Perri, Amanda---I don't want to make the perfect the enemy of the good for those of you who were hurting and were helped.
I just want to make sure that the kids who wouldn't qualify for involuntary commitment at 19 aren't involuntarily committed at 15-18.
And I don't want to keep out the kids who are hurting whose parents can persuade them to go, so who go voluntarily and stay voluntarily. I know a lot of people here are on the other end of the political spectrum and don't like Rush Limbaugh, but him checking himself into rehab, for whatever reasons, is a fair model for voluntary treatment--for the kids who aren't immediate dangers to self or others (who, of course, would then qualify for involuntary commitment).
I just want to keep out the kids who don't want to go, and don't belong there, even though their parents are for some reason wrongly convinced that they do. Parents are sometimes idiots. I *am* a parent I know this. I can be a total idiot sometimes, and I sure know other parents who can be. There *needs* to be a professional check and balance on our judgement on something as serious as involuntary commitment of a non-dangerous kid.
And I want to keep the kids out who shouldn't be there because the particular program is all wrong for the particular kid's diagnosis and the problems that go with it.
I tend to harp on bipolar disorder, but that's because I can only speak from my experience and what *I* know. Behaviorist punishment/reward based behavior modification strategies don't work for bipolars and are really disastrous for us. It's the punishment part that does the damage, because often negative behaviors or failure to accomplish required tasks can be something that because of the disease and the particular phase of it the patient is in or her particular brain damage, the patient has no control over. When the patient has no control over a "bad" behavior or a "bad" failure to do a responsibility, punishing that lapse causes learned helplessness and breaks the patient worse instead of helping make his or her behavior better. And it's really hard even for an expert to tell if that particular time the patient had control over his or her behavior or not.
So with bipolars you have to work pretty much on *only* rewards, and they have to be pretty much immediate. Oh, you *can* allow *natural* consequences for lapses to get through, and you should---but you have to make absolutely sure that the particular lapse was under the patient's control, and you have to actually be right when you think you're "sure"---or you can turn a willing, bidable kid into a nightmare in a hurry.
And you can't hold up functionality as "success." Functionality is great if you can get it. Just like it's wonderful with a blind or deaf kid if you can fix that particular form of blindness or deafness with some kind of operation. But sometimes--actually fairly often---total social security disability is the *best* you can do with that patient and keeping them out of the hospital and safe in the world at least *some* of the time is actually doing *well* for that patient. And then sometimes you get a Ted Turner or a Jane Pauley who flies so high in this world it takes your breath away.
Cross Creek helped you two. Depending on how the rules and standards were applied to a particular kid, it could break them a lot worse than they were when they first showed up. Or, if the particular staff were particularly good at divining when a particular problem was out of the patient's control and particularly good or particularly lucky at stabilizing the kid on the right meds, you could get a *good* result. It's a *very* tricky disorder to handle.
All I want to see, and I know it's a tall order, is the kids that *don't* need to be involuntarily hospitalized, whose parents are being idiots for whatever reason, diverted into better options for that family. And the kids that *do* need to be hospitalized matched with the right treatment strategies and competent staff for their particular set of problems.
The *big* problem with the programs is few to no external safeguards to protect the kids from their parents' screwups or inappropriate admission to the wrong program.
And allowing the kids free external communication with the outside world through written letters would go a long way towards adding a fundamental safeguard for the outside world to recognize when a mistake had been made, or was being made, and fix it before any serious damage---or any further serious damage---got done to that kid.
Most kids are poor enough at actually getting motivated to write snail mail letters that the potential abuses or damages just from having outside communication access to anybody they wanted are *very* small. And the education value of the kids writing letters, however badly, is also a huge benefit. And the practice of written communication enhances spoken communication skills and enhances impulse control in kids that tend to speak before they think by forcing them to slow down---so they get *practice* at slowing down and thinking about what they're saying. In and of itself, letter writing, no matter to who, is good therapy for almost any teen emotional or behavioral problem.
Timoclea
