Tim had a bad day yesterday, and I fear we’re seeing the start of the usual Winter cycle. Apparently he asked for his PRN in the morning because his voices were “loud,” but by 3:30 in the afternoon, they’d worn off. He got in to it with a new staff member at his group home, so aggressively that the guy called 911 for help because he couldn’t get backup from another group home on the grounds fast enough. By the time the police got there Tim was calmer, and had another PRN.
Today, his caseworker called me to recap the incident for me, and to discuss Tim seeing a psychiatrist for a possible med change we’ve been discussing for a few weeks. After last night’s incident, he should be seen by a doctor to review his records from last Winter when his psychosis was heightened to see if we need to tweak meds to help him through this Winter. BUT – the staff psychiatrist at his RTC retired three months ago, and they haven’t found a replacement for her yet. His caseworker said they are contracting with Children’s Hospital to fill the gap, but he talked to them today and the first available appointment they have is in March. MARCH. That will make six months since Tim, in a Residential Program for kids with mental health issues, has seen a psychiatrist.
His caseworker asked if Tim’s psychiatrist from before RTC would see him, and I said I could call him, but I can pretty much guarantee he won’t tweak any meds if Tim can’t be around to be monitored. And then I told the caseworker to have an administrator from the RTC call me, because this is bullshit.
So, what do we do now? While I wait for the administrator to call me, I debate calling our SASS worker to start looking for another RTC for Tim. I mean, seriously – how can they go SIX FREAKING MONTHS without a staff psychiatrist? This is my least favorite part of Tim in residential – the feeling that I don’t have any control.
The best bet is for me to take him to his pdoc down here near our home, the one he saw monthly for years before going into RTC. But I doubt he would change up Tim's meds without Tim being able to come in monthly, and it's a 4 hour round trip to get Tim, bring him here, and then get him back.
I can't talk to Tim until after school today, that's the next thing. I'm sure he won't want to switch, but he's not going to equate not having a pdoc there with being a big issue.
I also agree – he saw the pdoc on staff there monthly before she retired. Now it's been months since ANY kid there has seen one.
Would it be easier to get in to see a psychiatric nurse practitioner somewhere near him?
We have a psych ER here & they will adjust meds until a new pdoc appt can be made – is there anything like that in between you and Tim?? – I would ask your old doc if he would do a record review from last year & make med changes based on that – I would see about a cancellation appointment with the other place & I would see if another pdoc could see him – maybe even an adult one – he is old enough for that – After that – I would chew someone a new one b/c if they had made the new appt when the old doc left, then he would have one now – given what seems like a 3 month delay – How badly would a new facility rock his world? If the med piece was ok, would you be considering moving him? If no, then no, I wouldn't make a move – If yes, then I would – thinking of you
Kris, I just left a message for his old pdoc near us. This is so infuriating. Anna, that's a thought – I just got the form the clinic near his RTC needs filled out to see a doc and, ugh, I am experiencing the pain of a shortage of pediatric psychiatrists first hand. What a nightmare.
A new facility would rock him pretty hard Kris, you're right. I guess I'm thinking that we will probably have to move him in 6 months anyway because they will likely not have a space for him at the 18 and over group home where he is, and he turns 18 in 6 months, so why not accelerate it? I'm just so irritated that they had to call the police on my kid because his meds are off because they don't have a pdoc.
I just think its amazing they can give these powerful psychoactive drugs to a young man without regular medical monitoring. They all have side effects, so its really not safe just to keep the old prescription going indefinitely without review.
A real shame they got police involved. That does make you wonder if they are really in as much control of the situation as they think they are.
Good luck with getting hold of a psychiatrist.
Jules – YES. He should be seeing a pdoc monthly at least. I'm on the warpath now.
I've been on a waiting list to see a psychiatrist for 6 months. I'm in this limbo where I need help a GP can't provide, but I'm not so messed up that I get forwarded to primary care.
I sometimes get tempted to just walk into a hospital and demand psychiatric care but I have this fear that they won't let me out. I know it sound like a cop out but I really wish there was someone who could sort my situation out for me. As advocates go, you sound like a great one, and I know you'll get Tims situation sorted out one way or another.
That's TERRIBLE Chrisa and completely ridiculous! Not right! I don't get how they can get away with that.
What is there to say but AAAAARGH!?! How unbelievably frustrating.
No illness but mental illness, I think. Thank God for Tim that he has such a hardcore mom who will advocate for him no matter what it takes.
6 months without a psychiatrist is disgraceful. They would never allow a cancer ward to go without their specialists, how is it that our mental health is so messed up????
Hi Chrisa,
First, my heart really goes out to you. Have you considered filing medical neglect?
My son is also in a group home and recently told me that he did not understand why for the last few weeks he had been receiving 2 pills in the morning vs one. I called the group home and found out that they had been mistakenly double dosing his zyprexa in the AM. This isn't their first error.
It's a difficult enough decision placing our children in someone else's care (heart breaking) and I know we shouldn't expect perfection but this is inexcusable.Our children suffer from their negligence and at some point they need to be held accountable. I'm just so tired of trying to find quality care (or any care) within such a broken system.
Hasn't anybody there heard about Intervoice? What you describe is absolutely disgraceful for an institution that is supposed to help people cope with their voices.