He might have bipolar and may be moved to a "level 14 Residential Treatment Center (RTC)"

[CAmom]

Help! The possible diagnosis isn't a big surprise, but the potential move is.

Apparently, the easy child has seen what he feels is a pattern of mood swings that aren't triggered by anything in particular. When my son first went to the group home, he had recently been placed on medication for his mood for the first time. It seemed to work as far as calming him. But, by the time he entered the home, the dose had been doubled, and it was too much for my son. The easy child, who doesn't like to medicate kids for behavior to begin with UNLESS it's for a serious problem, took him off of medications (with the psychiatrists okay) to observe him. He's done so for the past three months.

Unfortunately, since he's been off the medications, he's back to his impulsive behavior which is getting him into trouble. He hasn't done anything horribly against the rules, but his easy child said that his Probation Officer could decide, based on these "incident reports" that he isn't progressing satisfactorily in the program based on his lack of self control.

When I asked what would happen then, the easy child told me that they could take him back to JH while waiting for a transfer to a "level 14" facility where they have an on-site psychiatrist who will basically do multiple drug trials to find something that will take care of the impulsiveness but not zombie-ize him.

His easy child said that he's not in the business of kicking kids out of the program and wants to get my son back on a medication trial at a smaller dose to see if he can function better in the program. I HOPE this will work because the "level 14" facility sounds really frightening. Does anyone have more information about what sort of place this might be?

 

[BusynMember]

I know nothing about the placement, but I do know about bipolar. It's insane not to medicate somebody with bipolar (I have it). Simply put, in a manicky mood, the kid can and will get into trouble, loving the risk, and may break the law and the law doesn't cut breaks for mental illness. It should, but it doesn't. A history of substance abuse in the family tree (like his birthfather) is a red flag for bipolar. And a diagnosis. of ADHD/ODD is commonly really bipolar. The rage attacks can be part of mixed states, but the kids and adults with bipolar NEED mood stabilizers. This is not "behaviors." This is a serious psychiatric illness that the person can't control, like diabetes and epilepsy. I hope he isn't penalized for being sick and that they put him on a good first line mood stabilizer and that they cut out the mindset that somebody with bipolar is willfully acting up. I'm sorry about all this. It is sooooooooo common. People in law enforcement just don't believe that behavior can be dictated because of illness. No "program" will help bipolar--medications will, if they are the right medications at a therapeutic dose. The jails are full of people who are mentally ill. I hope your son gets the proper help. I wouldn't allow them to put him on ADHD medications, if you have any say-so. That usually makes bipolar even worse, and it certainly doesn't do anything to stabilize the mood.

 

[CAmom]

Thanks, Midwest. We're very fortunate to have the easy child that we do, and he seems very savy about the bipolar issue. My son has been off and on ADHD medications since 5 years old, and even his pediatrician neuro was beginning to feel that his ADHD symptoms were looking more like bipolar--one clue was the effect that the stimulant medications always had on him. He stopped giving my son those several years back.

The drug that my son began was Zyprexa and really seemed to help at first. It wasn't until the psyc in JH doubled the dose (I think because my son's anxiety was at such an intense level due to his situation) that he began to have problems. When he went into placement, and the easy child saw how lethargic he was, he got the psychiatric to stop the medications to see who my son was off drugs.

Now, he feels that my son may not be able to consistently control his impulsivness and that he's not deliberately being oppositional and negative, i.e., that he may have an illness.

On the one hand, I'm happy that, IF he is truly bipolar, someone is paying attention and trying to get him treatment. On the other hand, it sounds as though they may just be shuffling him off to another facility which I'm afraid will really have a devastating effect on him. I'm wondering if we should get our attorney involved. I don't necessarily have any reason to believe that they won't act in his best interest, but the thought is still there...

 

[BusynMember]

CA Mom, that would explain a lot. My son was on Zyprexa and couldn't handle it. There are many options that aren't so harsh. I think this could be a new beginning for your son. I sure hope they don't decide he's "bad" and send him to JH!!!! Crossing my fingers for you and for him.

 

[DammitJanet]

CAMom. I wanted to let you know I saw this and am going to think on how to best respond to you on this topic overnite. I am really tired tonite and just not up to doing a well thought out post.

 

[everywoman]

I'm glad that they are at least seeing that his issues are not because he is "incorrigible" but they may have some bio/chemical roots. I hope that they can find a medication without sending him to a more secure facility.

 

[Lori4ever]

I don't know what part of California you're in, but I can tell you my experience here in Southern California. My son will be 17 years old tomorrow, been on probation since age 12 for car theft. Been in and out of so many I've lost count. They refuse to put him in level 14 which is a mental health Residential Treatment Center (RTC). His lawyer said there is only one they would ever send him to. If you google juvenile camps, you should find the list. I finally had to get an IEP to get Residential Treatment Center (RTC), before I have to visit mine in prison. His list of behaviors and violations scared me to death. I hope it works for the best. I'm sorry. I hope they give him medications where he is.

 

[CAmom]

Janet, I look forward to reading your thoughts about this...I'm SO scared right now...

 

[CAmom]

Kat, I think, if they try him again on the Zyprexa, but on the low dose he started out at, he can at least get through this program which has to be #1 priority at this time. If it turns out that he needs to be on medication on a life-long basis, we can deal with that later.

I'm not sure about the logic regarding sending him to a different facility. The easy child explained it as the PO, in general, has no interest in the individual child and his/her issues, only that that child has enough control over their behavior to be allowed to return to society without re-offending. If they can't demonstrate that in the group home setting, then the "Level 14 facility" is the next step.

 

[CAmom]

Lori, I'm not clear about why they refuse to send your son to a mental health facility. Is this because they are horrible facilities, or that they are not suitable for your son and his issues?

Should we be grateful that they are considering this for our son? He does have an IEP for school, but this has never been part of it in the past. I simply have no idea what this all means.

By the way, we're in the Central Coast area of California.

 

[DammitJanet]

Ok...I took a nap!

I have no idea about the level system in CA but here in Nc we have a level system that ranges from level 1 to 4 or 5 I think. I believe 5 is either locked inside a psyc ward or maybe even juvenile detention...Im not sure. But I know level 4 is a locked residential treatment center. Now...that can be either a behavioral residential treatment center or a psychiatric residential treatment facility. My son was in a PRTF. In my mind that was much better because he had a psychiatric diagnosis. He saw a psychiatrist, had tons of therapy, on site schooling...the works.

It sounds as if this level 14 is much the same as what my PRTF was. If so, then I think that may be a good thing. Now the question becomes does your son need this? I dont know. I do know that you are fast running out of time to get him treatment before he turns 18 and anything he gets now is a bonus. I would almost be willing to stand back and allow them to do this simply to get him all the treatment you can get since time is winding down. We arent talking like they can keep him for years here.

I would ask that they start the medications with a first line mood stabilizer like lithium, lamictal, etc. Then and only then to add on an antipsychotic. You may be able to ask while he is where he is now if you can take him to a psychiatrist yourself. Or ask if you can go with him to the one they take him to. You should be able to...you are still his mother.

 

[Ephchap]

CA Mom,

Sorry about this latest. It's hard when you're not sure which direction to go, which medication, or which facility. I don't know about the CA level thing or how the Residential Treatment Center (RTC) is that they are thinking about, but like Janet, think it might be better as well.

For my son, the Residential Treatment Center (RTC) he went to was a secure (locked) facility, but they also had a smaller ratio of social worker/therapist per person (they had twelve total kids in his unit, with two social workers that each worked exclusively with 6 of the 12). The kids lived together in this one wing, they each had chores to do (one week, one was the cook, another had dish duty, and so on). They had schooling on the grounds. It really was a confined setting, but it made each of them accountable to each other, which was a good thing. If one screwed up, the others would hold him accountable. I feel that setting really helped my son.

As I said, I don't know about CA and have no experience with bipolar, but would check with your son's pediatrician, check with the local children's hospital, with your son's psychiatrist, etc. to see if they have any feedback about that Residential Treatment Center (RTC) facility. Their input, if they have any, might help alleviate any ill feelings you have about the facility. Or, if they don't feel it's a good place or a good fit for your son, then you can put your warrior mom gear on again and fight for a different placement.

I also agree that getting the medications tweaked now is ideal, since your son is 17. The sooner they can get a handle on it, the better.

Sending hugs,
Deb

 

[rejectedmom]

CAmom, I have no advice. Just understanding for how scary all this is for you.
In one sence it is good that they are really observing and trying to help your son but on the other it is so hard to have to get used to another kind of placement. I am hoping for the silver lining. An accurate diagnosis and the proper medications could be the exact thing that will give you your son back. (((HUGS))) -RM

 

[SearchingForRainbows]

CA Mom,

While I don't know what a level "14 facility" is, and I don't have anything to add to the good advice the others have offered, I just want you to know that I'm thinking of you... Please take care of yourself. Hugs. WFEN

 

[witzend]

It seems irresponsible of them to take him off of the medication that was helping him for any length of time, let alone three months. I hope that you will be able to work something out with them.

As I recall it from when M was cheeking medications, there were studies done that showed that when kids were taken off of medications and then put back on them, they don't always have the same benefits that they may have the first time around.

Either kids need medications, or they don't. It seems really wrong to take a kid off because the change in dosage went from doing well at a low dose to doing poorly at a higher dose.

 

[JJJ]

Zyprexa is not a mood stabilizer -- its a tranquilizer (atypical antipsycotic). Have they tried any true mood stabilizers yet? (litium, depakote, trileptal, etc)???

Sorry things aren't going well.

 

[OTE]

I did a quick search and found this. A "level" placement usually refers to a mental health placement rather than a detention/ penal system placement. This is old but it will give you some idea of what a Level 14 is. Honestly, if I were you, I'd push for this. This is a psychiatric facility that knows what they're doing. The purpose is to get him stable and move him on. Typically there are different levels and kinds of facilities for adults vs under 18. So he can't be in this one past 18. I'd go for it now! My motto is always don't refuse a placement until you've looked at it. Some of the ugliest places with the most awful reputation can be good for your kid. Mind you, it may take a lot of research to overcome a lousy reputation, eg if all the old staff are gone and they've got new staff and new mgmt...