<p>I am fortunate to have been spared direct experience with this issue, but I have one cousin and one close set of friends who are dealing with similar problems. The one family’s experience has mostly been in the Midwest and the West Coast (and has mostly been bad, so let’s pass over that). The other had their then-19-year-old at McLean for three months, which was extremely successful in terms of resolving a confused diagnosis. After that, the kid in question has spent fairly long periods at Spring Lake Ranch in Vermont, and I think everyone in the family has been comfortable with the quality of life and treatment there.</p>
<p>Of course you can visit. They will interview you and family, and no reason you cannot see each place for yourself. It is probably a 2.5 hour drive between mcLean and AR, but seeing both places will help make this important decision.</p>
<p>I’ve been looking at the hospitals in Phila., and UPenn and Friends are ranked well. A Philly person could add their experience. My personal preference is for a facility that is all psychiatric, rather than a unit in a hospital.</p>
<p>DBT and CBT are the standards. In my last job, I broke down each into 8-10 programs for groups. Each group would have a theme, some role play, education and discussion. Other groups would focus on art therapy, exercise, family dynamics, etc. Since the OP is only looking among the top facilities, I suspect she will find really good people leading such groups.</p>
<p>
</p>
<p>I have not shared much of my story on CC due to privacy issues, but I am becoming more and more inclined to share my story with people I’m less intimate with. Mental health issues need to be addressed in our health care system, for reasons I’ve quoted above - SO many people are in need of this kind of help, yet it is cost-prohibitive.</p>
<p>A year ago September I had what some of my doctor’s called the perfect storm - I developed hyperthyroidism (am already on thyroid medication, but that’s another long story) about the time I started to experience some peri-menopausal issues. It all manifested itself in debilitating anxiety that peaked in the early winter, then in late spring. I went through several medication changes (another very long story, but the gist of it is that I fired most of my current health care team and found almost all new physicians), but the anxiety was so bad I became borderline agoraphobic. I tried two partial hospitalization programs (what a joke - our insurance company was convinced I didn’t need this level of care - oh, did I mention I lost almost 30 lbs from no appetite in about three months - they were already planning my discharge in the first couple of days), but the relenting anxiety sent me into a serious depression. Finally by April, I’d had enough. I wanted to be in a residential treatment center where the tweaking of some meds could be done under closer supervision and at a speedier rate, so in May I went to the Menninger Clinic in Houston. I know you’re not looking in that geographic region, but I will say that there were a lot of patients there from out-of-state, including teens/young adults. But I have family in the Houston area, which was supportive. I also consider Austen Riggs, but the only person I know in the Boston area is my oldest daughter, and I didn’t want that responsibility of being my only visitor on her.</p>
<p>I spent eight weeks at Menninger. Some of it was life-changing. Some of it was not so helpful. In the end, some of the med changes they recommended and initiated were not the ones my treating physician at home was comfortable with, so we continue to tweak meds, even now and I’ve learned I need more patience in making some lasting changes. I’m just going to be one of those very difficult to treat peri-menopausal women whose anxiety will never be managed without the cooperation of a good internist, endocrinologist, gynecologist and psychiatrist (I didn’t mention the breast surgery I had to have within a month of discharging from Menninger, either!), so I am learning to let go of the feeling of failure from being on so many meds, but hey, they help me function in life right now, although it’s still not perfect.</p>
<p>What I want to warn you about is your quote I highlighted above. Don’t be fooled by phrasing, semantics, etc. you might find in your coverage definitions. We had to pay up front for Menninger two weeks at a time, but fortunately we were in a position to make that happen. Our insurance company is still reviewing my medical records from Menninger (I was discharged in early July) to determine if they will cover anything beyond the first five or so days they covered at an out-of-network rate, which barely made a dent in the final tally.</p>
<p>We have little hope to see any more of that money reimburse to us, but I do wish the insurance company would make a decision so we can at least start an appeal process (there were other things that happened prior to Menninger that our insurance company screwed up that lead us to believe they may offer to pay more than they usually would so that we don’t tie them up with an appeal process). For if we are not reimbursed any more money (or even if we are, we know it won’t be 100%), for once, we will finally be able to take advantage of tax deductions for medical expenses in 2012, and it should help us get a sizable refund. As I said, we’ll never expect to see even 70% reimbursed of what we paid, but we will be surprised if we see anything.</p>
<p>This has been a difficult post to write - for the most part, I have been AWOL on CC as I continue to find some semblance of normalcy in my life; my priorities have changed, and I just don’t spend as much time on the computer anymore, but when I checked into CC and saw this thread, I knew my time had come to tell my story… that it might benefit someone else. For those who might judge me for what I have shared, they are not worth my worrying about and I can be OK with that. As far as my closest friends go, they have been nothing but supportive, even when they can’t understand what it is I’m going through. They don’t judge me, which is their gift to me since I’m my own worse judge.</p>
<p>I wish you the best, and if I can answer any more questions, please feel free to PM me.</p>
<p>Thanks for such a generous, honest, and helpful post, teriwtt!</p>
<p>teriwtt, thank you SO MUCH for sharing your story. I am feeling the same way about sharing my two sons’ stories. The more I share, the more I hear from other families going through mental health struggles. I am encouraged that people are sharing openly now. We HAVE to, in order to improve things. You are very brave to share like this, and it is deeply appreciated.</p>
<p>It’s discouraging to hear of your financial investment. I think my younger son would benefit greatly from residential treatment, but there is no way we could afford it. That makes me sad.</p>
<p>Another thank you to Teriwtt. Having my kids be 7 yrs apart I have spent a lot of years on CC. Though I have never met any of you in person I feel like I know you. Hugs to you.</p>
<p>The weird thing is I was having a thought on insurance that I wanted to share and came on CC and read your post and MaineLonghorn. What frustrates me regarding insurance and mental health coverage is how it doesn’t seem to care about the outcome. In our case we have a family member who has had both residential treatment and also hospital psych ward admissions. Having had experience with 4 different psych hospitals I have found that they are basically useless aside from keeping the patient safe from themselves. They make medication changes that they don’t know are going to work and won’t know if they work because the patient has long been discharged.A 5 day hospital stay costs the insurance company a ton of money and our co-pay was very little. With residential care our insurance only paid 180 dollars a day for 28 days. Where can you get care for that. One month of residential costs about what 5 days in the hospital cost. The work that gets done in residential treatment is far superior.Also in our experience 30 days is not near enough time. The first week is basically lost as the patient adjusts, they have two weeks of good work and then it is family week. After family week the patient is already thinking about when they get out. It becomes a case of those who have resources get better treatment. In our case our family member was in treatment for as long as it was needed not based on how long the insurance company was willing to pay.That makes me sad.
I do know of a family who was able to get their insurance to pay for 5 months of residential care. It was through the appeal process. They were able to show that they had exhausted all outpatient options prior to the hospitalization.
We also know a young male who spent 3 months at Menninger. The family was very happy with the quality of care.</p>
<p>Four Winds in Katonah, NY - about 1 hour north of NYC - about 3 hours from Boston - has a stellar reputation. They treat children and adults; I think that breadth of experience is important for a young adult. Good luck, I know it can’t be easy for you.</p>
<p>You might want to check out Spring Lake Ranch in Vermont. My nephew suffers from a severe mood disorder, and was very sick for several years. He had a life-changing experience at Spring Lake Ranch 2 years ago. Best of luck to you and your daughter.</p>
<p>Teriwtt, thank you and best wishes for your continued recovery.</p>
<p>As it happens, I worked at Silver Hill one summer during college, and my mother was an RN there for a number of years. Our experience was so long ago that it would probably not have much relevance today, but at the time they had a house for younger patients, although some of the younger patients were in other houses, if they needed a one-on-one aide, for example. None of the younger patients were there for addiction issues. </p>
<p>I know that Silver Hill had already changed significantly from its much earlier incarnation as a place where wealthy alcoholics went to dry out, so I assume it has evolved equally significantly since then. (The early 70s.) My impression is that they have always adhered to a high standard of care. But it has also always been a relatively luxurious facility that catered to a well-heeled and often well-known clientele. There is a significant price tag associated with that.</p>
<p>What about Institute of Living in Hartford, CT?</p>
<p>Just looked up Institute of Living, it is now part of Hartford Hospital. They were named US News and World Reports Best Psychiatrist Hospital, 2011-2012 and have a specialty treatment dept for 17-26 yr. olds. I knew someone whose brother was a patient there, but it was years ago.</p>
<p>^That sounds interesting! I’ll have to look into it.</p>
<p>Yes0 it is part of Hartford Hospital. Apologies for not clarifying that. Has had a very positive reputation.</p>
<p>And a belated thank you to all of you who have shared your personal journeys. It is hard enough to travel though this journey, and harder still to share it with others.</p>
<p>MaineLonghorn - thanks for the supportive words. You have set such an awesome example for me in sharing my story, by being so open with your sons. There is so much to do to get rid of the stigma of mental health issues, and I believe one of the first steps to start authorizing treatment and reimbursement the same as medical health, not separating medical health from mental health when it comes to benefits. That, and just speaking out about it without carrying around the shame that so many people feel.</p>