1 call to provider & PO

[klmno]

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.

 

[CrazyinVA]

I think you should let the referral get in, although definitely read what you sign carefully. This is at least getting the ball rolling on funding for services. Then have the assessment done. There is nothing to lose. If that place can't help you, you can move on to the next.

I'm not surprised the woman you spoke to had the reaction she did, that was common when I was trying to get Youngest help as well. Sadly, however, they aren't the ones making the choices on this. It IS all about funding and budgets. That's just the way it is, even though it absolutely hoovers.

 

[klmno]

I just called the place that PO ordered services from. I didn't give my name but told them that I had a 14yo with BiPolar (BP) that has had two acute stays in a month and that I had been trying to manage his mental health care needs and keep him supervised and subsequently am unable to work full time, leaving me with financial diffulties. Then asked if they provided in home services for help like that and she said no. She said that they provide therapy like family theerapy and marital counseling. She gave me a name of a place that might be able to help but shee suggested talking to psychiatrist for a referral, start calling places all over county and writing names, numbers and positions down and getting funding secured. She said to make sure these peopl know that he's BiPolar (BP) and has two recent acute stays. She said she wasn't allowed to go into a detailed opinion about what she thought might be needed. She gave me her name. I thanked her profusely.

 

[klmno]

I just googled the name this lady provided- it's a local psychiatric Residential Treatment Center (RTC).

 

[gcvmom]

Amazing. So if they just told you over the phone that they can't help difficult child, and this IS the place PO is ordering the evaluation from, it seems that the evenuality will be that they FINALLY come to the conclusions that in-home won't work (DUH) and a more intensely structured environment (like Residential Treatment Center (RTC)) is where he needs to be (Double DUH), and gee if they'd only listened to you in the first place (DUH) they would have saved TIME, MONEY, and boatloads of aggravation, not to mention getting difficult child the treatment he needs SOONER rather than later! (Correct me if I'm not getting this right...)

Wow.

 

[klmno]

Ok, so, I called the 4th place- this is one that the super had suggested yesterady. They do NO in-home services but said that they are a group home. They said any in-home provider needs to be aware that my son has an Axis 1 diagnosis. They gave me the name of 2 places that might do in home to help with psychiatric disorders.

Since it was getting late afternoon, I called to see if I could reach PO before she left to let her know what I'd learned. I got her voice mail and left message. Then, I called her super and he was in. He backed up what PO had told me and I reminded him that he was the one that said I could call these places yesterday. Anyway, he kept stressing that I have to let this assessment happen, even though I never questioned him or disputed that. All I said was that the admissions person there told me that don't handle cases like that, but these places might, wouldn't it make more sense to get an assessment from a place that does do in home with psychiatric disorders? That went around in circles.

Then, he wanted to know where difficult child was. I said he was in back room playing games. He asked if he went to school today and I said no. He said, see- it is you allowing that to happen. He should be punished because he is calling the shots in that house and just doing whatever he wants. So I guessed he stayed up all night and just told you he didn't want to go to school today.

I said no, that isn't what is going on and this is where the big communication problem lies. I think you guys are not seeing anything about the mental health issue here and maybe you are thinking that I'm just allowing all this and don't care and using mental health issues as an excuse. He said no, I was enabling my son and I was the crux of the problem because I bought into all that. He said all teens go thru things like this and I needed to learn not to let him- that good parents don't let their kids do things like that. He said when he was young, if he didn't feel like going to school, he had to stay in bed all day and I should be punishing my child all day. He point blank said that I was the problem. He said I'd let my son take over the house and that people didn't have issues like that when he was a child- they got in trouble for it.

I said what about what the professionals say and maybe it isn't all in difficult child's control or my control. He said well, he didn't know, he wasn't a dr and if this is what was wrong, why wasn't that dr giving the tools to fix it all. What was I paying him to do?

I didn't say anything. He said just let this assessment take place so we can figure out where to go from here and they need to figure out what is in difficult child's control and what isn't. I agreed to that.

Then he told me that I didn't need to keep calling over there- (even though the PO had told me to call and keep her informed) and as long as difficult child wasn't breaking the law, they didn't care about any of it- that I could take care of his mental health issues, but that difficult child needed to get to school.

 

[klmno]

The two things bugging the most are 1) every time difficult child goes thru a period of instability I go thru this. First, ti was thru day cares and schools- because the issues were coming out there and it became a battle with me thinking they were doing somehing wrong and them thinking it was either a bad kid or a bad parent. The following year, the school again. Then, the GAL, PO and mst guy. But this time, there is really no excuse for the PO going down this road agin. She was there when I testified about all this last year. The times of year that difficult child gets manic and everything. I thought it was an improvement that he hasn't been exhibiting this at school and community- so far, it's being kept in home. So, that doesn't mean that we still don't have room for impreovement, but for someone to say to me that I am causing this problem, after this has been an episodic thing with difficult child for 3 years now really rubs me the wrong way. Especially after already having a hearing discussing difficult child's treatment and having to prove to social services 18 mos ago what all I'd done to try to get difficult child help. PO is aware of all that. Am I going to catch this flack every time difficult child is unstable for the rest of his life? He went out of control because I LET him?

You know, the GAL got assigned because I said I couldn't get more help for difficult child. I ended up regretting that because she stirred up stuff that cost me thousands of dollars to prove in court, not to mention my time off work for it all. Now, I'm left again feeling like I need to get an attny on board again and I can't afford it.
2) Probably most of us here have had tdocs that thought it was the parents' fault and that if we just did things their way for some time, they could help the problem. I'm concerned that a therapist is going to show up to do this assessment that doesn't really understand BiPolar (BP) symptoms or thinks medications take care of all them or has already been convinced that difficult child has no problem but me and completely ignore any BiPolar (BP) issues here- so then it would look like an out of control kid. I'm going to call that lady from this place back on Monday and talk to her about this, plus see if I can get something in writing. Furthermore, anyone that does an assessment on us should be familiar working with BiPolar (BP). MST guy said he was but then refused to talk about any of them- he wanted this to all change to difficult child and me and our household dynamics to change to work like there was no mental health issue here. Is that possible if the kid isn't stable? I don't think so. If it was, I don't think we would be here on this board.

Super told me today that the assessment might be during the next meeting with PO. I said I thought I'd like some time to talk to the provider alone. He said ok. I asked him to verify that the assessment was going to be at the PO's office? He said he didn't know but it could be and he might stop by there. He said PO would be going over rules and he'd try to pop his head in just to see how things were going. I said should I bring previous reports on difficult child and everything? He said yeah, go ahead and bring that stuff. I swear, this is sounding more and more like this isn't really going to be an assessment- this is going to be orders and threats.

Isn't there any way for me to refuse this assessment and say they need to get one by a provider that works with psychiatric disorders?

Also, today the super said he didn't care what my financial or any other issues were, he was just concerned about getting difficult child what he needs. Well, how is difficult child going to get what he needs this way when I am telling them that I have no money to continue this? I really think the judge needs to get involved- or someone familiar with BiPolar (BP). The super said ALL the letters from profs said difficult child needed intensive in home services. No, they said we needed in home help thru county team and psychiatrists included that being on probation was interfering with my ability to get difficult child more services. But again, the guy cut me off when I started to say that and told me to listen to him some more.

When I testified last Jan, I told judge if my son was going to live in my home, he was going to be treated for what he was diagnosis'd with, the best we could hone in on the diagnosis and that meant that difficult child had to be compliant with it (which he is) and that I was going to have to be allowed to treat him accordingly. If they think I am the cause of the problem, why are they bucking it so much for me to place him somewhere else? Why not let him go out of the home? Wouldn't they be pushing for that? But instead of kletting me place him somewhere, they are forcing this KNOWING that I can't continue this way, then ultimately, they will take him away. It's like they are going out of their way to make sure it looks like I'm to blame.

Furthermore, it was bad enough when the judge ordered me to sign release forms for difficult child's mental health providers. But I've about had it with being ordered to sign to agreements to comply with a code of conduct when I don't trust what we are getting here and I can't guarantee them that I will comply. This reminds me of the school's idea of a BIP for difficult child 2 years ago- it was a letter stating that if he ever got in trouble again, he would be removed from school.

 

[klmno]

Is this the extent of the assessment that I can expect?

https://web.archive.org/web/2011120...e.va.us/html/training_technical/IFSPModel.dot

 

[Jena]

I wish i could help you in this area. i just wanted to offer some support.

 

[klmno]

Thanks, Jennifer. I think I've found some clues as to why this keeps turning out this way. Besides me being so impossible. LOL! Whatever Department of Juvenile Justice orders is going to come out of "crime prevention" funds. They have selected people/providers they use and those are targeted for conduct issues and what the family might be doing, even unknowingly, to instigate or not control that. These are the people that constant use the threat of arrest and detention/jail if you don't comply.

This is more like what I was trying to get:

The following services are available as community mental health rehabilitation services: intensive in-home services (under 21), therapeutic day treatment, crisis stabilization, crisis intervention, psychosocial rehabilitation, intensive community treatment, targeted case management, mental health supports; residential substance abuse services for pregnant and postpartum women and substance abuse services for day treatment for pregnant and postpartum women.

I should have contacted dept of medical assistance services first. Department of Juvenile Justice has no concept of this. I could almost assure you that the Licensed Clinical Social Worker (LCSW) sent will be used to dealing with different types of situations. This is another situation just like the mst. I will need to appear before the judge. There's no way to get the PO or super on board with this. It messes up there funding protocol.

That's ok- it might work in my favor- I had asked for difficult child to be removed from probation so I could access more services for him and for him to have a mental health case manager, not a PO. They might end up looking like the fools- this is exactly how mst got ordered- gal ASSUMED something and got it ordered, when I appeared before judge and explained situation and she saw that I was pursuing recommended treatment, appropriate for my son's diagnosis, she asked po "what exdactly is your problem with this". Now, PO has turned around and done this. Hmmm. I think it should come out in front of the judge. Furthermore, PO didn't do anything until I wrote that letter to the judge. The judge already knows that.

I just need to get something in writing from psychiatrist, some clearer I guess, although I think the judge is a little wiser and doesn't read these things the same way the PO does.

Still, I'll read whatever my "agreement" is before signing or not signing. I have told them several times that I don't have financial resources to continue this another month, and it is true, so I will go back to courthouse Mon am and check on hearing status, again, and talk to intake about filing for temporary placement for difficult child.

PO says judge can't order difficult child to be placed in Residential Treatment Center (RTC)- but that isn't true. I found it in writing.

Oops- I called the wrong place today - the PO didn't give the exact correct name and I ended up calling the wrong place. I found the place online that she was referring to. Sure enough it's approved by Department of Juvenile Justice to prevent re-incarceration of juveniles with serious behavior problems and focuses on their families to get the family to quit focusing on the kid and be held accountable.

 

[Ropefree]

klmno: you wrote"everytime he goes through a period of instability I go through this"

and the seasonal componant you are aware of.

Do you have your list of wishes for now AND next time? If it is simply and directly listed and you keep refering back to the basics as you go the fact that you do know and are stating it in as simple and directly as you can:this and this and this and this and this and for next time the plan set ready to go. The judge is going to see that faster, and every other overworked person as well.

Also who is the caregiver so you work steady no matter what? a day center. A retired friendly vet?

I have my party slippers ready to jump on my bed again when you get all the way through this klmno..Keep it up. Wrap it up.

 

[ML]

KLMNO xoxoxox

I have been away from the computer for a couple days and apoloize for not being up to date. After reading this thread I just feel your frustration. I just hope *you* are sleeping, eating and taking care of YOU. This is an ugly dark circular maze you are in. I am glad there are people in our group (like CinV) that can hold your hand through this process but I find myself feeling that this current dymanic is just not working for you or difficult child. I am praying for a new path to illumniate itself to you soon. Love, ML