A Long Day

I just spent all afternoon and long into the evening yesterday in an attempt to get mental health care for one of our residents. She’s not been with us long, and from the beginning demonstrated behaviors that could have been interpreted as mental health issues, but no one really knew for certain. We also did not get “the rest of the story” from the facility where she came from. They withheld information that would have been beneficial to us in making a determination whether to accept her or not. But that’s another blog.
After three elopements from school, three incidents of cutting, two incidents of theft, and many other negative behaviors, we determined that she needed help we were not equipped to provide. So we set out to find that help.
We’re not novices at navigating the mental health system in Kansas. We’ve done it before, and our Director of Services is a three-decade expert in Kansas mental health services. He knows his way around.
However, it isn’t as simple to obtain mental health services as it is to obtain services for, say, a broken arm. With the arm, you call an ambulance, show up at an emergency room, or go to a doctor’s office and they take care of you. With this issue, we had to go through three assessments within a 24 hour period, be seen by three different providers, visit with the insurance company, talk with providers, and generally cajole and convince people that this girl needed help. No psychiatrist ever physically saw her. Only one provider (behavioral health ARNP) ever talked with her.
I can understand why people hesitate to access these services…unless you know your way around, you get lost in the shuffle as they slide you back out the door you entered and onto the street. And the thing about it is they do it in such a way that you’re not even sure what happened until it’s all over.
What was supposed to be a direct admit to a facility (I’ll just tell you it was Prairie View in Newton, Kansas) turned into a four hour marathon of questions, phone calls, faxes, and thinly-veiled statements that she would not probably be admitted because she “didn’t meet criteria”. We had already obtained approval from the girl’s insurance, by the way. The doctor on call wouldn’t return his page. They called the medical director, who shoved us off onto another physician, who finally decided to admit.
I told the social worker who interviewed us (we never spoke with an RN or medical provider) that I was tired, hungry, and angry. I told her I would hold myself together in order to see this through for the benefit of the girl, but had no kind words for the system or for the facility. I asked the social worker what it took to obtain needed mental health services. She had no answer.
What would have happened had our girl been 18 years old and showed up there on her own to obtain services? She wouldn’t have had the staff at the children’s home, the ARNP, the counselors, the people at the insurance company, and others to make phone calls and ask professional friends and colleagues to help open doors for her. I know most of what we did to obtain services. It evidently takes at least that much. She wouldn't have had a snowball's chance on her own.
I’m not so tired today, but I am still angry. The admission to Prairie View will do little more than buy us more time to find an appropriate placement for the girl. We will have three to five days to make that determination and find an open bed for her. Prairie View will assess yet again, adjust medications, and warehouse her for the required period of time before declaring her “better” and dismissing her. At least Prairie View now has the burden of helping find an appropriate setting for her before they dismiss her. They cannot by law set her out on the street without needed services in place, even though I am convinced that they would do that in a heartbeat if they could. The story continues.