On 2004-12-09 16:15:00, Anonymous wrote:
"Just because these kids are not fixed, doesn't mean that RTC's don't work or are inherently bad. It makes me very angry to hear all of you guys say these things. I graduated from a RTC almost 2 years ago, and while I still struggle, I have continued to use the lessons that I learned in my everyday life. Going to a RTC did save my life. I know that many of you will claim that I am brainwashed or whatever, but the truth is, I am a happy person who learned how to be functional because of my RTC. The fact that former residents have relapsed is 1. NORMAL! 2. not the fault of the RTC. Granted, I can't speak for every RTC out there, but neither can all of you. and to claim that all are bad and destructive is b.s. and I hope that you all can realize that."
You haven't, and *won't* hear me say that all RTC's are bad and destructive.
There are situations where residential psychiatric care is necessary and appropriate, although it is *always* difficult for everyone involved.
What you *will* hear me say is that because there are so many bad RTCs out there, and so little oversight and enforcement, it is very difficult for parents to tell the difference between a good, quality RTC that will probably help there child and will *at least* provide quality care for their child and a lousy, fraudulent RTC that lies outright to the parents and defrauds them while mistreating their children.
The solution is not to abolish residential care.
The solution is Reform, Oversight, Standards, Enforcement, and Sunshine.
In this case, "sunshine" being ready access to the child for the parents, and sufficient access for the child's other family members for them to be able to assure themselves that their relative is not being abused. The ability of the patients to regularly send unread, uncensored mail to the outside world, and to receive mail that's only been screened for contraband would probably be adequate. (Subject to 30 days or less of *incoming only* mail stoppage by a licensed psychiatrist if and only if he/she has personally examined and is personally treating that patient and determines it to be necessary to the mental health of that *specific* patient.)
The scandal of sub-par RTCs is not anything new to the mental health profession. The entire history of mental health care has been one of many people doing the best they know how to do to care for patients, and some being flagrantly abusive. Then some pshrink or pshrinks either find out better ways to treat certain problems, or patient's relatives get fed up with the abuses, and reforms are made. Then another treatment fad comes along and the cockroaches work their way into the woodwork and it all starts over again.
Thing is, usually with each iteration mental health care has gotten substantially better for some groups of patients.
A prime example would be the general paresis patients getting antibiotics *early* in their syphilis infections and never getting mentally ill at all.
Another would be the improvement in the lives of schizophrenics, even in institutions, after the discovery of thorazine, or the improvement for bipolars after the discovery of lithium.
My great grandmother had to be chained to a tree in the yard like a dog when her manic phases made her violent. My great aunt was in and out of mental hospitals all her life. My daughter and I will probably have significantly better lives than our relatives from earlier generations because as times change, treatments improve.
A lot of current RTCs are either fraudulent outright, or using outdated treatment protocols that amount to abuse.
Nobody even remotely sane (or able to fake it on meds, at least :smile: ) is trying to keep seriously disturbed teenagers from getting the care they need---including residential care, when necessary.
What those of us who are rational (which is most of us) are trying to do is get the industry reformed so that patients get *quality* care, and so that parents and other family members get *honest* representations of what services their money is actually buying for their child.
I'm thrilled that you're okay---really.
Please understand that other kids who have not received the services their parents were promised, or who have received last-decade's-fad treatments that psychiatrists and clinicians now know to be ineffective or harmful, are *NOT* okay.
We don't want to make it so kids like you were aren't okay, either.
We want to reform care so that the parents are getting what they're paying for and the kids are getting treatments with good track records in peer-reviewed research, or promising new treatments, rather than treatments that the mental health experts have already established are ineffective or harmful for the kid's particular condition.
And, of course, where a treatment is experimental, the parents need to be told and give informed consent, and trials need to be structured and data collected to determine whether the treatment actually works or not.
One of the biggest reforms is that therapeutic approaches need to be tested and validated, or invalidated, just like we evaluate psychiatric drugs.
Parents, and the community, have a right to know whether the treatment works or not, and to know based on something more than testimonials and rigged customer-satisfaction surveys.
I'm not saying parents shouldn't be able to choose pastoral counseling or color therapy or aromatherapy or repetitive-thumb-rotation-zen therapy as long as there's no evidence the kids are being *harmed* by it.
I'm just saying psychiatry has developed to the point that it's time to do to residential treatment what the FDA did to patent medicines----reform it so that when consumers buy a treatment, if they're told it works, they can trust that it really does.
If the bottle on the shelf says "penicillin," the capsules in it shouldn't be full of sawdust.
If the RTC brochure says "cognitive behavioral therapy," the treatment behind the closed doors shouldn't be a dunking stool and a pool of cold water.
Reform.
Just because your folks, figuratively speaking, bought a willow-bark syrup that cured your headache doesn't mean the kid down the road didn't have his parents buy snake oil for *his* headache.
So I'm glad you're okay.
There are an awful lot of people who aren't.
We're all trying to deal with *that*, without preventing people like yourself from getting care that works for you.
Timoclea
