arts and crafts supplies.

As for visiting, Rotsne, your idea is interesting, but I would like to see some structure put in place. Visits from family or friends when the resident is stable enough to receive them, and the visits would not set therapy back. Visits can include supervised outings (e.g. trip to the local movie cinema accompanied by staff) or at the centre, in a common room or visiting area or something.

I think the location should be as home-like as possible. Not a hospital-like setting, but more like a house. Imagine the type of house that 3 or 4 university room mates would live in together (3 or 4 bedrooms, shared bathroom and kitchen, a few common rooms).

Funding. There should be some sort of public funding available, so that acceptance into the facility is not contingent on whether a parent can afford it.

With regard to Rosalie Greenberg, I'm sorry that she sounded so cold when you spoke to her Jen. I suspect that there are deeper ramifications at play, though. I would expect that she gets that sort of request many times a day from many sources. She may simply not be in a position to help everyone, and has therefore decided to draw her lines based on economic viability. If she doesn't keep an eye on the bottom line, then she might not be able to help anyone at all. This way, her books are still available with reasonable cost and her facilities are there for those who can afford them, which gives her the funding to write more books...etc.

I think there may be some legal issues as well. If she allows help to one family without charging the usual fees, does it do anything to her business model? Is she on the hook to help everyone who asks?

I don't know the answers to these questions, I'm just throwing it out there as a thought. When people say a blunt "No" like that, it's usually not arbitrary.

So...I think we have the makings of a good Residential Treatment Center (RTC) with all the ideas we've been floating around. Anything else we can think of?

Trinity

 

[TerryJ2]

Great ideas!!!

ROFLMA, KLMNO!!!!

 

[totoro]

One of us just needs to win the Lottery.
husband keeps playing, I told him a few years ago that I already have the money spent if we win!

 

[Jena]

i'm soo telling you!! I"m into the scratch off i'm sad to say. it's a habit forming thing. it's all about the thrill of the scratch!!

there is funding for these things. once I :

get difficult child level
lock easy child in a really big closet tried to "give" her away on gift exchange thread.......no one made any offers LOL........apparently i had to take someone else's easy child. hmmmm
get better
keep my new job
buy a horse

I'll look into funding!!