This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Wednesday, October 12, 2011

Kitty's safety

I sent out this letter on Friday to all of Kitty's teachers and the school admin. I had forgotten that Monday was a school holiday.

Kitty will be released from the Hospital either today or Monday, in which case she’ll be back in school on Tuesday at the latest. Her IEP meeting is not scheduled until October 21st at 2:25pm. In the meantime I am very concerned about her safety, therefore I am requesting a parent/teacher conference ASAP.

As you know, Kitty is returning to school after her second psychiatric hospitalization in less than 2 weeks (4th psych hospitalization this year). Her psychiatrists are recommending residential treatment upon release from the hospital; however we are struggling to secure funding, so she will be returning home for now. Obviously an RTC-bound special education student simply does not meet the criteria of the lesser restrictive environment.

Safety: Kitty is in a state of unstable mental illness that includes self-harming behaviors and suicidal ideation. During her educational day, Kitty’s mental status must be monitored by qualified staff that do not have their attention constantly diverted by the needs of many other students. Although we have all been lucky that Kitty appears to have not made any suicidal gestures at school without alerting someone to her state of mind, this behavior cannot be relied upon! To require Kitty to be responsible for knowing when she needs help puts Kitty’s life in danger.

For Kitty’s safety and protection, we are requesting the maximum equivalent education environment and accommodations to residential psychiatric treatment that the school district can provide. If the school cannot offer the accommodations Kitty needs, even if they are on a temporary or trial basis, then she must be placed elsewhere, immediately. I don’t think any of us want Kitty to hurt herself or anyone else while on campus or to have to be return to the hospital.

Areas that Kitty’s current Crisis Plan does not address:



  • There are no description of interventions and supports beyond the behavior program staff taking her to nurse or counselor’s office for assessment

  • At what point should parents take Kitty home if not sick (fever, rash…) – what are the alternatives?

  • How should we handle the large chunks of time that Kitty is spending in the nurse’s/counselor’s office instead of class?

What to do when:



  • Kitty is not willing to return to class from nurse’s office, despite not being sick (fever, rash…).

  • Kitty is having subjective symptoms – exhaustion, headache, stomach ache…

  • Kitty is exhibiting self-harming behaviors.

  • Kitty is feeling she is not “safe” (in particular from urges to self-harm unless she’s being actively supervised by someone aware of this behavior, but also from threats, criticism, and judgment of others– real, implied or perceived)

  • Kitty is exhibiting signs of stress* and being overwhelmed but is not requesting support (*feeling ill or tired, non-participation in class, inability to focus, sleepiness/head on desk, vibrating body parts, self-harming behaviors, pressured speech or laughter, disruptive talking or laughter, inappropriate emotional responses, lashing out physically or verbally …)

  • Kitty is having difficulty during unstructured times such as between classes and lunch (she no longer rides the bus so before school is no longer an issue, but after school…)

  • Kitty is feeling overwhelmed or stressed (we had discussed sending her to the NON-behavior specialist, Ms. V).

  • Kitty is discussing her issues/concerns/ stressors with a non-trained professional (such as nurse and Ms. V) vs. a trained behavior specialist {I did find out later that Ms. V has a counseling degree}

I can be reached at (###)###-#### or home (###)###-#### and of course via e-mail marythemommy@gmail.com.


Mary


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On Monday evening I got this response:


Hi Mary-


We would like to have a parent - teacher conference to discuss your safety concerns regarding Kitty. In order to gain pertinent information regarding Kitty's safety at school,the school psychologist, has tried to contact, Mr. B, Kitty's psychiatrist, at the Hospital and has been unsuccessful. She is unable to leave a message as his voicemail box is full. This would be valuable information to have prior to the conference.


Thank you,


The IEP Meeting Faciliator


*******************************************************


My immediate response:


Actually Mr. B is the social worker. Her psychiatrist was Mr. L. We’ve had difficulty getting in touch with Mr. B as well. I know he was out sick today so I was unable to get any info from him when Kitty was discharged this evening.

So how should we proceed? Kitty is still very emotionally volatile and unsafe. She really needs this extra supervision.

I feel I should warn you that tonight Kitty went to an adoption teen support group with her siblings, and despite my warnings ahead of time not to burden other kids with her issues, she proceeded to monopolize the group, divulging to a brand new group leader she’d never met before, and all present (including her siblings) about how much she wanted to stay at the hospital, and her sexual abuse history among other things. Apparently all of the children present were extremely uncomfortable, and all of her siblings are now furious with her. Kitty didn’t seem to understand the boundaries she’d crossed. They’ve been attending this group for years, so she should know better. I’m VERY worried about what she’s going to say to her friends at school.


Mary


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Tuesday morning I took Kitty to school and immediately started trying to make sure that she was going to have the support and supervision she needed. No one knew anything about a parent teacher conference.


Then I discovered that our favorite Assistant Principal who knows us and Kitty and Bear and has always been uber supportive... got a promotion and his last day was Friday. *AAARRGGGHHH!!!!!*


So I spent a couple more hours waiting to meet the replacement AP (Of course I kept busy getting attendance reports, info on how many times Kitty went to the nurse's office - she'd already gone once that morning for a bandaid, and making tons of calls to TX Medicaid and NE Medicaid and half a dozen other people). I ended up meeting with a different AP, still not sure why. She was very sympathetic and sounded like she was going to make sure Kitty was taken care of (specifically lunch), but as I walked out the door, she walked into another meeting.


I decided to run by Ms. V's office to get records of how many times she'd interacted with Kitty. While I was waiting to speak to her, Kitty showed up. She didn't feel good (stomach ache and tired) and wanted to go home. She'd already eaten her large lunch (at the beginning of second period - an hour and a half before her actual lunch time), and she was starving! I told her that was up to Ms. V. We cuddled while we waited.


Ms. V talked to Kitty for about 30 minutes (I mostly listened). She let Kitty vent, and yell at me for not "trusting" her enough to back off on making the school protect her by escorting her. To which I responded, "You're right out of the mental hospital. I CAN'T trust you right now. You need to show me with your behaviors that you can handle this, not just say it with words. Then Ms. V basically said, you're getting old enough that you need to start acting like an independent adult - to which Kitty continued to rant about me not giving her the chance.


Then Ms. V said, "OK, it's time to go back to class."


Kitty's reaction was almost comical. The teen who had been almost rationally insisting that she just needed a chance to show me that she was ready to be trusted with independence in the hallways, not to hurt herself, and handle her feelings... immediately melted. We tried to point out that she'd just said she was able to handle it, but Kitty was not rational. She'd thought she was going home. Still, Ms. V, did not give her any options and sent her back to class (with an escort from the behavior staff).


When the escort showed up I tried to confirm the plans for Kitty to be supervised at lunch. She knew nothing about it. Frustrated I tried to explain to her the need for supervision, in front of Kitty who totally disagreed. Finally I just said it was what the AP and Ms. V had agreed to. The escort went and talked to Ms. V, and they compromised by telling Kitty she had to stay in line of site of one of the teachers. NOT what had been agreed to, but I wasn't given a choice and didn't know what happened until after school.


***********************************************


I left the school totally frustrated and went to Grandma's for lunch. Called Hubby and expressed my frustration. He decided that we needed to go over to the school and talk to the Principal of the school. I thought that was jumping too many levels, but he was insistant. So he took off work, and since I got nothing but voice mails we just showed up.


The Principal was happy to talk to us. Of course he knew nothing of our kids (although he had heard of Bear's joyriding escapade last month - just didn't know Bear by name). The school has over 3000 kids.


Will tell you what happened tomorrow. I'm tired and still need a bath.


Our potential TX Medicaid casemanager will be here early tomorrow and I still need to clean the house.

2 comments:

beemommy said...

Oh geez, why can't the district use their funds in a more efficient way and just have a small campus specifically designated for kids with these kind of issues? Or, did you say they already had that and thought Kitty didn't need it? Sorry, it's so difficult to just get through.

Struggling to Stand said...

At this point I don't think you *can* go too high up in the chain of command. It is shocking how few people knew what was going on when you'd sent the email to so many. ... Something this significant should also go to the director of special ed -- let him/her worry about whether it is something he/she needs to know. ... it doesn't matter HOW big the school is ... I can't imagine a principal not wanting to be aware of a kid on campus who has been in a mental hospital 2 times in 2 weeks ... (Although I can imagine someone "in charge" not DOING anything about it.) Don't forget the principal is employed by the school district which is run by the school board -- who are elected by the community. There are many more levels you can go "up", and don't hesitate to do so (plenty other parents do.)
Thanks for giving us an update. Keep hanging on ...