<p>Hi - My D has just melted down again. Without going into too much detail her medical professionals recommend and she and we agree that she needs to go to an residential psychiatric facility to kickstart her recovery. Primary issue is depression plus (IMHO) narcissistic personality disorder. Right now the two names that are coming up most often are Austen Riggs and Silver Hill. If you have information on either of these facilities or others in the New England or Mid-Atlantic areas that you can share, based on experience of your son or daughter, or of someone else very close to you, I would appreciate your input. </p>
<p>Please don’t post responses questioning why we are doing this, or lists of facilities from the internet. We are clear that she needs this type of intervention. If you know of someplace other than CC where I could post this inquiry, that would also be helpful.</p>
<p>Thanks, Photo Op. I should have specified in my initial post that she is 19, since that does make a difference as to which programs will accept her. </p>
<p>Have you had any experiences with the McLean adult programs?</p>
<p>Thanks, Bookworm. I know, we’re just assuming we’ll be paying for this ourselves, with perhaps a pittance from our insurance. Can you tell me something about you or your family’s experience at McLean? Please feel free to PM me if you prefer.</p>
<p>Know about Silver Hills through work in ER and a family member’s experience. Good, solid reputation. Are these the facilities recommended by her psychiatrist? Will they, (Silver Hills), include him/her in the team meetings or planning? Thoughts and prayers with you both. If you should chose not to go the inpatient route, Danbury Hospital has several comprehensive day programs that work with teens. I know of some teens that have had a successful experience and other that had a mediocre one. I believe a great deal depends upon who is your private therapist and how they will work with you and the program.</p>
<p>From my experience handling benefits for several companies I am somewhat familiar with Silver Hill. They have been around a very long time and have a solid reputation. Absolutely beautiful facility, too.</p>
<p>A member of my family was a patient at Silver Hill a long time ago. Very nice facility. However, at that time, the vast majority of the patients at Silver Hill were being treated for addiction. My relative said that the whole structure of the place was geared to the needs of this group and that the other patients got the short end of the stick.</p>
<p>I wonder whether this is still true. It might be worth inquiring about the proportion of patients who are being treated for addiction vs. other problems.</p>
<p>It’s been 20 years since I worked at McLeans. I have only positives to say about the staff. I did some training at Austen Riggs and again, was impressed. </p>
<p>I would talk to admissions and ask how clients are grouped together, e.g. By age or diagnosis. Get a weekly roster of groups and amount of individual therapy. Ask if her therapist will be an intern or a PhD or LMSW. The websites offer a lot of info, but it helps to talk to someone in admissions. Also, ask about sleeping arrangements.</p>
<p>I think all your choices are good, it is a matter of what you think will be a good fit for your daughter. If all else is the same, chose the facility closest to you. Many places wants one session of family therapy a week, and visiting day can be on Sunday. When I was working in a residential facility a few years ago, I did family sessions on the phone, but it was preferable to have at least one family member in person.</p>
<p>Shepherd-Pratt in Baltimore came to my mind, since you mention Mid-Atlantic, as well as New England. My direct experience is more than 40 years old, however: they treated my mom and also employed me as a psychiatric nurse’s aide (not at the same time!) one college summer. Back then, they were leagues ahead in every way for treating depression. They were keyed in to medical community from Johns Hopkins U. Perhaps still so? I don’t know. </p>
<p>IIRC, That was also the treatment location for the author of the famous autobiography, “I Never Promised You a Rose Garden.”</p>
<p>Actually, I was just looking at the websites. Both McLean and A R take insurance. AR states that insurance companies pay for initial time, but often not extended stay. I think that will be true anywhere.</p>
<p>At my last job in a facility, after a few weeks, I’d had to call weekly to get another week or 2 covered. That was an eating disorder facility, and each insurance carrier had specialists in that field. I got to know each person by name. If insurance only covered 3 or 4 weeks, many families would pay for extended treatment. The directors had the final say if they would reduce the fee.</p>
<p>One reason I liked working in residential facilities was that I saw so much change in the clients. Granted, my specialty was adolescents, and almost every one would say they were pushed to enter, but they learned so much about themselves, their family dynamics, how to relate to peers, how to express themselves, far more than they ever learned in weekly outpatient therapy. It is an intense experience, but can be life changing in a positive way.</p>
<p>We recently went through this process with my husband’s niece. The facilities we looked at were Austin Riggs, Macleans, Yale-New Haven, U Mass, Silver Hill and Brattleboro Retreat. The facility we settled on was Silver Hill, based on reputation and the fact that they had an immediate opening. It was a mistake, and a very expensive one.</p>
<p>My husband’s niece (depressed, suicidal, bi-polar, possible borderline personality disorder) never made it through the 7-10 day intake period into the residential program. The psychiatrist in charge of intake was arrogant, lacked interpersonal skills, and worked poorly with the family. His inability to connect with my husband’s niece undermined her attitude, which had initially been positive, and, because she is of age, she was able to sign herself out of the facility. (The psychiatrist felt, at the time, that she was not likely to harm herself, or else he would have gone for involuntary commitment.) </p>
<p>Since then, we have been fortunate to find outpatient options that she seems, for now, to be responding to–but every day is fraught, and I can sympathize with all that I know you and your family are going through.</p>
<p>I am sure there are many people who have had and will have very positive experiences at Silver Hill, but I felt I would have been remiss had I not shared our experience with you. Since you already have your own medical professionals involved, I think you should be in a better position to deal with these residential facilities with their help.</p>
<p>EC - My D’s former adolescent therapist recommended S/H, but her current adult therapist (different city) has reservations because the adult program includes little if any one-on one psychotherapy, and is more DBT(?) based. We all think she needs both, so it may be a non-starter. </p>
<p>Thanks, Worm, that’s very helpful. The only place that anyone is recommending that’s anywhere near us is Sheppard Pratt. From the website I’m not sure it’s the right program for her, and the daily cost is TWICE what the other places are asking (and of course they’re not inexpensive to begin with!). </p>
<p>If you have any suggestions for the mid-Atlantic area I’d love to hear them.</p>
<p>Lorna - Thank you so much for the disclosure. It is certainly something we will take into account. Do you have any thoughts you can share about the other facilities you mentioned?</p>
<p>Update - My husband found out that our insurance will pay something towards this whole endeavor - based on the “reasonable and customary fee” they determine. Still, it’ll certainly help.</p>
<p>Next question - do people go and visit these places before they choose? And if so, with or w/o the intended patient? </p>
<p>I am happy to say that my daughter is being released from the hospital and will be coming home for a few days while we sort this whole thing out.</p>
<p>A member of my family had a positive experience at Austen Riggs 50 years ago and is still involved as an “alum” because of the belief that the place had a transformational impact. When a friend recently needed placement for a college-aged child, they checked out Mcleans and AR and decided on AR for several reasons, one of which was a more bucolic location!</p>