Entering the System, Part 1/4
Welcome to the first post of a 4 part series written by Jennifer Griffis. Visit the homepage for her series for a full look into their experiences.
“The treatment team is recommending long-term residential placement. Have you filled out an application for Children’s Mental Health services?”
I was sitting on the floor of my bedroom, door closed and phone pressed to my ear. At best I only had a few minutes of quiet before a child came looking for me, desperate for a snack or ready for a snuggle. It had been a hard few weeks for all of us. I tried to comprehend the words of the hospital social worker on the other end of the line.
“No. Do we need to?”
“It’s the only way to access residential treatment services in Idaho. I’ll email you the contact information for your region.”
As I hung up the phone, tears started flowing. This was our daughter’s second psychiatric hospitalization in just three weeks. She was only six years old. Medication wasn’t working; outpatient therapy and parenting classes were also proving unsuccessful. While a solid diagnosis seemed elusive, the behaviors were concerning for everyone involved.
The idea of my six year old spending months in a residential treatment center was overwhelming. But even those concerns paled in comparison to the necessity of entering yet another system in order to access that care. A system that, on the surface, looked like it might be connected to child protection services. I wasn’t thrilled about opening our lives up to strangers…especially in the midst of the uncertain chaos we were facing as a result of our daughter’s mental health challenges. Would they think this was our fault? Would we risk losing our children? Would they believe what we were saying?
But we knew that residential care was the only way we were going to make progress, both diagnostically and therapeutically. We’d exhausted all of the other resources, so with trepidation I began filling out the application.
Families enter into children’s mental health systems in a variety of ways. Sometimes it’s by filling out a voluntary application after being referred by a doctor, therapist, or school counselor. Other times it’s court-ordered, maybe through child welfare or juvenile justice. Regardless of how a family enters the system, there are some common challenges…
- “I don’t understand why I have to fill out another application. How is this system/service/agency different?” Filling out applications to different agencies within the same system is time consuming and confusing for parents. It highlights the lack of communication and information sharing between system partners.
- “I’ve been transferred to four different people and still can’t find anyone to answer my question.” Even within a larger state system, professionals working within specific agencies or departments rarely have knowledge about how the system works as a whole. This leaves parents who are entering the system struggling to find answers to their questions. They often ask the wrong person. And that person, although well-meaning and knowledgable about their own work, doesn’t have enough system knowledge to direct them to the right person.
- “It feels like the decision has already been made, even before I make the request.” When systems are focused on their own policies and procedures instead of the needs of the children and families seeking their services, parents may feel as if the decisions were made without their voice being heard.
A system that is child-centered instead of system-centered will help support parents through the process of entering the system. It will help parents fill out the application, provide a warm handoff between system partners, and help answer questions about all aspects of the system in ways that are easily accessible.
While there are systems that do this well, many of us are currently accessing services for our children within systems that are either transitioning to a child-centered model or are still firmly system-centered. Even in these systems there are ways you as a parent can help the system work in a more family friendly way.
- Ask questions. If you find yourself frustrated by the way something in a system is functioning, instead of complaining try being curious. Ask questions of the professionals working in the system. Just like people, systems often function out of habit. By asking questions about the specific area of your frustration, you may help highlight needed changes others haven’t noticed.
- Request a meeting. If your child is engaged with multiple system partners request a meeting with representatives from each group. Just getting everyone at the same table to discuss your child’s and family’s strengths and needs can help shift the perspective and encourage collaboration.
- Talk with another parent. Find a parent who has walked through the system recently. If you can call a local or state advocacy organization they may be able to connect you with a parent who can offer you advice for navigating a system that is in transition. And if you’re a parent who has been navigating a system for a while, reach out to your advocacy organizations and offer to be a point of contact for other parents entering the system.
Entering a children’s mental health system is a challenging moment for any family. By working together we can make the transition empowering for parents and encourage their further engagement in the treatment process.