If you are like me, residential treatment never crossed your mind as you held your newborn baby in your arms for the first time and rolled through the list hopes and dreams you imagined for your child. My dreams for my firstborn included sleep overs, dirt and sweaty play outdoors, team sports, hitting developmental milestones and so many other “normal” things you think of in childhood. Yet, that has not been our story. Rather, ours has been one of struggle, years filled with doctor and therapy appointments, and along the way an unexpected placement out of our home.
The first time I heard the term residential treatment was at my support group, shortly before my son’s first psychiatric hospitalization. The world of RTC (Residential Treatment Centers), hospitalizations, psychiatry and therapy were often talked about as we each shared how our children were doing as they struggled with various mental health challenges. Several months later we found ourselves in a place unimaginable – court involved and fighting to get our 12 year old son out of the youth detention center and into residential treatment.
I spent hours upon hours researching and applying to residential treatment programs in Colorado, and then eventually out of state, working through our insurance company. We finally found a center in Atlanta, GA who would accept my son into their program. Which was a relief and heartbreaking at the same time, since he would be a plane ride away from us, his biggest support system. This placement was the beginning of 18 months in RTC for our son – 3 months in GA, and 15 months back in a program in CO.
Through our experience, we have found that so many families struggle silently at home (believe me, the home is not silent, but the sharing with the outside world is) with unimaginable challenges in raising children who have significant mental and behavioral health needs. I want our experience to help others feel better equipped for the difficult road of parenting they have been called to. And I hope that by going first I might give someone else a voice to speak out when they are desperate for help.
This post is Part 1 of several blog posts to come, where I will outline all the details a family needs to know about residential treatment facilities. I will answer the questions most families have: How do you gain admission, who pays for the program, what happens once your child is there, what therapy and schooling will your child receive, what does parent involvement look like, and how to bring your child home.
Part 1: What is Residential Treatment, does my child need that level of care, and how do I get my child admitted?
What: A Residential Treatment Center (RTC) or Facility is a live-in treatment center which offers 24/7 supervision and therapeutic care for children under the age of 18. There are many different kinds of centers. Some are general in their mental and behavioral health care, and some are specific: substance abuse, addiction recovery, trauma based healing (from sex trafficking, for instance), mental health and behavioral health (Autism), eating-disorders etc.
Why: Residential Treatment may become necessary if your child needs 24/7 supervision and therapy. Your child has become unsafe at home for themselves and/or for others. Usually your child will have a stay at a psychiatric hospital first for a short term plan, before going down the road of longer term care. (Read my earlier post on Psychiatric Hospital HERE.)
The minimum stay at a Residential Treatment Center or Facility (RTC) usually lasts at least 3 weeks, and can go on for a year or more (20 months in our case).
How: There are a few ways a child lands in Residential Treatment.
- You may apply on your own to a program that is in your insurance network. Your insurance provider will have a list of facilities that are In Network. Call your insurance provider and request a Health Care Coordinator to be assigned to your family. This person can help you navigate In Network placements and costs. The average cost is $1,200/week Out of Pocket for a residential stay.
- A psychiatric facility, or a doctor may recommend placement. If the child is currently in a psychiatric hospital, the social worker assigned to your case will make a “Referral” to residential facilities in your state and your child can transfer directly from the hospital to the treatment center.
- If your child gets arrested and becomes court involved, the court can order the child to residential treatment. This is their solution to avoiding youth detention centers (short-term kid jail) and DYS, Department of Youth Services (long-term kid jail). If you know that your child has special needs and/or mental health diagnosis, bring this to the court’s attention immediately. When the police remove a child from their home because they are unsafe for themselves and others, they may be taken to a psychiatric hospital on an M-1 Hold* first. After a short term stay, they will be transferred by police to be processed/booked, then taken to a youth detention center to await their first pre-trial court appearance. You will need to advocate strongly to get your child out of the youth detention center and back to your home (if you feel it is safe) or into a more appropriate therapeutic setting. Youth detention centers are NOT therapeutic settings. A great resource for navigating the juvenile court system is “When Kids Get Arrested: What Every Adult Should Know” by Sandra Simkins, Esq.
Depending on the situation, you can request that your county Department of Human Services get involved (Social Services or Child Protective Services). They have the ability to make referrals to programs and to possibly provide funds for the placement. **You will especially have to request funding if your insurance deems that your child “does not meet medical criteria” to stay in a RTC – meaning, your child can stay in placement but you, the policy holder, must pay 100% of the costs. However, if the court has ordered RTC and will not let the child return home, then you may request that DHS step in and cover the costs.
(*M1 Hold / 27-65-101 Care and Treatment of Persons with Mental Illness. An M1 Hold is placed when an individual is deemed to be in imminent danger of harming him or herself or someone else or is “gravely disabled”. )
Placing your child out of your home may be one of the hardest things you will ever do as a parent. It is heartbreaking and harrowing. But you have probably come to this point because you have run out of options. You love your family too much to continue to let your child harm themselves and/or others. You are a good and loving parent.
My upcoming post will cover the Admission and Referral process. Please be sure to sign up for Email notifications (below) so that you do not miss a post.
And so we journey on….
Davina
