Plea for help letters

Letter to Kitty's school, mental health providers, therapist, and the head of the special school that Bear attends:

Hi guys,

I feel it’s time to request an ARD (IEP meeting) to see if we can come up with a plan F, G… not sure what letter we’re up to… as this is just not working. Everybody has been amazing and super supportive, but Kitty is still so unstable. On top of the stress/anxiety that started all of this, now Kitty is adding to her own anxiety because she knows she’s getting further and further behind due to missing so many classes. She told {school psychiatrist}that she’s having suicidal thoughts, which we know about, but of course still have to address. This is worrying me because she’s starting to try to keep this from her mental health team and myself because she knows we might have to put her back in the psych hospital if she’s suicidal.

She’s starting yet another med tomorrow, but it’s only supposed to be a PRN (it can be addictive) so I don’t think we can expect it to make changes in the underlying issues. My biggest concern is that it feels like we’ve maxed what {the high school} is capable of providing Kitty and it’s just not enough. If you guys have more suggestions I’d love to hear them. I do think we should consider {the Special School for emotionally disturbed kids that Bear attends} or some other type of contained classroom for Kitty, at least for the rest of the school year.

I know TAKS {Texas standardized testing} is coming up next week. I need to get her schedule so we can try to get her there for the key times when at all possible.

Kitty has been complaining of bad stomach pain and threw up once last night and once this morning. No fever, but it could be stomach flu so I kept her home today (Bear said he hasn't slept in a week and that's why he's throwing up, but since that makes two, it's probably stomach flu). She’s resting now. We have not started the anti-anxiety med yet, as it is supposed to be PRN, and with her vomiting and not in school anyway it would be difficult to tell if it is working or causing side effects. Assuming she’s feeling better tomorrow she’ll start it then.

We’re working with her mental health provider to introduce a new skills trainer and case manager, who would like to meet with her at school since that’s where Kitty seems to need the most services right now. I realize this is made even more difficult by the fact that we’re having trouble getting Kitty to stay in school at all (she
appears to be only able to make it through a class a day). Plus {school psychiatrist} is trying to get Kitty’s testing done for the new FIE {school psych eval}. Next week because of TAKS we’ll try to have the meeting at home.

Thanks for everything you guys are doing to help Kitty through this!
Mary

Sent to the Nebraska casemanager who is trying to help us access post-adoptive services if she's able:

Hi Kari,

I'm not sure if there is someone else I'm supposed to be working with here, but here's what I found out this week.

Good news! I talked to the TX adoption specialist with CPS. They said they'd extend Bear's TX Medicaid to age 19 (instead of cutting him off when he turns 18) as long as they have a letter stating Nebraska is extending services with a subsidy to age 19 (which of course you are because that's how long it goes anyway). The 601 form that was filled out by ICAMA that qualified him for TX Medicaid when he was adopted, with the extension to age 19, must be sent where it was sent the first time in 2008 (when Bear was adopted). The ICAMA coordinator is {###}. If there is someone in Nebraska that I should speak directly to about this, please just give me the contact info and I will. Obviously if we're going to do this for Bear, then it only makes sense to do it for both kids at the same time.

Additional help urgently needed:
Kitty went to a psych hospital 3 weeks ago for domestic violence (she punched me in the face) and suicidal threats. She was there less than a week and then was released, but they put her on an anti-depressant which triggered self-harming behaviors (she's never really self-harmed before). They tried a second SSRI (anti-depressant) with similar results. Currently she's not taking anything new (she's on quite a few meds), although we have an anti-anxiety PRN med she'll start taking. So here's where I need help. The school is unable to keep her feeling safe, she still has suicidal thoughts, and despite cutting her back to half days, she's still coming home after attending only one class (so is getting even further behind in school. which adds to her anxiety). I don't think she needs to be in a psych hospital (we seem to be able to keep her safe so far), residential treatment seems a bit extreme at this point (although we're heading there), and her psychiatrist is suggesting partial day hospitalization (school and therapy all day, but she comes home every night). Unfortunately there is only one place in our area that offers this type of program and they don't take TX Medicaid. They take other kinds of insurance though. We had residential treatment written into our adoption subsidies for the kids (- if we can't get funding on our own, then Nebraska will pay for it). Partial day hospitalization is not residential treatment, but we're hoping that Nebraska can help us get it to prevent needing residential. This is absolutely desperate. Kitty is getting worse and I am on the edge trying to keep her stable. Can you help?


Mary