Treatment refusal .... update

[timer lady]

So here's the scoop on kt's refusal to enter treatment last week - turns out she can do it. She's also talking back & forth about becoming an emancipated minor. Get the feeling she's learned a bit in Residential Treatment Center (RTC) this last stint?

Last week Wednesday there was a bed at a Residential Treatment Center (RTC) open for kt (an all girls Residential Treatment Center (RTC)); kt refused to go. We had no recourse as she wasn't out of control so I couldn't call the police for transport. The psychiatrist can push for admit (which he did) but if kt refuses to go.....

Mental health CM did his best to force the issue; even went to court to try to get a judge to order treatment. Our best response is that kt is not an immediate danger to herself or others.

The team believes that kt's "best friend" is pimping kt out. kt believes everything this "friend" tells kt & is so naive that she's sure this time the guy will turn out to be her one true love. As far as we can ascertain, kt is not getting money out of this - the local police are getting involved. There was a video (disgusting) on kt's computer that showed a man in her bedroom however kt isn't naming names nor is her "friend".

Of course kt is telling everyone & their brother that I cannot hear at night - those she's told are inviting themselves or kt is inviting them over for a party & other things. That has since ended.

The treatment team came up with a contract. Mental health CM told kt that the county was demanding a contract that kt signs. If kt doesn't comply the consequence will be to follow the teams plan for out of home placement. kt will not be able to refuse. kt signed the contract & there were 3 witnesses.

In the meantime, I have to ask for a GAL to appeal to the court on kt's behalf if another bed opens & kt once again refuses treatment.

 

[klmno]

This sounds like the best plan you could hope for given the circumstances. I'm sorry it has come to this but I swear, I don't know that we parents have too many choices with difficult child's in today's society.

 

[tiredmommy]

How can her behavior not be construed as dangerous to herself?

 

[klmno]

I found that here, they have another criteria for admittance to a psychiatric hospital- it's called "deteriation of functioning" or something like that. I'm not sure how enforcable it is if the person is refusing. But I wonder if it wouldn't fit your (kt's) situation.

 

[crazymama30]

While she is not a danger to herself (or so they say) she IS putting you at danger. I know here people can be committed if they are a danger to themselves or others. Would that work?

 

[gcvmom]

I'm with TM. How can sex or whatever... with a stranger NOT be putting herself in danger?!

 

[KTMom91]

Linda, I'm so sorry. I'm with gcvmom...how can her behavior not be considered dangerous to herself, especially if she IS being pimped out? And having half the town over at night is a definite danger to you.

For emancipation, don't they have to prove they can be self-supporting? That was the stumbling block for Miss KT, when I pointed out that emancipation meant supporting herself, paying her own bills, etc., and she wasn't going to be living here, getting room and board.

 

[flutterby]

Linda, I'm just dumbfounded.

A contract? Now? I get the point, but it seems a bit late in the game.

She is most certainly a danger to herself and others (you). Sigh...

I'm glad the police are involved. I really don't know what to say. Your team always seems to be so on top of things, but they dropped the ball in a big way this time.

 

[Hound dog]

(((hugs))) Linda. Sorry I'm getting in a bit late. I've been following to some extent from a distance.

Since when is deviant sexual behavior from a 15 yr old not considered a danger to herself?? And sneaking strangers into the house during the middle of the night is most certainly a danger to you both. UGH! Why do I get the impression if this was the judges kid they would see things differently? Makes me so darn mad.

How old is this boy? Any chance he can be charged with child porn?

You and kt are very much in my prayers my friend.

 

[DaisyFace]

Linda--

This whole situation is outrageous!

KT is a MINOR! How can she be calling the shots???

And regardless of witnesses, a minor's signature on a contract is worthless.

So what is the point of all of this? With every screw-up, I'm sure that KT is just feeling more and more empowered. She can do what she wants. Obviously nobody can stop her....not her mother, not her doctor, not an entire team of professionals--certainly any contract is going to be just an un-enforceable. {{How's that conversation going to go, anyway? KT is still refusing treatment. But she signed a contract a couple of weeks ago. She signed a contract? O well in that case, NOW we can force her into treatment.}}

And you are just supposed to live like this? Letting her do as she pleases? Continuing to provide for her despite her behaviors? Continuing to live in fear in your own home???

What would everyone do if suddenly you were not available to be KT's support system? I'm sure she is not capable of truly being "emancipated"--no matter how much everyone is acting as if she is the adult.

Linda--

Perhaps it is time for YOU to request treatment for yourself. Something residential ...

 

[CrazyinVA]

I learned this the hard way with youngest. "Danger to self or others" means, *immediate* danger. If she wasn't in danger of hurting herself or another person on that particular day, she didn't get admitted. Likewise, once they declared her "stable" and not in immediate danger, they released her. That's just the way it works. With mental health cuts and bed shortages, I suspect it's even worse now.

 

[gcvmom]

So essentially, TL would have to catch KT in the act and call for her to be admitted at that moment, right?

 

[CrazyinVA]

Well, the assessor makes a determination as to whether the danger is "imminent." Catching in the act isn't even enough, if they think the moment is gone and no other danger exists. It's pretty subjective, if you ask me. Sometimes I got a TDO (temporary detention order) for a suicide threat, other times time I didn't. That didn't stop me from calling on each and every threat and documenting it until I finally got her into residential treatment. Even then, of course, she had to consent, because she was over 14.

 

[Marguerite]

Hidden cameras in kt's room maybe? At least it would gather evidence for the police... you'd have to put the camera in place while she's at school, maybe hide it inside a book on her bookshelf.

Talk to the police first about this, make sure it's legal. But it could be a way to catch someone doing something illegal.

Marg

 

[Hound dog]

I still would like to know the brilliant mind behind thinking a teen is qualified to decide if they need treatment or not. I'd like to know I can take them out back of the barn and knock some horse sense into them.

I think Marg's camera idea is a good one. Even if it doesn't help her get admitted, it may help catch those involved.

Hugs

 

[slsh]

The original reasoning behind the ridiculous age of consent for psychiatric treatment was so that children who were being abused could seek out treatment without parental consent (to cover kids who were being abused by parents). Unfortunately, the flip side of that coin is that children who can authorize psychiatric treatment can also refuse it. Age of consent varies by state. Here in IL, it's 12. You can imagine my joy when upon admission to Residential Treatment Center (RTC) #3, the admission clerk made *sure* to advise thank you of his "rights". Barf. This archaic law also doesn't take into consideration the competency of a mentally ill child to give or not give consent in the first place. And this law also became a major thorn in a lot of our sides when HIPAA came about, because HIPAA defers to state law. Therefore, once your child legally hits the age of consent, you no longer have any right to his/her medical information in terms of psychiatric treatment *and* insurance companies can get really stupid when you try to get bills paid for minors who have the right to consent. In IL law, there is a loophole at least in terms of getting bills paid, but our insurance was woefully ignorant of the law. I finally kept a copy of the statute in my desk and faxed it to whichever genius I was dealing with. I adamantly refused to get an authorization for release of information signed by thank you - I thought it would set a bad precedent in terms of reminding him that he was actually in the driver's seat.

Interestingly, if you obtain guardianship of an adult child, the HIPAA garbage doesn't apply in terms of psychiatric treatment. By virtue of being guardian of an adult, you have the right to access that information. Just can't for your minor child.

Anyway - Linda, it sounds like the team it getting creative and that's something. I would bet that the "contract" isn't legally binding because she's a minor (Catch-22), but let's hope no one points that out to her. And even if she doesn't follow the contract, they're still not going to be able to force a therapeutic placement.

Emancipation? Good heavens.... she certainly has been paying attention to her peers. Darn it, LOL.

While her behavior is without question dangerous, I understand why they can't force treatment. She isn't a danger to herself or others in the technical sense they use for involuntary hospitalizations. She's making horrific choices, but.... just like you can't force substance abuse treatment, you cannot force treatment for this kind of behavior.

Linda, your girl sure has taken you to some very difficult places. My heart aches for you. There's a stunning lack of common sense, in my humble opinion, when it comes to placing and treating our kids as they get to the brink of adulthood. The cynical side of me says there's a method to state agencies' madness. Children like ours don't tend to end up on the books as adults needing or obtaining mental health services, because of their noncompliance and baseline thought disorders. I think it's horribly short-sighted, because I think the cycle will continue on. Decompensation, admit, discharge, decompensation. Lather, rinse, repeat.

My main concern is for your safety, Linda. I'm glad you've been able to shut down her late night socializing. The thought of strangers in your home terrifies me.

Hugs.