My 13-year old daughter’s emotional health has been declining for the past 18 months. She’s either very depressed or very angry, and is becoming more and more abusive. Counseling isn’t working fast enough. Her pediatrician has prescribed three different antidepressants during the past 18 months and now recommends a child psychiatrist. The closest appointment is two months away. We can’t wait that long. She can barely function at home, is in trouble at school when she attends, and doesn’t seem to care about anything.  She is failing everything, and I don’t know what to do.

A long wait for a child psychiatrist appointment is not unusual, and getting one is further complicated by the need to see an MD who is on your insurance provider list. An often-overlooked resource is a clinical research study. If your daughter meets the criteria for a particular study, she can be seen by an advanced practice nurse or a psychiatrist within a few days of the initial call. As a participant in clinical research, she would receive free medical care during the time she participates. This includes ongoing physical exams and laboratory screening tests. She would receive free medication during the trial, and may be eligible to continue receiving free medications up to several weeks after she completes the study. During participation in the research, you may also be paid a small stipend to help offset your time and travel. There are several practicing psychiatrists in the St. Louis metro area who are recognized for conducting quality psychiatric clinical research. We all know how research benefits our greater society, but many are not aware of the extent to which psychiatric research can benefit an individual. 

Nan Roberts, RN, CS, AP/MHCNS
Saaid Khojasteh, MD & Associates
St. Charles, MO  63301
636-916-1900

You may not be able to fix your daughter’s school problems at this juncture. Over the long term, therapy and medication will assist but, for the time being, it is unlikely that the behaviors at school will change significantly.  The reasons are as follows. Your child has “dug a hole” from which she perceives it is almost impossible to get out. She begins to feel hopeless about her failing grades and her ability to turn them around, so she thinks there is little point in going to school and trying to be productive while the school environment has become a hostile one. The student has been in trouble for skipping, not completing homework, disciplinary infractions, etc., and she now feels that teachers and administrators view her as a problem student and are trying to find ways to have her removed from their system. The typical adolescent response to this perception is to avoid school and/or to defy authority while there. Usually when the student is in this type of situation, the recommended step would be to remove her from the environment, and place her in some type of alternative program where she can see the potential for a “fresh start” and some success. If this is accompanied by appropriate therapy and frequent and consistent communication among teachers, parents and therapist, the prognosis for improvement is much greater. 

Shirley Kaczmarski, Ed.D
Electus Academy
636-441-0402 

 Want to see other Open Mind columns?  Click here for Archive Index.