I am requesting that my son be released from probation so that I may access urgently needed assistance for difficult child myself if the court cannot order FAPT or placement in XXX Residential Treatment Facility. Attached are copies of letters from my son's psychologist, psychiatrist, and the social worker at YYY, the psychiatric portion of ZZZ hospital, where he was just discharged from last evening.
difficult child was hospitalized at YYY, an acute care facility, after being TDO'd on December 18, 2008, for self-harming behavior and again on January 13th, willingly, after I called the police due to difficult child becoming aggressive at home. His difficulties the past few months began with signs of serious depression last October and worsened with medication changes to address the depression and a physical illness that could have lead to asthmatic wheezing. He has experienced increasing mood lability and instability and has missed over 20 days of school this school year. He has not been arrested during this time for any illegal actions and has not posed any behavioral difficulties at school.
As difficult child's sole care-giver and mother, I am increasingly concerned that I cannot continue to keep him safe from himself, ensure that he stay directly supervised at all hours of every day, prepare and attend all appointments and meetings necessary, prevent a crisis or illegal action, and as a result of making these efforts without assistance, I am unable to work enough hours to financially cover household expenses and private insurance costs. Please note that when my son is manic, he might stay awake for two days straight and it requires staff who are awake to provide a highly structured environment and supervise his actions during those periods. At other times, he self-injures and speaks of being overwhelmed and not being able to handle his life.
Apparently there are many types of in-home services, not just MST as was previously ordered and removed due to not being an appropriate type of therapy for difficult child. However, in-home therapy alone will not solve all these problems and can only be minimally helpful until mood lability is stabilized through medications. Once stability is regained, in-home services might not be necessary. For these reasons, I personally believe a temporary placement with full time psychiatric and therapeutic staff is in his best interest at this time.
I filed a request for a hearing due to a Child in Need of Services on Thursday, January 8, 2009. I have since learned from the clerk that this was denied because I needed to speak with CSA and DSS. I had spoken to Ms. ABC, the county's CSA coordinator, in December, 2008, and was told that any services requested and needed must go through FAPT, and that FAPT can be referred by either Children Services Board (CSB), DSS, the school system, or Department of Juvenile Justice. Below are the responses I received from these agencies:
Children Services Board (CSB): According to DEF County Mental Health, Children Services Board (CSB) is not accessible to me without changing difficult child's private mental health care providers to the county's providers and allowing them to start over with evaluation and treatment first. If their treatment is not successful, they would determine if Children Services Board (CSB) and ultimately, FAPT should be recommended. Due to the length of time involved to go through that process and the urgency of difficult child's needs, I have sought other avenues.
DSS: I have spoken to three social workers from DSS. One was regarding obtaining a waiver for difficult child to receive Medicaid, which funds more services and relieves me from paying for his high cost of medical insurance out of pocket, which I can no longer afford because I have not been able to work full time hours in almost two years. Apparently, difficult child cannot get this waiver. The second social worker stated that DSS cannot get involved in referring services thru FAPT because I do not abuse or neglect my child. The third stated that I could pursue a temporary parental placement into a more therapeutic environment and/or family preservations services if difficult child was not on probation, but that I do not have control over his placement as long as he is on probation.
The social worker also indicated that the FAPT team, if accessed, would probably follow any recommendation from difficult child's probation officer and that the probation officer would be difficult child's case manager, instead of getting a mental health case manager. Given the nature of the problems, the fact that the probation officer is not a mental health professional, the difficulty reaching the probation officer by phone, and the fact that she has been aware of difficulties and has not pursued additional services to date, this concerns me greatly, as I am held accountable if difficult child's needs and recommended services are not provided.
School: The principal at difficult child's school attended a school meeting earlier today regarding this matter and it was decided that the school would not recommend FAPT for this matter. However, Ms. ABC was there and relayed through the principal that I needed to access FAPT through the probation officer for any services requested, other than Residential Facility Center placement.
Probation Officer: I am not aware of any action by the Probation Officer regarding this matter. She did previously inform me that she would have ordered FAPT if she had thought it was needed. It is my understanding that the social worker at the hospital also tried to contact the Probation Officer regarding placement and getting funding for recommended services but received no response prior to discharge.
The Probation Officer has been kept informed of difficult child's mental health status, recommendations from his psychiatrist and psychologist, hospitalizations, my requests to obtain help at home, and some of my financial difficulties resulting from meeting difficult child's needs and court requirements. difficult child and I have complied with all rules of probation with the exception of one incident where he left home without permission and I reported that to the Probation Officer, as well as punishing difficult child myself.
Other: I have been trying to look for other options since October of 2008. I pursued an opportunity to get services for difficult child through the National Institute for Mental Health but he was disqualified due to the fact that he is on probation.
As you can see from the attached letters, difficult child's individual therapist recommends placement at home with additional services (financial, therapy, respite, etc) provided through FAPT. The hospital staff recommends pursuing either more extensive services at home or medication stabilization at XXX Residential Treatment Facility where they have full time psychiatric care in addition to educational, therapeutic, and behavioral components.
If an immediate placement into XXX Residential Treatment Facility (RTF) is not an option, I am happy to have my son at home if necessary assistance in areas of crisis prevention and intervention, supervision, financial, and mental health care are provided until stabilization is again established. When I discussed our situation with Ms. ABC last December, she suggested an informal brainstorming session with FAPT to determine which services might be appropriate and available, in addition to maintaining the private services already in place.
I respectfully request that you hear this case at your earliest convenience. It is my sincere hope that you can and will help me obtain more appropriate services for my son.
Thank you for your consideration in this matter,