Psychiatric News April 15, 2005
Volume 40 Number 8
© 2005 American Psychiatric Association
p. 20
Mother Grateful for Options For Daughter's Care
Eve Bender
A Seattle-area mother gains some control over her daughter's
treatment with the help of a program that enables families to decide how funds
can best be spent to help their child with mental illness.
By the time Selena Walker became involved with the Blended Funding Project
at age 15, she'd been ousted by a number of residential facilities and
psychiatric programs whose staff declared that she was "too tough"
or "too difficult."
According to her mother, Tammy Walker, Selena's difficulties began in early
childhood and intensified as she grew older. She often acted on aggressive and
self-destructive impulses, endangering the safety of herself and others.
When Selena was 9, Walker placed her in a group home. "She stabbed me
with a butcher knife, and at that point I knew she was more than I could
handle," Walker told Psychiatric News.
Her aggressive and self-harming behavior did not abate in the group home,
and Selena was transferred after a year because she was deemed "too
tough" for staff to manage.
Over Walker's objections, state administrators sent Selena to a group home
in Spokane, Wash., more than 300 miles from where Tammy Walker lives and works
in Seattle as an information-technology specialist.
But that stay, as well as the psychiatric hospitalization that followed,
was short-lived.
This wasn't true of her next placement at the Child Study and Treatment
Center at Western State Hospital in Tacoma. While the average length of stay
is nine months, Selena stayed for more than five years.
Tammy Walker noted that few of the children at the state hospital had
contact with their families, but she was involved to the point where she
assumed the role of Selena's case manager for the state.
By this time, Walker noted, Selena had seen a number of psychiatrists and
mental health professionals and tried several treatment modalities, none of
which seemed to help.
However, during her fourth year of hospitalization, Selena began receiving
dialectic behavioral therapy (DBT), and "we started seeing positive
results," her mother said. The DBT enabled Selena to cope with strong
emotions in a constructive way, rather than using maladaptive behaviors, such
as cutting herself, destroying property, or acting out.
Months after Selena's behavior began to improve, there was pressure from
hospital administrators to discharge her to a community setting.
"I asked them, `How can you discharge her so soon?'" Walker
said. "Up until that time, Selena had nothing but failures and problems
with treatment."
Despite Walker's concerns, Selena was discharged to a less-restrictive
setting—a group home for young women with mental illness—and began
to decompensate again.
The self-injurious and violent behavior resumed, as did the multiple and
serious suicide attempts. Selena had to be transferred out of the home after
one year there.
While at the residential facility, Walker said, Selena began receiving
services through the Blended Funding Project. Walker, who had acted as her
daughter's case manager for years, led the team of family, friends, and
clinicians who dedicated themselves to Selena's recovery and "decided
how funds set aside for Selena could best be spent," she said (see
page 20).
Many of her daughter's subsequent placements, such as treatment at
Seattle-area outpatient mental health programs combined with psychiatric
hospitalization at night, were coordinated and paid for through the Blended
Funding Project, Walker said.
Due to a bout of violent behavior when she was 17, Selena was sentenced to
a year in a juvenile-justice facility. The Blended Funding Project enabled
Selena to serve her sentence at Echo Glen, a facility in which women with
mental illness are treated with DBT. Selena worked diligently in treatment,
according to Walker, and improved.
While Selena served her sentence, the Blended Funding Project enabled
Walker and her husband to receive counseling.
Since her release, Selena, now 22, has made no suicide attempts and has
been living in the community.
"She still struggles, but she is out there making her way,"
Walker said, crediting the Blended Funding Project with the stability Selena
has found as a young adult.
"The skills and experience Selena use today to live on her own she
acquired through the Blended Funding Project," her mother said.
"This project went to the mat for Selena. What we see today is that,
despite the odds, Selena is a rousing success." 
Related Article:
-
Families Are the Experts In Child MH Programs
- Eve Bender
Psychiatr News 2005 40: 20-63.
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