Help please, need placement suggestions

[erbaledge]

Gfg15 was hospitalized July 25 to July 30. Her last hospitalization was in April. Both times she went because she said the voices she hears are telling her to kill herself or hurt herself.
This last hospitalization she reported some feeble attempts at hurting herself - 1) tried to 'smother' herself with her pillow. 2) tried to 'strangle' herself with her bare hands. 3) she did quit eating for 24 hours. We (staff and I) were considering the hospitalization with the no eating added to the mix, but then made our 100% decision when she threatened to run from her current PMIC placement.

Okay, so that was the short update. I need resources to look for other services for her. Either boot camps or better PMIC placements. Because as we stand now, after I talked with the 'head' lady last week - it appears that they may want to send her to someplace is Iowa because she is not progressing at the PMIC, and they do not feel that they may be the best placement for her (I pretty much agree). I am somewhat kind of going okay fine, if she goes to the Iowa program, she'll get a 30 day evaluation - and maybe that would help pinpoint maybe better diagnosis's and pinpoint us in the right direction for the best treatment possible for her.

I also have a counselor that my other children see, she's going to ask around with her colleagues about other resources/placements that would best suit gfg15. She did mention she knows of a patient that went to a place out in Florida, however, that is so far away, I'd prefer something Midwestern so I can actually see my daughter.

But what I wondered from some of you: do you have any recommendations of places? (names and location of the place please) If she goes for this 30 day evaluation, or even if they suggest somewhere else, I want to have confidence in where she'd go, or be able to offer the best/better solution.
She needs/we need a place that can fully evaluate her regarding these voices she hears to find out if they are REAL or more of an excuse to use when the going gets tough. (however being that she reported them every day during this last hospital stay it makes me think they may be)
And also to address her overall issues, as she is really oppositional to all services we've provided to her.
Help? And please feel free to ask me questions. (and yes, I've addressed any medication concerns to my best ability)

Here's the main thread I have on here about her: http://www.conductdisorders.com/forum/f6/theft-problem-childs-33801/index5.html#post364134
However it does not cover it all.

TIA
Patty

 

[BusynMember]

Have you tried Day Treatment? I doubt they'd keep her in a boot camp. She isn't bad...if she hears voices, she is mentally ill, and boot camp isn't going to change that, plus they don't really like to deal with kids who have mental health issues.

I think your best bets are Day Treatment or long term Residential Treatment Center (RTC) mental health placement. If she is hearing voices, she really needs a medication switch. Is she taking an antipsychotic? Certain medications can even CAUSE hallucinations. Can you please list her medications? That would help us help you.

Hugs...good luck.

 

[smallworld]

Hi Patti,

I needed to edit your post to delete the name of the facility you are considering in Iowa. Our board rules do not allow posting the names of doctors or facilities. Furthermore, if members have suggestions of facilities for your difficult child to attend, they need to send them to you via PM.

In general, I agree with MWM that your difficult child would not do well in a boot camp. She would not receive psychiatric care in a boot camp, which she desperately needs to address her hallucinations. The mainstay of treatment for hallucinations is antipsychotics (Risperdal, Seroquel, Abilify, Geodon, Zyprexa, Invega, Saphris, Fanapt). If she is on an SSRI antidepressant, that could be causing hallucinations.

What is a PMIC?

 

[erbaledge]

Oh, yeah, she's had several stints at various Day Treatment programs.
PMIC - Psychiatric Medical Institute for Children, I believe is the right definition. I believe it is also the same as Residential Treatment. This is her second stint at a PMIC placement.

Sorry Smallworld, I didn't know about not posting names of facilities.

I know you have many times mentioned her Lexapro could cause her hallucinations, however I have specifically asked & talked with her current psychiatric and also the treating psychiatric at the hospital stays - and both assure me that is not what is causing her hallucinations.

Current medications:
Abilify
Clomipramine
Lexapro
Clonidine - this was added at this last hospitalization - 0.05 mg I believ

 

[erbaledge]

Here's just a list of services she's had:
In-patient hospitalizations ( I believe 3 total, one at age 8, one in April of this year, and one last week)
Out-patient hospitalization program
PMIC/Residential Treatment - 2 stints, one current, and one at age of 9
Individual Therapy
Family Therapy
Play Therapy
Art Therapy
Anger Replacement Therapy
Day Programs - she's been to every single one in our vicinity, a total of like 3 or 4 different ones - never really 'graduated' from the programs
When she was at home prior to this most recent PMIC placement, we had daily visits in the home with help

So ya, I'm at my wits end and completely lsot on what to do now.

 

[smallworld]

The way to tell if the voices are real or not is to have her undergo projective or personality testing with a neuropsychologist who does this type of testing often. It will be able to test how reality-based her thinking is.

 

[erbaledge]

The way to tell if the voices are real or not is to have her undergo projective or personality testing with a neuropsychologist who does this type of testing often. It will be able to test how reality-based her thinking is.

This is good information. Thank you! Looks like I have some research ahead of me for tonight. Does anyone know, do you have to be referred to a neuropsychologist?

 

[smallworld]

My children didn't need a referral, but their psychiatrist gave us the name of a very good neuropsychologist who was very skilled in projective testing.

 

[erbaledge]

I do have a question about this Smallworld - would these have been tests that they did during her 4 hour psychiatric & educ evaluation? Though that was about 2 or 3 years ago now. Just wondering what I would be looking for on the evaluation paperwork, as I do have it and will scrounge it up later.

 

[erbaledge]

Okay, here is what it says:

Basis of Evalution:
Record Review
Behaviorial Observation
Clinical Interview
Reynolds Adolescent Depression Scale - 2nd Edition (RADS-2)
Wechsler Intelligence Scale for Children - 4th Edition (WISC-IV)
Team Consultation
Parent Consultation


Looking at that list, I do not think any of those are the testing that Smallword is talking about, but I could be wrong.

 

[smallworld]

No, it doesn't look as if she had projective testing. Furthermore, when did her hallucinations begin? If they began after the previous testing, you'd need to repeat it anyway.