The answer should be yes. Not "how can I get my loved one help?"

Category Archives: acceptable practice

Against Medical Advice

Against Medical Advice.

It’s been two years since this happened. Two years ago he was discharged against medical advice, 

The only thing bad about mental health is the way we treat those who have mental illness.

David was discharged from the facility in another state because the insurance people who create the Certificate of Need decided that he wasn’t making any progress and needed to go home.

This week, he will be discharged from a different facility.  Not because of the Certificate of Need.  But because the facility says he doesn’t need support and should be sent home.  How can David continue to see the successes he has seen in care if he comes home to no support?  Even David recognizes that he needs support.

I don’t understand how so few can over power the recommendations of so many doctors.

Bad Parent

I am a bad parent.  It’s a title my wife and I wear with honor.

What makes us bad parents?  We are fighting for the 24/7 supports that 3/4 medical professionals say he needs.  The people who provide said supports and the funding to pay for them have chosen to listen to the one psychologist who says he doesn’t need support.  It’s not easy for us to fight to keep OUR SON in care.  But we will fight for the care he needs.

So we are looking at a discharge against medical advice.

How we treat the mentally ill

Now, I am going to make a general statement.  If David had cancer and I decided to pull him out against medical advice, I would be facing the fight of my life and his to make that happen.  There would be no question about it.  So.  Why is mental illness treated differently?  David doesn’t have cancer.  He does have mental illness.  I am not saying it’s worse than cancer.  I am saying that like cancer, mental illness needs appropriate treatment by qualified personnel.

The future

In the end we are left with few options.  David will come home.  Things will be good for a week or two or six.  Then his world will fall in on itself and we will be right back where he was two years ago.  Violent. Stealing. Aggressive. Narcissistic.  David will be 16 this summer.  Some of the things he has tried and done in the past could land him in adult court.  Prison is no place to get mental health care.

 

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Destroying Success – please pray that we aren’t

I title this post “Destroying Success” for a simple fact.

English: Causal loop diagram - system archetyp...

English: Causal loop diagram – system archetype “Success to successful” (Photo credit: Wikipedia)

David has been in facility based care before.  He has been discharged from such a care to home three times out of the 5 placements he has had.  Each time home has resulted in behaviors so volatile that he experiences frequent trips to the mental health unit at the hospital in the city, frequent visits by law enforcement and many trips to safe bed.

By volatile, I mean violent aggressive behaviors, not to mention stealing, forging and other activities like trying to kill pets.

So he transitioned to his current placement in late June of this year.

He is successful.  He is always successful in placement.  Sure he has rough periods, but what teen doesn’t?  Heck, I would wonder what was wrong if he didn’t have rough periods.  So why would you destroy the safe world that he is in right now by sending him home?

I get least restrictive environment.  Believe me, I know what the phrase means.  When it comes to the success or failure of his life experience, I would much rather see him be successful.  Right now success occurs in care.

Today we were told that since the goal of the new placement is reunification, that if we didn’t bring him home for passes and visits, then they would just discharge him.  Passes and visits aren’t the issue here, the issue is two fold.

If he gets violent.  What do we do?  The only people he regularly attacks are family.  We call law enforcement.  Sure.  Great.  If they are on the other side of the county it can take them an hour to respond.

So they say we can bring him back early, if we have difficulty or he misbehaves.  Right?!  because transporting an angry, upset and hurt child 60 miles is a good idea?  Hey, lets get law enforcement to do it.  Because they are mental health professionals – right?!

I know. I am making excuses.

The other issue.  David knows exactly what he has to do to get out of care. How can they not see that?  He was discharged 18 months ago from a facility against doctors orders because insurance and medicaid wouldn’t cover.

I get that he isn’t exhibiting behaviors, and really, I am quite happy that he is doing so well.  But please, for his sake, don’t sabotage that.

In fairness to David, we, meaning both at home, and him in the facility, really need to work on our communication skills.

So we are going to try.

We will bring him home on pass.  Please pray that he continues to be successful.  Because in the end, all I want is for him to be able to live a happy well rounded life that is generally trouble free.  Don’t be destroying success because he doesn’t fit your mold of what should be in your facility.  I don’t know that this is what staff are doing, but he really hasn’t been there long enough to get an idea of who David really is.  Right now he allows them to see what they need to see.  Hear what they need to hear.

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Playing with fire

I feel like we are playing with fire here.  Admittedly, David also likes to play with fire.

David admitted to that too.  We had blamed another child for the small fires.  David claims that it was him that did the deed.  We have not had any of the fires during any of the periods when David has been in facility based care.

What methods can we employ do we deal with that?  Sure we can keep all matches, lighters, knives, candles, and other things that could be used to hurt the family, but at what point does it become too much?  In what reality is it fair for everyone in the house to live in an environment like this?  Why should the other kids feel like they too are being punished for David’s deeds?

Safety and Security

Sure we can fill the house with fire extinguishers, we have smoke detectors and other things like places where we can lock

Smoke detector

Playing with fire

up knives.  But what if he lights a fire while everyone is sleeping?  Even as much as I stay awake when he is home and sleeping, even I can’t stay awake all the time.  It would kill me to try.

Plus he is smart enough to know how to disable things like smoke detectors.

We can put alarms on his doors and windows, but he is techy enough that he can figure out how to get around those devices.

Reasons and Logic

I can think of so many reasons why he shouldn’t come home.  Then too, are the reasons why he should be able to come home.

Regardless of what I, the facility, or the state want, what keeps people safe? What is best for David?

How can he learn to interact in public without being able to be out in public like his peers?  What can we do to help him learn that it is not acceptable to try to kill other living creatures, including people?  How?

At the end of each day, I only have more questions. More fear.