After the Crisis
There are so many possible outcomes after the crisis is over, that it would be impossible for me to cover them all in detail in just one blog. So instead, I will briefly outline some likely scenarios: favorable and others not so much. No matter what final decision is made in the Emergency Department (ED), make sure your child’s Therapist and Psychiatrist are aware of the situation and kept informed. An open and honest avenue of communication with these professionals will make the follow up treatment so much easier.
Prior to being discharged from the ED, a safety and treatment plan will need to be created. The complexity of the plan will depend significantly on what your child needs, once the most severe symptoms are treated. I will discuss a few that my family has experienced over the years, from the least intrusive to the most restrictive.
- Homeward Bound: The simplest and most common outcome has been that our child was discharged with a safety plan in place requiring additional parental supervision and a follow up appointment with his Psychiatrist. In most cases, a medication evaluation is recommended. You may find yourself frustrated by spending so much time waiting in the ED for this outcome, but I remind you of the possible tragic consequence if you had not sought help.
- Intensive Outpatient Treatment: This is a much more intense and intrusive therapeutic option without removing the child from the home. There are several ways this type of therapy can be provided.
- In-Home Therapy – A form of intense therapy, where more than one therapist will come to your home to provide individual and family therapy. This usually involves 10-30 hours a week in the home with all family members. We have had mixed results with in-home therapy. It requires a major commitment on everyone’s part, not just the child. For this to work, you must have an open mind, and be agreeable (personally, I would prefer willing or open, but it’s your decision) to change both habits and your frame of mind.
- Day Treatment – A combination of school and therapy, day treatment provides an emphasis on coping skills and strategies. This type of treatment is especially useful when a child is struggling behaviorally and emotionally in a school environment. Day treatment can be a short term step-down service or a long term schooling alternative.
- Inpatient Hospitalization: A short term out of home placement in a medical facility for supervised, controlled medication treatment and stabilization. Now that’s a mouthful! Again we have had some mixed results depending on the facility. Our experience with a Children’s Hospital has always been stellar in regards to treatment and communication.
- Residential Facility: One of our least favorite options. This long term treatment is reserved for when nothing else has worked. Residential Facilities are used in conjunction with the legal system for a few reasons. First, the cost alone would make a person faint in astonishment. I personally have not seen a private insurance policy willing to cover this treatment. Second, these facilities are reserved for the last possible resort. Despite the common misconceptions, Social Services would prefer to keep a family together.
I know this has been a lot of information to process, but keep your head up. As I mentioned at the beginning of this 3 part op-ed, you are not alone. There is a wealth of knowledge and support available, no matter what form it comes in. Ask your mental health provider about local groups in your area. Also, check out some of the helpful online groups below:
- Support Group for Parents/Guardians of Children with Mental Health issues