Program Parents often try to shrug us other parents off by saying we don't know and saying we're radical extremists who think all care is bad.
I've said, over and over again, that as a woman with bipolar disorder, with a child with bipolar disorder, and a lot of people in our family with it and bipolar-spectrum problems, that quality care is the bottom line.
Well, unfortunately I am now in a position to elaborate.
I have Katie's permission to tell the following:
A couple of weeks ago, we had to hospitalize Katie because she needed it. I'll give you no details except to say that I would have needed to be hospitalized, and would have been hospitalized, in the same situation. I'm retaining the details for her privacy.
Now we come to James and I putting our actions where our mouths have been.
First, we called a friend whose friend is an EMT to make sure that Katie wouldn't be sent from the ER to Georgia Regional Medical (you've heard about them in the news). Then we called Katie's pdoc to say we were having to take her to the ER and he said, "Why don't you just take her to Ridgeview?" Then he called ahead for us.
This is what quality care looks like.
We get there and there are no walls or gates or anything, but there are signs and arrows directing visitors to various different buildings, one of which is for admissions.
Immediately, it is obvious that this facility has the ability to serve pediatrics up through all of adulthood--not just eighteen to twenty-low-something. Yes, this is the facility I would be hospitalized in if it were me instead of her.
Okay, so we go in and the buildings are nice, the furnishings are nice, the staff are professional, as we go through the admit procedure. They then tell us that they do have a bed for her, and walk us down to the cottage for kids and teens.
The grounds are green, the plants are lush, there is a lot of artwork on the walls. The doors are locked, and there are signs on the doors to keep them that way. We pass the dining hall on the way. It's also nice.
We pass a coke machine on the sidewalk between the dining hall and the cottage.
In the cottage, we check her in in the day room in front of the nurses station. The day room has posters and pictures on the walls. The carpet is nice. Everything is in good repair. Colorful flower decorations hang from the ceilings. The center area has two big square areas of plants surrounded by benches, like you'd see in a mall. The tables have chessboards printed on them. Then there are couches, comfy chairs, and low tables on both sides, with a TV in the corner. We're showed which side of the dayroom is the boys' side, and which the girls' side, and told boys and girls can't talk to each other outside of group. (Yes, boys can talk to all the boys and girls can talk to all the girls from day one--these adults are sane, not Programmies.) There's a water fountain along the wall.
The facility does have kids with drug abuse problems, too. Thing is, they've got a substance abuse track, a mental illness track, and a dual track. One of the things they say filling out forms, "Since she's not here for substance abuse, we won't need to sign her up for twelve step...." It's immediately obvious the tracks really are different.
There's a kid rolled over sleeping in the shadowy area of the dayroom away from the lights of the nurses station, but still in view. The kid's on a mattress, curled up under clean white sheets. It's as dim as they can get it for the kid and still be able to see him clearly. They tell us that Katie will be sleeping the same tonight, because that's how the kids sleep on thirty minute checks, and they all come in that way. If they can (if she doesn't try to hurt herself or someone else), they'll get her in a room in the morning.
I see "level system" and my blood pressure jumps through the roof. I start asking very tough questions. They do not react like I'm a bad parent. They're taken aback, but they answer all my questions. They've got level one, level two, and Maximum Observation. Everybody comes in on level one, except that that first night they do have you sleep in the day room and watch you to make sure you're okay.
M.O. means you sleep in the dayroom, don't get your shoelaces, are on thirty-minute checks--it's basically suicide watch, but they obviously, visibly, do it as gently as they can.
Level one means you get to have two dollars for the machines on movie nights.
Level two means you get four dollars on movie nights and get dessert at dinner.
You don't have to be on level two to get discharged from inpatient. It turns out that level two is almost a consolation prize for kids who have to be inpatient longer than usual.
We're told kids are usually inpatient from three to five days. The facility also has an Intensive Outpatient program and a day hospitalization program--more on these later. Despite how few days kids stay, obviously the place serves people with serious, ongoing needs. Again, that's people of all ages, we're just in the child and adolescent cottage.
We get the schedule. Weekends we get to visit from 3:30 to 5pm, T-Th it's an hour in the evenings---6 to 7, iirc. She gets a five minute call home twice a day--morning and evening--but she has to sign up on a sheet each day for them to know she wants the evening call.
They have a policy that if the kid excessively nags the parents to go home, they'll stop the call. I tell them we're grown-ups and can deal with any nagging just fine, we don't want her calls cut off for any reason. They're okay with this.
We can also bring any snacks/soft drinks she wants for her when we visit, we just have to take the uneaten portions when we leave. There are snack and drink machines in the big group room in case we forget something. My concerns about that level two dessert go out the window.
She'll have to do her own laundry and make her own bed. They have laundry machines, and basic courtesy rules about not handling other kids' laundry. They give us a full list of toiletries she can and can't have, and what other grooming stuff we can bring that she'll have to check out of the closet to use. This includes the special laundry detergent we bring because she's allergic--again, it's no problem that she needs this.
They look at us weird when we ask how many changes of clothes she can have. "Uh...as many as you want to bring?" We can also bring books, and a radio with headphones for daily quiet time in their rooms. They can also check out card decks or board games from the closet to play with their roommate at quiet time, if they want. Oh--level twos can have parents bring an approved musical instrument to check out for their room at quiet time. Okaaaaay. Whatever. Again, I get the impression that level two is a consolation prize to cheer up kids who have to stay for longer than some of the kids they see around them.
Katie later tells us everybody seems to be on level one. However, she also tells us what she had to eat at each meal, because it turns out the chow is great. Her biggest disappointment is that we got there a week before they open the pool, and that it's hard to draw kids out to play a group basketball game or even one on one at gym time.
She and the other kids get peeved on behalf of the poor kids whose parents don't visit--which is very few of the kids.
We meet her roommate and roommate's parents when we visit. Katie, a bit of an extrovert, also introduces us to other girls whose parents are there with their favorite snacks, etc. She's torn--she hates being away from home, but she doesn't want to leave because the food is good, the kids are nice, she wants to stay until the pool opens, etc.
Oh--the first night the rules they hand us say she can get mail from anybody, but it has to be opened in the presence of staff. I get the impression this is a clear precaution against other kids mailing in contraband--has nothing to do with the letter content. It doesn't even appear to cross their minds to be interested in the content of the kid's incoming mail. Which, it shouldn't, of course--it's just a breath of sanity after seeing how the Programs we bitch about on here mistreat kids.
We tell them we have no behavioral concerns, that she's only there to be safe while getting restabilized on medication. They actually listen. We get a call the next morning from the psychiatrist who examined her, telling us what he sees, what he wants to do, and asking if the medication changes he proposes are okay with us. Oh, yeah--when we checked her in, there was the typical hospital notification that they use non-employee contracting professionals (doctors) and that we'll be billed separately by those professionals for their services. The psychiatrist sees her regularly (every day or every other day) during her stay--we know this because he calls us and tells us how he thinks her condition is progressing.
On the fifth day, when I ask him on his call, "When do you think she can come home?" "Today--you can get her any time after three. We'll want her to go into IOP for awhile so we can keep following her."
IOP = intensive outpatient. It runs from 9-12 each week day. The rest of the time she's home. The facility has other degrees of inpatient and outpatient care, too, depending on the patient's needs, but this is the one we're on. We'd already be off IOP if she hadn't gotten allergic to one of her meds and needed a major med change.
I could go on and on, but the point is it's a nice, sane place and as different from the Programs we criticize on Fornits as night is from day.
The things I tell other parents to look for in quality care? The ones where Program Parents tell me I'm being ridiculously unrealistic in my expectations? Obviously not.
The point is not that Ridgeview had some things that initially concerned me. The point is that in checking them out on the internet I found they had a rolls royce reputation, while being covered by our insurance. There was so much continuous parent contact it would have been impossible to hide bad care. The point is the huge number of green flags on my list that they had and have. The point is that they have no ex-patients out on the internet screaming about mistreatment.
Let me make this clear---Ridgeview clearly had the ability to treat kids who needed it indefinitely. They had the ability to use federal law to get the kids ongoing work in from the kids' own school, keep the kids up with their schoolwork, and keep the kids current for credit and grades and everything with their own schools. They had a day hospitalization program where the kids could live in cottages on the grounds, without being inpatient, and just be in treatment during the day. Sure, they could and would refer patients and parents out to quality care in their home communities. They could also handle treating kids as long as they needed it if that community-based care was unavailable for a particular patient.
They had neither the time nor the inclination to keep the kid in a more restrictive level of care than was absolutely necessary, nor to keep holding onto kids just because insurance was still paying.
Quality Care. What a concept.
My advice to the Program Parents who think no such thing exists is, if you really think your kid is going to end up deadinsaneorinjail without care for the problems Program Parents usually complain about, then move to the metro Atlanta area and use Ridgeview.
There's plenty of other quality care out there, it is NOT in the teen warehousing Programs, but if you can't find it any other place, then come here. We in Atlanta clearly have it.
Again, everyone reading this should note that if I myself got destabilized to the point of needing hospitalization, Ridgeview is where my own family would need to hospitalize me. It's certainly where I would want to be if I had to go inpatient.
Quality Care.
It can be done, it is being done, and for anybody who has garden-variety decent insurance, it's affordable.
I'm not trying to recruit anybody to go there, by the way. There are lots of facilities out there, like Ridgeview, that do mental health and substance abuse care the right way--the right way being by providing quality care as close to the home community as possible.
It's just that since Program Parents have alleged no such place exists, I'm telling you that it clearly does. Parents, if your child gets sick and really does need in-depth care, don't settle for the fourth-rate, dangerous, half-assed "care" provided by the Programs.
If you genuinely need a facility to care for a family member of any age, insist on quality care. It's out there, your loved one deserves it, don't believe the fourth-raters who try to tell you it's impossible just to sucker you in and cheat you.
Julie
