On 2005-01-08 02:55:00, Perrigaud wrote:
"Niles,
Somehow I don't think that you would be satisfied. I don't think you'll ever be satisfied. Oh and if you weren't paying close attention it wasn't just me saying that we did get to experience the outer world. [ This Message was edited by: Perrigaud on 2005-01-08 02:55 ]"
Perrigaud--look, I believe that you believe Niles wouldn't be satisfied. I believe that Niles is young and *possibly* wouldn't recognize appropriate safeguards as adequate.
*However*---I'm middle-aged, and I and a whole raft of other middle-aged parents with kids of varying ages, including teens, including special needs teens who can be a handful, all agree that the current teen residential care and outpatient care system has problems and needs improvements.
One of my friends did send her daughter to a program, and did have good results.
While I might not have sent my daughter in the same situation, I agree that in her daughter's case she had good reason to be concerned that her daughter was actively a danger to herself and needed to be watched round the clock while being stabilized. It was not a totally *unreasonable* call on her part.
I have seen a kid sent to a program, and graduate, where the placement was inappropriate and it *was* a totally unreasonable call on the part of downright flaky parents.
The friend who used a program agrees that there are things about the system that could use new safeguards and could use fixing.
I have trouble seeing how anybody running an honest program and not a conjob could disagree that reforms and safeguards are needed, frankly.
For one thing, if we had governmental oversight and safeguards in place to guarantee a kid admitted to a program needed to be there and that the specific program was appropriate to the kid's needs, then it would be easier to arrange both insurance coverage for the kid's hospitalization and funding for the educational part of the program under federal IDEA legislation that requires a free and appropriate education for each kid regardless. Envision for a moment parents *not* having to lose their house to commit their dangerously unstable kid for *needed*, appropriate, competent, compassionate treatment.
Why would *any* reasonable, competent program have a problem with that? They wouldn't. Which is why when they aggressively resist even talking about reform and oversight, despite the obvious benefits to them if it's done *right*, I get *very* suspicious of their motives.
When I talk about people that might someday legitimately need involuntary commitment, I'm talking about me and my family. I don't want any of us to need it, but if we do, I want it to be done right, and work right, and not catastrophically bankrupt the family to the point that our functional members quit being functional and become yet more burdens on society.
I'm not saying we want services and we don't want to pay---I'm saying it's in nobody's best interests if the payment is structured catastrophically so that it prevents those of us who can contribute to society from doing so.
Look, a lot of the kids that are getting committed to programs maybe *are* too wild for outpatient care. But a lot of them (not all) could be served with a couple of weeks inpatient to stabilize them and then in a day hospitalization program and back home in the evening with deadbolts on the doors to reduce the temptation to sneak out at night.
With the *right* safeguards on the system, referrals to day hospitalization could be tracked and matched to make sure that supply was adequate to demand. Day hospitalization is, incidentally, cheaper to provide than full inpatient residential treatment.
Some of the kids need foster care---like the gay kid (a program staffer friend told me about him) who got placed in her program because his parents wanted him "cured" and what they really had to do was provide a safe place for the kid while they jerked a knot in the parents and told them, "Your kid is gay. He's not going to quit being gay no matter what you do. You're being ridiculous. Learn to live with it and leave him alone."
That kid didn't need a program. He needed foster care and outpatient family therapy. Which would have been a lot cheaper to provide, by the way.
Why I'm pointing out cost is that it would be a lot easier for government and insurance to help with the costs of this care for the kids that need it if inappropriate placements were being intercepted and diverted to less restrictive, effective, and incidentally less expensive alternatives.
When a kid absolutely loathes a new stepparent but *otherwise* there's not a lot wrong with the kid, foster care is an appropriate solution. It gets the kid out of the house safely for everyone, but is all he really needs.
Day hospitalization, AA or NA, family therapy, and deadbolts on the house for nighttime may work better for drug rehab (for *real* addicts, not parent-imagined ones) after the intensive first three weeks, anyway. Reason being that the kid learns to live sober around home and family--reducing the odds of relapse.
Some kids (hell, some adults) really do need to be involuntarily committed. Some people deserve to be imprisoned for the safety of everyone else in society. Fine.
Many of us who are critics really would be satisfied with specific, reasonable, workable reforms to the system.
I mean, Ginger and I disagree on methods---but if her consumer education campaign actually fixed the problem, I'd cheer and be satisfied. I'm sure if we got workable legislation that was enforced and actually fixed the problem, she'd be one of the first ones out there celebrating. Deborah and I disagree on the medication issue---but if the problem got fixed so that better therapies and better medicines were actually helping the kids that needed each respective solution (with fewer risks and side effects) and the problems with the programs got fixed, hey, I'd take her out to lunch with cake, confetti, and streamers.
And wouldn't *you* cheer if a safeguard process *also* meant that in cases where the kid really did need inpatient care it was not only quality care but the parents got more financial assistance so they weren't spending their savings for the kid's college?
Really, wouldn't you cheer?
Niles heart is in the right place. And he's mostly on the right track. Is he young? Sure. We all are or have been, and we all get over it.
I have more faith in him than you do, though. I think if the safeguards were there, that there would be a lot more fun things to do in this world than stand around and bitch about something that wasn't a problem anymore.
Look, I'm glad you feel well-served and came out okay, but does that have to be a reason not to fix the parts of the system that are broke? What harm would it have done you if in the first 48 hours you were there, yet another shrink came by, talked to you, looked at your record, and said, "Yep, you're in the right place" if some kid who *didn't* need to be there got a less restrictive treatment as a result?
I've got a friend who's divorced and has a daughter who's a cutter. My friend has legal custody, but the daughter was living with dad and was starting to have teen social conflicts with dad. Dad hospitalized her against the advice of the girl's psychiatrist, mostly to get her out of the house (loves her, but was overstressed and is rather immature). Mom faxed the hospital the custody papers and went and got daughter. Daughter is getting treatment, is in a less stressful home environment, and is cooperating fully with outpatient treatment program.
Sometimes the person who wants to take the kid *out* of the program is right. Or right enough.
Can you really say the current system is so perfect that it can't stand a few reforms?
Timoclea