My mentally ill son Michael has “aged out” of his Residential Therapeutic Hospital.
The Residential unit was part of a psychiatric hospital. It was located in a separate wing from the other psych wards. This was a perfect accommodation. Should the child become acute, they transfer to the intensive juvenile psych unit, their bed is held in the residential facility, and when out of crisis, the child transfers back to the residential unit.
This was a “lock down” facility. “Structure” guides the day. The kids got up at 7:00 am, took meds, and ate meals with the general hospital population. There was morning group, chores, and a laundry schedule.
School ran from 9 to 3 and was located as part of the Hospital campus. The school was run by the County Board of Education and also took in children from the local community. These children had the same needs as the Residential kids; but did not require Residential supervision (or was that a funding issue????). Cigarettes and drugs could be purchased at School. The School was a Special Education facility and would accommodate each child according to ability, not age. The “sending” school district paid for school. Medicaid paid for the Residence.
After School the entire afternoon and evening was structured. There was group and individual therapy, more time for chores, some down time in your room, dinner, time in the gym or pool, maybe an Alcoholics Anonymous meeting or a Narcotics Meeting, television time, and more group.
The kids worked for privileges based on a point and level system. If the child showed up for structure and didn’t break the rules there were many rewards. They went on two overnight camping trips, horseback riding, movies in the local area, Great Adventure, day trips to the beach, they went out to dinner, out for ice-cream, order pizza or Chinese food in; especially on holidays for the children who did not leave on pass and had no visitors.
Every child had a School Therapist, a Residential Therapist, a floor Councilor, the same Psychiatrist and a Social Worker from outside the Hospital. My child’s psychotropic medication changes were made with the consultation of my own Psychiatrist.
Many kids were DYFS kids (Division of Youth and Family Services). These children came from highly dysfunctional homes. Sexual abuse, physical abuse, substance abuse, and gross neglect. Some were abandoned by their families because the family “gave up” and these kids had no visitors except for their DYFS case worker.
Some DYFS kids were abandoned to the State because the family lacked the advocacy skills to keep the child safe and “in the system”. Families are forced to make this decision all of the time. DYFS kids could only be visited by family under supervision/staff in the room.
DYFS patients were given a clothing allowance of $200.00 a month. Hygiene products were provided by the Residential Facility. Medicaid covered the Residential Program. On Holidays and Birthdays the children were given gift cards to purchase presents for themselves (usually electronics).
Other children were in the custody of their parents, like Mike. Mike could have visitors on Wednesday and Friday evenings. He could also leave on 12 hour passes; provided of course that he were on level. He could only be signed out by a short list of family members. He could only send and receive phone calls from this select group. I was advised to not take Mike home on overnights because that would prevent him from staying in supervised housing after aging-out of the current facility.
Two weeks prior to Mike’s 18th birthday he transferred to a Psychiatric Community Residence for 18 to 21 year olds who are coming out of institutions. He attends a Division of Human Services High School. This school accepts Special Needs persons with all disabilities. Mike says it is like a kindergarten babysitting service where he and his peers play cards all day. Mike’s IQ is 2 points higher than mine and needs a challenging environment that accommodates his particular learning differences. He has a Central Processing Disorder, ADHD, and an Auditory Transference difficulty. Mike hates school.
Here comes the fear. Being 18, Michael can sign himself out of the program. He can set himself up to fall through the cracks. Mike must apply to Social Security in person, to request Social Security Disability Income (about $700.00 a month) and to activate Medicaid.. If Michael does not continue his education, I cannot carry him on my personal insurance. In fact, Mike becomes uninsurable because of his pre-existing diagnosis/condition.
Mike has been living at the PCR for about a week. All of our phone calls require me to ask all of the questions, even when he initiates the call. The answers to my questions are yup, nope, good, nope, yup, yup. I know nothing except that he hates the place, feels he has more restrictions than the previous Institution, and is threatening to sign himself out if I don’t find him another placement; which is completely out of my hands.
Michael and I have had a long, loving, and difficult journey. He was the most beautiful, delightful, loving, funny little guy. As the cloud of Mental Illness set in his life and the lives of my family has forever changed. However I know that inside my boy, behind the mask of Mental Illness is my forever Michael. That is how I love him when he seems unlovable. That love brings me to visit with him every time he is eligible for visitors. That love allows me to forgive him for things that to outsiders might seem unforgivable.
I have been able to carry Mike up until now. At 18 our road will have many forks. The direction he travels now is his own choice. He is choosing his own destiny. It is time for me to let go. This is really, really hard.
Passionately yours,
anonymousmom
