Parents

Levels of Care For School Avoidance

A child with school avoidance should be getting mental health assistance from an experienced professional. The level of care will be determined by your child’s progression or severity of symptoms. School avoidance can be disruptive to the whole family unit as well, so you may require more assistance for yourself, your other children, or the entire family.

The following is a list of levels of care that may be suitable for your child with school avoidance.

Levels of Care

Outpatient

This is your basic once or twice-a-week therapy session at your provider’s office or online. Therapists have to be licensed in your state to provide you with teletherapy. Outpatient treatment is appropriate when your school-avoidant child needs help but their symptoms aren’t bad enough to affect their daily functioning.

Intensive Outpatient (IOP)

Usually incorporates multiple visits per week (2-5) with more structured programming for clients with more severe symptoms. Hours per day will vary among programs. When the program is for youth or adolescents, they are often offered after the school day.

Partial Hospitalization Program (PHP) aka Partial Care Program (PCP)

Partial programs are a way to get intensive treatment without being in a residential setting or hospitalization. These are day programs where the hours of treatment could be an entire morning, a whole afternoon, or a full day, usually five days a week. Sometimes partial programs are utilized as a “step down” program. Going from an inpatient setting and then gradually reducing the intensity and level of care. This type of program is also used as an alternative to inpatient.

The Day Program Dilemma

Many of these programs have top-notch clinicians, and therapeutic interventions specifically developed to help kids with school avoidance. But some school avoidant kids are too anxious to start going to these programs every day. The programs know this can be an issue and many will have strategies to help ease your child into the program. Of course, you will speak with the program director and they will help you determine if their program is a suitable option.

Inpatient Hospitalization

This is the most intensive level of care for people who are in emergency situations. If this is for a child whose school avoidance has gone into a crisis situation; these facilities will most likely be psychiatric hospitals with children/adolescent/teenager programs.

These programs are usually within (or affiliated) with a general hospital containing a child’s psychiatric unit or in a specific psychiatric clinic with a children’s program.

The team that treats your child will develop a plan of care for their stay. The length of stay will vary. It usually is between 3-7 days and sometimes can be 7-14 days.

The purpose of this level of care is to stabilize, get through a crisis situation and get a plan for ongoing treatment upon discharge.

The treatment plan will identify the next level of care needed, possibly medication management, it may note preferred modes of therapy, and possibly referrals to other treatment providers.

A parent, emergency room doctor, personal psychiatrist or psychologist can do the referral to an inpatient program (hospitalization).

These programs are required to have a school-like component, but truth be told, many have an educational supervisor to assist with any school work provided for them from their home school district.

  • You will want to call the inpatient program before you plan to go, in order to:
  • Find out if you need a referral from a mental health provider or if you can just bring them in as their parent or caregiver.
  • Make sure that this is an appropriate program for your child and ask questions about who is on a child’s care team and what the typical day entails.
  • Find out if they have a bed for your child or how long the waitlist is.
  • Ask what their typical length of stay is
  • Determine if they take your health insurance, or will they submit your claims as an out-of-network provider on your behalf?

Residential Treatment Center (RTC)

Residential treatment is similar to when you hear that someone went to “rehab.” It may be appropriate for kids with entrenched school avoidance who have a major depressive disorder, a severe anxiety disorder, OCD, PTSD or other mental health challenges that are fueling their school avoidance.

It differs from inpatient hospitalization because:

  • Although they treat kids in crisis, there is no immediate concern about the child hurting himself or another person.
  • They are usually located in a more home-like environment where all the kids in the program live together in dorm-like rooms or in houses on the property.
  • The stays are longer and can vary from 30-90 days plus.
  • The treatment is much more in-depth with staff who are specialized in disorders associated with school avoidance.

 

In addition to getting more intensive forms of therapy, it also allows the clients to get away from their usual everyday environment and concentrate on improving their mental health.

These programs usually have a well-structured school component. You will need to find out if they take your health insurance or will they submit your claims as an out-of-network provider on your behalf?*

The Emergency Room

If your child is in crisis and/or you fear he may be in danger, do not hesitate to go to your local emergency room. Some hospitals have a pediatric emergency room. If you have been considering this option and have time without jeopardizing safety, you can call the hospital ER and ask them. Some ER’s also have a space for mental health evaluations.

Your State Children’s Mobile Response Crisis Intervention (24/7)

Most states and counties have designated mental health intervention services for children in crisis. This could be another option for crisis intervention when a child is not in danger of hurting themselves or others.

Mobile Response and Stabilization Services are available 24 hours a day, seven days a week, to help children and youth experiencing emotional or behavioral crises. The services are designed to defuse an immediate crisis, keep children and their families safe, and maintain the children in their own homes or current living situation in the community.

The responder will meet with you and your child and determine the level of care needed at the time and help connect you with community mental health providers.

You can usually find these programs on your state or county’s Division of Mental Health website.

Or you can try googling: “your state or your county children’s crisis intervention,” “children’s mobile response,” or “children’s system of care.”

You can also try “your states Division of Child” and Families and “Mobile Crisis Response.”

This is a directory of some states and their crisis response contact information courtesy of Black Emotional and Mental Health Collective.

*https://www.ashcreekranchacademy.com/residential-treatment-centers-complete-guide-for-parents/

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