My friend’s 9 year old has had severe behavioral problems and several alternating diagnoses. The Dr. has prescribed Focalin, Trileptal, Lamictal, and Seroquel. She has no concentration, violent outbursts, hallucinations, etc. She has been diagnosed, at present, with ADHD, Bipolar, ODD, and PDD. She will not do work at school; instead, she sits and picks at her skin. She has been violent and tried to choke other individuals. Mam says she can’t even leave the house with her.
My friend has no money. The state has removed an older child due to DMH reasons. She is afraid of the state agencies, but has nowhere to turn. Court appointed attorney said to call if she won the lottery. What happens to these children? These medications seem excessive and risky considering her age, the possibility of adverse interaction, and off label usage. Any advice or help. We are desperate. Thank you.
Dr. Fink answers…
This is an all too common situation in children with multiple levels of developmental, emotional , and behavioral symptoms, especially when the family’s resources are limited. The first place to start is with the current doctor to get a clearer picture of the reasons for the current medications and to express clearly the ongoing symptoms that are not being addressed.
The doctor should also be able to assist the family in locating additional support services, such as a therapist in a clinic or university setting that has a sliding scale. A therapist that works with the child and family is going to be a core piece of the puzzle here and if that isn’t in place it will be hard for the child to get better.
If the doctor does not seem willing to work with the family to develop a more comprehensive treatment approach, your friend can seek out a second opinion through a similar clinic or university setting. Her child may qualify for health insurance through the state even if the parents do not – and that may help to access more care for her child.
Each state and county has different systems for providing services to mentally ill children and their families. While your friend is afraid of the public agencies, she will have more success if she seeks out help voluntarily and proactively, rather than waiting until a major crisis erupts and the authorities get involved anyway. Many counties now have Family Advocacy agencies that will help families mobilize the services they need and provide support to the children and families through all the challenges that they face. Child Protective Services may be able to refer your friend to such an agency where she might find support groups and other help free of charge.
The other place to seek help is through the schools. As this child is not functioning at school, the family can request an evaluation and pursue more supports through the district. Special education law requires that states have education advocates available to families to help with this process, at no charge to the families, so your friend could look into this as well.
By the way, a court-appointed attorney cannot reject a case; they are court appointed for people who don’t have any resources, so your friend might want to explore that more with the state bar association.
Photo by Megyarsh, available under a Creative Commons attribution license.