difficult child discharged - 24 Hrs after "Team" Mtg Agreement to Keep Him!

Discussion in 'General Parenting' started by tessaturtle, Jan 12, 2012.

  1. tessaturtle

    tessaturtle New Member

    So much incompetence I don't even know where to begin! I get a call from some psychiatrist (haven't met her at any of the visits or "team" meetings) at the psychiatric hospital this morning and she says she has difficult child's hospital sw in the room with her - asks if I mind being conferenced in - go ahead I say. She starts by saying who she is and that Dr. (can't pronounce his name and have never seen it spelled - bet he is difficult child's psychiatrist while at the psychiatric hospital) isn't there today. She explains that she met with the team (which appears to only be the sw and the psychiatrist, who wasn't there)again today regarding difficult child because she was "concerned" when she heard about the plan that was agreed on yesterday. THe plan that was agreed on yesterday (see other thread for more details) ended with-them agreeing to keep him while he re-starts attending school to monitor how he is after his school day (original psychiatrist's suggestion).

    All of a sudden, according to this new psychiatrist, the plan is not workable since today was a snow day, and then MONDAY is a holiday. That would mean he "sits here with nothing to do for 5 days". She says transportation can take awhile to set up, so she didn't think he would even start school until late next week. This was ALL discussed at the "team" meeting 24 hours ago! In fact, we told them the school district themselves provide the transport and had told us they could immediately restart as soon as they get the word! The SW at the "team" meeting said they would have their educational liason call to start - that was at noon on Wednesday that we made that plan. I was assuming they were professionals and that they realize how important education is (these kids have a hard of time already - difficult child is falling way behind), so I had no thoughts that they wouldn't make the call that day - especially since we all agreed he would start FRIDAY. I explain all this (and remind sw) to this new psychiatrist on the phone - they had a VERY lame excuse of there wasn't time after the meeting before school got out (?!) to make the call on Wednesday. Complete incompetence and laziness.

    So, I bring up the fact that difficult child finally had an incident in the psychiatric hospital last night. He became so angry at a peer because he wouldn't move when difficult child wanted him to, difficult child kicked the door next to the peer so hard that his ankle promptly swelled 2x its size! husband was there for a visit right after and got to see the ankle. I then point out that at "team" meeting, they said they were not seeing the behaviors that school and us see - but now what about this incident? They start going on about how he is not really injured, he was only playing it up while his dad was there and they are not seeing him being hurt at all. I interrupt and point out, while I am concerned for his ankle, my point was that him losing control to that extreme is exactly what we are talking about. They did not have any good response to that except to say that he could go on adhd medications again but that can be done outside the hospital.

    I finally asked them bottom line, are you telling me you are discharging him or not (they also went on and on about insurance concerns and offered to keep him "if we want" but if insurance turns them down, then they are sending us a bill). psychiatrist says "well, the roads are not that good today (we have a big snowstorm right now) so we will keep him until tomorrow if that helps you out." Wow, how generous~

    I asked to get off the phone so I could call husband as I wanted him to make the decision as he is the insurance holder - the sw gets all upset, "he encouraged us to call you if we needed anything!" I explained, as nice as I could, that was for if you guys wanted to ask any questions about home life, school life, difficult child's history, etc. - I told her I am NOT going to make this decision on behalf of husband when he is the one who would be on the hook financially!! Anyway, I called husband and told him - he was just as ticked off as I was. He called them immediately and told them that we can have the bus pick him up Friday morning, no problem - they told husband that he was NOT ALLOWED to set that up himself - THEY had to do it - so then when he pressed them on why not, no valid answer was given and they could not even say if this mysterious (we have never met this person or talked to) educational liason was even in the loop or even had plans to call the school!!! When husband pressed them also on why they were not making him do his school work so that he wouldn't fall behind and also so they could see his behavior - they said "that is not our responsibility here"!! Needless to say husband had enough, they have made obvious through inaction and veiled threats what their position is, so husband said fine, discharge him at 3pm tomorrow (Friday).

    I am beside myself with the utter lack of professionalism, the incompetence, and the lack of action on their part. This hospital was NOT like this last time he was there in 2008. It seems now their focus is on pumping them up with all the medications they can and then spitting them out back into the community with a one size fits all model of community care.

    Wish us luck - this was clearly a vacation for difficult child, so he did not learn anything and did not learn any new skills - he himself said "yeah they have groups, but we don't get to talk about our actual issues, so they are not helping me out." We are considering keeping him with us this weekend (it is supposed to be biomom's weekend) since it is much calmer and structured here.

    On the good side, since we HAVE to change his counseling services back to his original place, they have since added a whole new service array that includes anger management groups and SOCIAL SKILLS!!! (everyone has pointed this out as being on of the basis for a lot of difficult child's behaviors)!
  2. buddy

    buddy New Member

    :919Mad: just so sorry.
  3. DaisyFace

    DaisyFace Love me...Love me not


    I am so sorry...

    I wish I could say this surprises me, but unfortunately, we went through the same thing. difficult child stayed at the psychiatric hospital for the max number of days the insurance paid - and then she was being discharged no matter what.

    As it happened, on the day she was being discharged, she hit another patient and was confined to her room - where she proceeded to have a full-blown meltdown. Screaming, crying, banging her head into the walls. And when we arrived, the attendants told us they were SO HAPPY we had arrived because she was getting out of control. What??? Yep - they brought her out still kicking and screaming for us to take her home!

    The system is broken.
  4. tessaturtle

    tessaturtle New Member

    OMG DaisyFace! That sounds terrible! So sorry you had to go through that! I don't even know if she is correct on the insurance thing anyway because she wouldn't give me straight answer when I asked her flat out if the insurance IS already telling her that difficult child has hit his limit. 4 years ago, under the same insurance, the insurance covered 100% of his 2 1/2 month stay. I know things have changed somewhat with insurances, but he still has the same (primary is through husband, but secondary is through the state since he qualifies with his mental illness).

    Oh I forgot too, the psychiatrist said, "if you find that you need to bring him back next week, we can have him admitted again." I replied "yeah, after another 12 hour er visit...." She did not have a reply to that. Well onward we go, right?!
  5. buddy

    buddy New Member

    HOLY COW, I now will make sure I have my cell phone charged and ready to go for any future hospital stay.... thank you for sharing this. At least if they kick him out ever when he is "out of control" I will have it all on video and let them know it is going to the medical board, to the media etc. That is the most crazy thing ever. Well, sadly probably not.
  6. InsaneCdn

    InsaneCdn Well-Known Member

    Should have got that statement in writing - as in, a pre-authorization waiting at ER, so if you have to bring him back next week, it ISN'T a 12-hr wait.
    Because... what I'm reading into this is that they simply don't want him in for the weekend. That being the case, why do they have to "discharge" - can't they just send him out on "leave"?
  7. CrazyinVA

    CrazyinVA Well-Known Member Staff Member

    I'm so sorry. But count me as one that's been there done that, as well. Many of Youngest's hospitalizations went the same way. Left hand doesn't talk to right hand, lots of twiddling of thumbs, lots of conflicting answers. Different psychiatrists on different days with different plans. The worst was when one day I had a family meeting where the staff agreed with all my concerns, and said she'd probably be there a few more days, and the very next day I got a call at work to come pick Youngest up, she'd been discharged. Past tense. No warning, no discharge plan, nothing. They got snippy when I said I would have to wait until that evening to come get her, because I was working. More than once, she was discharged and then re-admitted within a week.

    It saddens me that these stories are still so common (mine took place 6-8 years ago). I suspect they will only get worse as more funding gets cut and insurance companies continue call the shots and make decisions on what "stable" means.
  8. susiestar

    susiestar Roll With It

    I wish I could say I was surprised by your experience. In many ways it reminds me of Wiz' last 2 psychiatric hospital stays. His were 2-3 days each, and didn't accomplish much. These were the ones where we got the advice to spend 1hr each night per parent doing an expensive activity outside of our home that was just Wiz and a parent. THAT would show him that we loved him. Yeah. NOT. Esp as we had 2 other kids and were not independently wealthy. It was about the stupidest koi I had heard.

    You may end up with multiple admissions before you get any real help. I know it will seem uber-pointless, but keep readmitting him. If you get enough admissions you will eventually get to a point that they start to offer some real help. It just will take a LOT of patience and time and frustration tolerance.

    I would file a complaint with whomever the director/CEO of the facility is. You should know who the psychiatrist is. Period. You should know hwo the educational person is. Period. It should NOT take a week to make a phone call to the school, it should be done the first day. Then having a meeting and agreeing on a plan, but then calling the next day to completely change the plan? Stupid and should.not.happen. List your complaints in outline or bullet form and call the CEO. You may be surprised at the results.
  9. buddy

    buddy New Member

    I agree with susie, Heck, the psychiatric hospital school person was freaked out within 8 hours that I had not gotten the school to send his work yet! They had me sign and I had her business card in the middle of the night day dong one! That should be a priority with kids and is obviously (as YOU clearly know) a huge part of their lives and stories.... how silly can they be.
  10. susiestar

    susiestar Roll With It

    I think what made me the angriest during the whole experience with the 2 later psychiatric hospital admissions was that the decision to admit was NOT made by a healthcare professional who was trained in the various problems the patients could have but instead was made by a $10/hr employee based on what the insurance co was willing to pay. Unless someone was brought in in shackles while ranting, screaming and being totally out of control and dangerous, there was NO ONE with anything above an associates (2yr) degree who was involved in the process of deciding to admit or not to admit. They had a checklist and if enough boxes were checked and the correct boxes were checked then you got admitted. Have all but one box checked and that one box was about insurance? You went home. It wasn't even as much about having a bed available.

    Part of the reason they responded to my complaints was that I claimed that their staff was practicing medicine and were not licensed healthcare professionals because the intake person decided if you were sick enough to be admitted. If she said you were not sick enough to be admitted, then you didn't get treatment. So care was being delivered based on her decisions and she was NOT a nurse or doctor or licensed anything. She admitted to me that she had a 2 yr associates degree in being a veterinary tech, but this job paid better and had better hours. Seemed she wasn't supposed to tell patients what her background was. I actually thought she was a parent or friend of someone waiting to be admitted when she told me this - it was at the vending machine outside the locked waiting room and she took her break there. I was taking a break from Wiz, who needed to be admitted but was getting very agitated by me just sitting in the same waiting room, so I went to the lobby just outside where I could see him but there was some distance between us.

    We had orders from Wiz' psychiatrist, who worked for this psychiatric hospital, to admit him but we still had to fight tooth and claw to get him admitted because this admissions person (who was about 22, so she had sooooooooooooooooooooooooo much experience - NOT) had the POWER to over-ride the psychiatrist's orders. I cannot think of a regular hospital that would allow a 22yo with an associate's degree to send a patient home after an M.D. had ordered admission to treat a problem. But that is how crazy the entire mental health system is. I think most psychiatrists are pretty sick of the system too - how frustrating it must be for them to know they spend about a decade going to school and getting advanced training so that they could send a person to be admitted to a hospital and a 22yo kid could override their orders.

    But, I am preaching to the choir here. So I will get off my soapbox.
  11. buddy

    buddy New Member

    Is he home now??? Did he go to school? How did the day go for you guys???