Any Good Institutions?

[helpmymom]

I just barely found out the actual diagnosis my mother has been living with for years and I am now determined to seek help for her although she denies anything wrong. See, I always knew she was ill, but never knew it was as serious as it is getting now. I want to put her in an institution so that she can recieve 24 hour attention (the kind I cannot provide now b/c of school and work), but am a little uneasy about a county hospital. Would anyone know of a reasonably priced facility in Houston?

[Guest ASchwartz]

Hello, HelpMyMom and Welcome to our community,

Many people make the same error in believing they can have a loved on hospitalized for having a mental illness. In actuality, people cannot be hospitalized unless they are threatening to commit suicide or are threatening to harm someone else. It is not only that insurance companies will not pay but hospitals will not admit unless there is a threat to life and limb.

So, unless your mother is suicidal or homicidal there is nothing much you can do. If she were willing to admit she has a problem she could be sent to a psychiatrist for evaluation and medication.

I know this must be extremely upsetting for you.

Anyone else have any ideas?

[Natalie]

Hi-

What sorts of issues (i.e. what diagnosis?) is your mother dealing with?

[townjg]

Unfortunately, there's a huge gap between people who qualify for long-term hospitalization (immediate danger to self or others) and people who can function without a significant support network. They're not ill enough to qualify for hospitalization but, without constant support, will not be able to adequately care for themselves.

Many communities have support centers (privately funded, non-profit, and government funded) that help people with mental illness live relatively independent lives. Unfortunately, my mom's support center just got slashed out of the county budget. I've got about a month to figure out how to get her in a safe situation from hundreds of miles away. The few remaining support organizations in the area were already "full" and can only take on a few of the clients from my mom's group provided they get a referral from the county's mental health department. And that requires that she make an appointment with her social worker, keep that appointment, convince him that she needs the services, follow through with the paperwork, and beat out the other 80 or so people trying to get into the same program. If she had the initiative and follow-through to do that, she wouldn't need the help.

So, on the one hand, she can't adequately care for herself. On the other hand, she's not ill enough to qualify for long-term hospitalization. And the organization that used to fill the gap for her and around 80 other people just got the ax without adequate resources of a similar nature to take up the slack. Welcome to mental health care in America.

BTW, according to her case worker, we wouldn't have any problems if she was suffering from dementia. Plenty of support for that.

[Natalie]

Hi-

Unfortunately, I see this sort of thing happening all of the time. Doesn't make it any easier for you to deal with... I second your opinion that our mental health system is REALLY CRAPPY.

So, does your mother have the legal power to make her own medical decisions? In other words, if you were her conservator/guardian you could take all of those steps on her behalf. Pursuing that now probably would take longer than you have, but it's a thought for the future.

Are there any group homes in her community?

[townjg]

Thanks for replying. Conservatorship may become an issue/tool but she's not rejecting assistance at all. In fact, the more the better as far as she's concerned. The problem is that they key support network that keeps her functioning is about to disappear with no replacement services available.

There are board-and-care facilities as well as a group home (16 residents) but the group home is full and the only available board-and-care facilities charge roughly double what she gets in disability/ss*/etc. If she was entering that level of care from an involuntary commitment, there'd be no problem but it's a one-way street. Do not back up. Severe tire damage.

About 10 years ago, she was hospitalized for about 2 years. Then went to the group home, then board-and-care, then (with housing assistance and support services) her apartment. There was no cost involved as the process was initiated by the involuntary commitment. And, each transition was handled by mental health services. Once she was making progress in the hospital, they started the process of getting her into the group home. As soon as she was in the home, they filed her application for housing assistance. While waiting for that to go through, they moved her to a board-and-care to get one little step closer to independence. When the housing assistance, support services, and apartment were lined up, they moved her. All smooth as silk.

However, she can't regress from "independent" to "board-and-care" voluntarily unless she comes up with the money to pay for it. The fact that they removed a key element of her current living situation doesn't seem to matter. Very frustrating.

[Natalie]

That's so frustrating for your mother... and you. Is the case worker providing any alternative suggestions for you to pursue?

A couple of other ideas that come to mind:

Have you tried to contact the the Information Helpline of the National Alliance for the Mentally Ill? Calli 1-800-950-NAMI (6264), Monday through Friday, 10 am- 6 pm, Eastern time. They have regional offices that might be able to help out.

Also, is your mother old enough to qualify for Medicare/Medicaid? I wonder if pursuing options through the aging network route might be an option. I ask because you mentioned dementia in the previous post.

[townjg]

Her case worker at the support organization is putting me in contact with her doctor, county social worker, and a person she's worked with at APS (Adult Protective Services). The director of the organization should be able to give me a wider picture of what services are available in that county and surrounding areas. It's just all happened so fast. (Even the APS contact wasn't aware that a date had been set.) They're doing what they can with the resources available.

I'll certainly give NAMI a call. Maybe they can help me find options closer to where I live. It would be nice if visiting mom didn't involve 6+ hours of driving. I know she'd like that.

As for aging network support, I mentioned dementia because there wouldn't be a problem if she was suffering from some form of it. Plenty of support. But the groups and organizations in the area providing support for dementia don't include mental illness in their scope. While they seem similar on the surface, I can understand why they would want to limit their focus. Mental illness is a whole different animal when you get down to it. Treatment and recovery vs. management and comfort.

I'll give NAMI a call. Thanks again.

[Natalie]

Does anyone else have any ideas for townjg? I imagine that this isn't the only person who has had to cope with this type of situation...

[townjg]

To follow up: A county mental health rep assures me that all of the people being displaced will be transitioned to other existing programs in the area and that the county is working with the support group to make sure nobody falls through the cracks. This conflicts with mom's case worker at the support group who says that the other programs don't have the resources to handle their entire client base and that the clients would be required to be proactive and seek a referral from the county to apply for one of the few spots open in the other programs.

I'm supposed to get a callback next week to tell me exactly what her situation is/will be. I'm somewhat less uneasy but there's still a big gap between the pictures I'm getting from these two groups.

BTW, NAMI does have an office in her city. I haven't received a callback yet but it seems like they could be a good source of information.