Insurance is denying continued residential treatment for severely depressed 14yo

I lived through this exact experience with my 14 year-old daughter.  It is horrible.  You have to get your insurance company to let her stay. It's insane:  they kick her out of residential treatment, she attempts suicide, goes back to ER, back to residential, leaves before she's ready, until, I guess, she succeeds at suicide. If she's suicidal, you can't have her at home because you can't watch her 24 hours/day.  She needs to be in a residential facility.  I can share with you how I got the insurance company to keep her in residential.  Please ask the moderator for my contact info. Also, contact Willows in the Wind. They are a great resource and helped me find an educational consultant.  

Don't lose hope!  My kid got through this and is now 18, just finished freshman year in an out-of-state college, is thriving.  

We had to give a $5K down payment for services then a % placement fee if we ended up placing her in a camp/facility/school. We ended up working it out at home by ramping up meds in the short term to stabilize, taking time off to monitor her fulltime at home (we also put an alarm on her door / taking anything away she could use to hurt herself), then going to DBT (Clearwater in Oakland). My greatest desire was to have my daughter stay home with us.  To do this, we (parents/family) had to change our tune big time to make things work.  DBT trained us to deal with ourselves and my lovely daughter magnificently. Volunteering with my daughter 4 hours a week helped tremendously too.  She loves animals so we ended up volunteering at the SPCA.  After a wild and bumpy ride, I'm forever grateful to have my daughter happy and safe at home with us 2 years later.

I’m so sorry you are dealing with this. My heart goes out to you and your daughter. 

One area you may want to start with is speaking with the school psychologist and principal to explain the situation and take them as a partner and resource. They could assess for a 504 plan for accommodations or an IEP if there is an underlying disability that is a root cause of her depression. An educational consultant might not be necessary (and an added expense).

I hope you find the support that you need to guide your daughter through this difficult time.

I've been in this emotional and financial hell for more than 3 years, starting with hospitalizations, 5150's, local treatment centers and step-downs, PHP, IOP, and more than two years of out of state RTC. With time, tenacity, legal assistance, DREDF, and Willows in the Wind I have made it through the financial hell. The emotional hell remains, I guess for always.

Connect with Willows in the Wind and DREDF as a first step. Also get a copy of your statement of benefits/coverage from your health insurance, in electronic format is best. Get and keep the WRITTEN justification for treatment from the professionals. Learn what your recourse for disputes is with your insurer and look up the California Dept of Managed Health Care.

Hope we can connect through Willows.

Hang in there. It's awful, but can work out.

I'm very sorry to hear about the struggles you're going through with your daughter. You mentioned the insurance company is denying additional treatment: this might be a really good time to speak with an Insurance Advocate. This can save you thousands of dollars later AND help you to get appropriate services. Karen Fessel of the Mental Health and Autism Insurance Project is a good place to start: 925-388-0892 or info [at] autismhealth.org. You can speak with Karen for the first 30 minutes for free. She has a sliding scale fee of $75-$150. Karen can help anyone who is working with an insurance company--not just parents of children with autism. 

To the best of my knowledge, Ed Consultant fees currently range between $5,000-$15,000 for a package of services. You might not be ready to commit to the whole process of finding a higher level of care for your daughter yet--the "package"--and if this case, it doesn't hurt to ask if you can arrangement an initial hourly consultancy fee (hourly or a mini consultation of $1,500-$3,000). Some Ed Consultants that you may have heard of:  Jen Taylor    Jennifer [at] jetedconsulting.com      415-887-8998Shayna Abraham   shayna [at] preparetobloom.com  (650)888-4575

It does sound like you will need an IEP moving forward and possibly a neuropsychological evaluation if you don't already have one. In my experience, district assessments are often not very comprehensive--and it can be very helpful to get one of your own in order to get a clearer picture of what's going on with your daughter. Always check with your insurance company first to see if they will help you get the evaluation done. Summer time is a popular time to get a neuropsychological evaluation, so you may need to get on someone's waiting list if you decide to do this on your own. Hopefully other parents on this list will mention places to go for the neuropsych eval. You mentioned not being sure where the money will come from: a cheaper route for a neuropsychological eval is to contact UC Berkeley's psychology department. They have grad students who do them under supervision, and I've heard they can be very well done.  

I don't have the name offhand, but I've also seen the name of a therapist on Solano Ave that advocates keeping your child at home and has some expertise in this area. I wish I could find her name! First name might have been Terry?

I volunteer with a parent-to-parent program that offers free monthly support groups for parents called Willows in the Wind. You may already have heard of this group or attended a meeting in Oakland, San Rafael or Los Altos. Upcoming Willows meetings are listed at the bottom of this message. If you want more information, please feel free to contact me at: s.mackaylynch [at] gmail.com or contact the director, Jan Rao at: jrao [at] willowsinthewind.com

Everybody's path is different. I hope that you'll find what works for your daughter and your family.

Willows Oakland Meeting: Saturday,  June 16, 2018, 1:00 - 3:00 PM, Kaiser Medical Building, 3600 Broadway, Lower Level, Conference Room C, Oakland

San Rafael Willows Meeting: Sunday, June 24 , 2018, 1:00 - 3:00 PM, Center for Families, 1104 Lincoln Avenue, San Rafael

I'm sorry for your daughter's suffering. I can not directly answer your question about costs as it was some time ago that I hired an educational consultant for my teen.  I have two suggestions for you:

1. Call The Bodin Group in Los Altos (http://www.thebodingroup.com).  They can give you pricing over the phone.

2. Consider reaching out to Willows in the Wind (http://willowsinthewind.wixsite.com/willowsinthewind).  They provide support for parents going through what you are going through free of charge, and are an excellent resource in the community.

Know you are not alone.

Dear Concerned Mom,

I do not know of any resources here in bay area, however, I do want to encourage an IEP, typically given through school district, I would start there. Our daughter struggled with severe depression & self-harm at this same age for several years, she is now a thriving, talented young lady entering her sophomore year of college. She went through several residential treatments, Dr's & therapists. I recommend Timberline Knolls in Lemont Illinois, they offer schooling, it is one of the best. I know your heartache, stay the course, it does get better. I am from Chicago suburbs and was very fortune our district had resources to help. I am now in bay area. My hope is wellness & health, I am praying for your family.

Love & Peace

I'm so sorry for your struggles. It is so hard to watch our children experience so much pain and not be able to help. Mental health services are so underfunded by health insurance! We have had good advice from Shayna Abraham, owner of Prepare to Bloom, who works with teens to find placements that are appropriate for them. https://www.preparetobloom.com/. She develops relationships with many services across the nation and knows their advantages specific for particular needs. She was able to help us get placement in a program that normally has a more rigorous process and waiting list. But because they know Shayna, her recommendation helped us cut through all of that. If it is a location away from home, she will check in regularly with them when she visits. Of course any ongoing services include a fee. If you are overwhelmed and need an advocate, she would be perfect. I think she would be happy to talk with you about costs and levels of service initially without a fee. We found her through our psychologist and our school. Good luck to you!