As we drive through the beautiful rolling hills of western New York, my husband reaches over to grasp my hand. I glance over and see a stream of tears run down his cheek as he navigates the car.
My eyes are dry. I’ve cried so much over these days, I have no tears left.
We are driving our son to the residential treatment center where he will live for the next year, and each mile takes our boy farther away from home. How is it possible that loving someone means days like today — when holding on means letting go?
Residential Treatment: Never the Goal
No one gives birth or adopts a child with the hope that residential treatment will be in the picture someday.
Residential treatment is when a child lives in an institutional setting 24 hours a day/7 days a week under careful supervision.
What’s ironic and unfortunate is that kids do better in families. Certainly, children with attachment issues NEED to be with families.
How will my son learn to attach to his parents if he is not with his parents?
Yet there often comes a day when safety supersedes all else. Yes, the goal is family preservation, but not at any cost.
Residential treatment wasn’t initially in our plans, but for the last several years we have know this was most likely coming for our son. These last few years his behavior has continued to spiral out of control.
Therapy and tight supervision helped. We saw progress. Improvements were made.
Then — one afternoon our son made an incredibly poor decision, shifting our whole world dramatically and instantly.
For the sake of our family’s privacy, I’m sure you understand that I don’t share specifics. In my last post I told about one mom’s courageous story of living with her son’s behaviors. This gives a realistic idea of the types challenges we face.
Residential Treatment: Nearly Impossible to Obtain
When parents feel their child needs residential treatment, what are the next steps?
Unfortunately, the path from when parents make the decision to place their child in residential treatment, and when a child actually goes to residential treatment, is often a winding, bumpy road. We knew getting a child into residential treatment was challenging, but we had no idea just how difficult the steps involved.
As one therapist told us, “What we do to parents in our country who are seeking treatment for their children with mental health issues – it borders on criminal.”
From the time we knew our son needed residential treatment until the time he went to residential treatment was 2 1/2 years.
We applied and were denied multiple times.
We tried different funding sources.
We advocated through agencies.
We hired an attorney.
We went to court.
We were threatened and threats were made against us in regard to our reputations, our jobs, and the security of the other children in our home.
We were mocked. We were belittled. We were patronized.
The pressure placed upon us to walk away from all of this and keep our son in our home — despite the fact that he was a danger to himself and others – was massive.
Residential treatment is incredibly expensive and sadly, at the end of the day much of the conflict comes down to who will pay. There are several ways residential treatment is funded:
- Insurance. Because private insurance will eventually run out, children who are privately insured will need to apply for Medicaid. With a mental health diagnosis, a child can be placed in a residential setting if he meets certain strict criteria.
- Court systems. If charges are pressed, a judge can order placement in a residential setting.
- Foster care. Parents may voluntarily place a child in foster care. The foster care system will now have physical custody of the child but parents retain parental rights. If no suitable foster home is found, a child may be placed in a group home or residential setting. The goal is reunification after the child has received proper care. The child may also age out of the foster care system.
- Relinquishment of Parental Rights or Termination of Parental Rights (TPR). When parents no longer wish to maintain a relationship (most often this is the case with an adoption situation), they move to relinquish parental rights. Depending on the state, relinquishment is not easy to obtain. Typically another adoptive family needs to be arranged before a judge will grant relinquishment. Adoption is legally binding. However, in the case of a child with severe mental health or behavioral issues, a judge may grant relinquishment in order for the child to receive needed services.
- School districts. Although rare, it is possible for a school district to pay for an out-of-district placement if parents can prove this is the least restrictive option and no in-district option is suitable to meet the needs of the child.
- Private pay. Parents may pay privately for residential care.
Residential Treatment: When Holding On Means Letting Go
The facility where my son is – it’s a good place. The staff cares about the kids and they welcome us as part of our son’s treatment team.
The program is surrounded by beautiful countryside.
This is good.
It’s not home, though.
After he had been there for about a week, when I went back to visit my son he said, “It’s like being at camp, except I don’t come home.”
When he first left, I felt relief. Immense relief, like I could take a deep breath after months of being forced to breathe shallow ones. I cried some, but I also laughed bigger and joked more. It was a bitter – but sweet – gift, this freedom.
Then grief settled in about a month later, and when it came it grasped me by the neck and would not let go. Our son has been in-patient for mental health care a number of times, so I thought I was a pro at him being away from home.
I thought I had this handled.
I don’t and I didn’t.
I came down with a nasty case of the flu which kept me in bed for a week. I shook with chills and my whole body ached. I now understand the definition of what it means to be sick with grief.
These last weeks have been better, although my tender emotions are just under the surface. The layer of grief is always there, continually waiting for me to attend to it.
Our son has been at the facility for several months now.
We visit as often as we can, which is about once a week. By the time we drive a couple hours, visit, and drive a couple hours back it takes most of a day.
Many of the other kids there have no one who comes to visit. As much as a part of me wants to judge parents, I get it.
We’ve been through the living nightmares – Trauma. Courts. Accusations. Effects on siblings.
Now, we are taking care of ourselves. This feels weird and amazing. Self-care takes practice when you are out of the habit. Mike and I go on dates. We go to therapy. We do activities as a family.
Sometimes, we just sit and enjoy the quiet.
Only by God’s power are we able to love fully, to give and forgive with grace. God holds on to me so tightly.
God holds on to my son, too.
God gives me peace so I can hold on…and let go.
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I can’t imagine but it seems the safest and best place for your son and your family. Such hard things you have dealt with, Sara. Prayers and Love…
Thank you for the prayers and support!
So GR8TFUL for your transparency and willingness to share your heart and story. I know many will be helped through your post. They’ll be more brave and take healthier steps. They will know that it is possible to get to the “solution side of things” even if the solution is not ideal!!! God bless sweet Sister!!!
Thank you so much! I greatly appreciate the support and love.
I cannot begin to understand what you are going through. I pray that you continue to care for yourself as you adjust to this change in your family dynamics. Don’t let anyone tell you what to do or that you are making horrible choices for your son and the rest of your family. Only you and your husband know what is best for all of you. May God give you peace, understanding, and guidance as you and yours walk this unwanted but needed path. Sometimes the hard times bring about the greatest blessings. God Bless You.
Thank you so much Cheryl! I appreciate your support. I loved what you write, “sometimes the hard times bring about the greatest blessings.” How true that is!
Sara
Thank you for sharing your story. I will keep you, your son, and your entire family in my thoughts and prayers. I can only imagine how hard this must be for all of you.
I am now retired, but I worked for our school district as a one on one aide to children with disabilities. I was floored when I read your son’s school refused to provide one. I have seen children who were helped with a one on one. I had a student with anger issues and sometimes just going outside for a walk would help. Every child is unique! Please take care of yourself, and remember, you are doing the right thing. I worked with teachers who had no clue, blamed the family, judged me for being an aide and on and on. Remember that you are loved.
Thanks for all you did as a one on one aide. That is at times a very difficult job! I know districts can be hesitant to provide that because it’s expensive! But sometimes it’s what is necessary. Thank you for your kindness and encouragement. xoxo
I have first hand experience with being a mental health patient, and I must say that your son is probably very lucky to be there. Beautiful work getting him there. If he doesn’t appreciate your hard work now, he probably will later on.
Thank you for sharing, Nanette! I pray you are doing better now and have experienced healing and peace.
Thank you for sharing and being real about your feelings and what you have experienced. Praying for you this morning. I just recently came across your blog and it has been refreshing to read. When you are in the battle zone of parenting a child with RAD it can be very isolating and weary. This morning is tough at my home. I have already shed private tears of how much longer can we hold this together. Ninety percent of the people in my world don’t get it so it is nice and refreshing to read your words.
Thank you for sharing and being real about your feelings and what you have experienced. Praying for you this morning. I just recently came across your blog and it has been refreshing to read. When you are in the battle zone of parenting a child with RAD it can be very isolating and weary. This morning is tough at my home. I have already shed private tears of how much longer can we hold this together. Ninety percent of the people in my world don’t get it so it is nice and refreshing to read your words.
Michelle, I am sorry to hear you are walking a similar path. Please feel free to email me anytime, sara@saraborgstede.com if you need to share. You are NOT alone. I know this gets incredibly lonely at times. xoxo
Sara, I can’t imagine how hard this must be for you – continually fighting with the guilt but knowing in your heart that you did the right thing. I have close friends who can identify so well with you. We didn’t understand at first, but when we had their son live with us a few weeks we realized what a burden they carried. He’s in his early 20’s and has a job now, but I know things are still difficult for the family. Thank you for sharing your story. I have shared several of your posts with them and I know they’ve been helpful in helping them see they are not alone.
Blessings to you and may God give you much peace and surround you with his loving arms.
Thank you, Gayl, for the way you have helped another family going through a similar time, and that you have come to more understanding. These types of situations can be incredibly isolating and that adds to the difficulty. I am sure they deeply appreciate your friendship! Thanks for sharing and for your support.
Hugs and loves, Sara. What a difficult road for all involved! Thankfully, we have a loving God who holds is the palm of his hand throughout everything. Tough decisions, made with love. Trusting God to lead the way. What a journey.
We are certainly in need of mental health care for our children in a variety of ways. Finding a place to treat our children, figuring out who will pay for it, managing the personal feelings to get the help that has needed – so many hills and mountains to climb.
Sharing your story helps so many. Thank you for that and thank you too God for giving you the gift of writing!
Thanks, Kerri, for being a faithful reader and ever encouraging! xoxo I appreciate you! There have been many mountains to climb but God gives us the strength when we feel like we can’t take another step. He is faithful.
Sara,
My heart goes out to you and your family. My prayers are with you. Thank you. Thank you for being a parent who will stop at nothing to find the answers. Thank you for loving a child who is challenging. Thank you for sharing your story so others may find inspiration and answers. You have a great strength. And with God nothing is impossible. My favorite verse in the bible is Jeremiah 29:11.
Thanks so much for your support, Claudette! I appreciate your Christian encouragement. It is so true that with God all things are possible, and that is the truth I cling to in the tough times.
Thank you for sharing your story. Our family is walking a very similar path with our son and we, too, have had to fight to keep safety the defining factor in our home.
Thinking of you, Micci. Anyone who has walked a similar road knows a great deal of heartache. While I wouldn’t wish this on any other family, it helps to know we aren’t alone. Prayers and peace to you.
Thank you for sharing your story, Sara. I worked in two different residential treatment facilities early in my career and it was some of the most challenging work I’d ever done. But I saw great progress many times, especially for the kids whose families actively participated in their treatment (family therapy). I know you and Mike made the best decision for you, your son, and the rest of your family. I will keep all of you in my prayers. I’m sure this is very hard on all of you. Hopefully, by sharing your story, others will have the courage to get help for their loved ones.
Thanks for sharing, Jenny! I appreciate the work you did and do for people and families that need it. I’m sure your experiences at treatment facilities have given you greater compassion for the work you are doing now. Thanks for your insights and most of all for your prayers.