A Gap In The System

Hi. I haven’t posted here in a long time, due to being sideswiped repeatedly by life. Now, it’s time for our son to prepare to come home and I’m back to tripping over bureaucratic red tape left and right. I have the feeling that this site will be much more active over the next few months.

As some people reading this know, my now 14 year-old son has been diagnosed with severe Post-Traumatic Stress Disorder (PTSD), due to previous physical and emotional abuse. All the years of fighting and half-baked diagnoses have led us here. After almost a year of recovery in a long-term program, he’s doing much better and will likely be able to finish his treatment on the outside.

Unfortunately, both he and my younger son, who has not been diagnosed with PTSD, but exhibits many of the symptoms, are coming up against a new wall that is making their recovery harder. I call it “real life syndrome”. You know exactly what I mean.

“Why can’t you get past this?”
“You have to stop living in the past and deal with now some time, you know.”
“Stop talking about all this stuff that happened to you before!”
“You have to deal with real life!”

What is this real life of which you speak? Even people who have survived trauma, who should know better, still expect them to buck up and move on. Despite the fact that listening to a litany of what was actually done to them makes people grit their teeth and want to break something, they’re still expected to shove the past away and get going with the future.

J is 14. A is 11. Neither one has had contact with their abuser in four years, but they lived with occasional, secret abuse for many years before that. Every day, his actions live on in them. They can’t get past it yet, because they still have to live with the reverberations of it every single day. When someone acts in a fashion that reminds them of their abuse, they lock up and fall into old patterns, either closing down into protective mode or falling apart emotionally. Despite years of therapy, he still has a hold on them.

How the hell are they supposed to get over that easily? Years of therapy and loving care will slowly wear it down and I expect that they will have normal lives. Sometimes they’ll be happy, sometimes they won’t, but they’ll always remember. Who has the right to say that their reactions are wrong, for the place that they are in now?

Last night, I was linked to a series of three essays by someone on LiveJournal.com that really resonated with this situation.

A User’s Guide to PTSD
by Rachel Manija Brown

• Part I: What I Did In The War. (Introduction; background; what happens during trauma; what happened to me.)

• Part II: What Does A Flashback Feel Like? (My history with PTSD, and what it felt like to me.)

• Part III: I Don’t Have To Do This Any More. (On recovery; lingering effects; book, film, TV, and music recommendations.)

Read those. Think about them the next time you want to tell someone that they’re “living in the past”. Think about my sons who constantly have to deal with the memories and the fact that someone that they loved and trusted hurt them bad enough that they have PTSD. Maybe a little more empathy and understanding may result.

For the first part of this post, read “91 Long-Term Beds in the State, 91 Long-Term Beds in the State, Fill Them Up, Pass Kids Around, 91 Long-Term Beds in the State“. The start our journey can be found at “Through the Looking Glass“. I’m still working on filling in the gaps between the two posts.

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In the wee hours of an early November morning in 2006, Children’s Hospital refused to take my child any more, after he was brought in by the police and ambulance, stating that he just seemed to want to go back to the hospital. I had the option of just taking him home or getting the police back to press charges. It was an insane hour of the morning and we were all exhausted. My husband and I took him home.

A few days later, we had to call 911 again, due to J. assaulting both my husband and me. When I told the police that my son would not be accepted at Children’s, it was determined that the only option left was King County Juvenile Detention, where he was held on two charges of Assault in the Fourth Degree, Domestic Violence. It had been determined that he was a danger to us and to the community at large, so he couldn’t leave before all his hearings were up. He was finally allowed to leave just before Thanksgiving, due to the extra work of his lawyer and the kindness of a judge.

The next week he was brought in and agreed to a deferred sentence. He is on one year’s probation, had his right to be firearms removed (a requirement of domestic violence situations), and was assessed a financial penalty. If he completes all requirements, there will be no conviction on his record.

My son is thirteen years old. If he fails at this deferred sentence, that conviction will be on his record until he’s at least 18.

Another few days later, we were back calling 911. Fortunately, that time, a police officer more familiar with the mental health system was present. He suggested that J. be taken to Harborview Medical Center, where they could at least probably get a 3 day Involuntary Treatment Act (ITA) order and give us a break. I wish I knew that officer’s name, so that I could thank him. [continued…]

This is skipping to the end of our story, but I was reminded of this by a discussion that I had this weekend and it’s what I want to write about now.

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Children’s Long-Term Inpatient Programs (CLIP) is the adminstration in charge of the Washington State programs for children who are too mentally-ill to function in society. They are often violent and suicidal and can be seriously involved in the juvenile justice system. Families are usually at the absolute end of their rope when their children are sent to one of these programs. For a child to be admitted to CLIP, they have to meet the Medicaid criteria for medical necessity.

CLIP was first mentioned to me in 2005, as something that we might want to look into if things continued as bad as they were. That person, a Children’s Crisis Outreach Response Services (CCORS) therapist, was the only person through out this whole mess to look towards the future with J. and it was determined that it was probably too early to look at that long term of a solution at that point. We were told that the waiting list was very long, so we would want to keep that in mind.

[continued…]