Help me help my teenage sister get help.

February 26, 2012 10:35 AM

What rights does a 16 year old in Texas have regarding pursuing her own health-care, specifically mental health?

My previous questions have dealt with my mother's mental health, and I'm happy to say I've resolved to low-contact with her and accepted the fact that I can do nothing to help or change her. This question is about my [minor] sister.

My sister will be 16 in May and will have her driver's license and car then, so transportation will be no issue. She started showing signs of depression a couple of years ago, and was receiving help through MHMR. I recently found out that my mother pulled her from the MHMR system about 6 months ago because she "seemed to be doing a lot better" (mom's words).

Sis is now having frequent, random bouts of hours-long crying fits for "no reason" (Sis's explanation). Mom apparently tried to take her back to MHMR, but they won't accept her again. While both Mom and Sis tell me that mom's looking into other options, I really don't trust that she's really putting in the effort. MHMR was the "easy" route, and mom's not known for doing much more than the "easy" path in most situations. It has been at least a month since my sister made me aware of the situation, and she till hasn't seen anyone.

As her sister, I obviously have no legal rights to get her the help she needs (and knows she needs and even desperately wants). Her father is useless in this regard as he doesn't believe in mental illness. (To him, it is a behavior/discipline issue) I am in no financial position to try for guardianship/custody.

I am being the best older sister I can from 250miles away. Sis is aware that I'll drive down to her at the drop of a hat if she needs it, and she always has an open door here too. We chat via text at least once, but more often two or three times a week.

My question is, given the above, what rights does my sister have (if any) in finding her own mental health providers? I know she has insurance coverage, though through which parent, and what the coverage entails, I cannot be sure. I'm more than willing to go to bat for my sister in any way I can, so I'm willing to explore other paths, if anyone has any other suggestions.

Location Info, if relevant: My sister/family lives in San Patricio county (po-dunk South Texas), and once she has her license, will have better access to the surrounding counties.

posted by MuChao to Health & Fitness (6 answers total)

If your sister finds treatment on her own, do you think your mom will try to stand in the way of her pursuing it? Your sister could start by visiting a guidance counselor or school nurse. They should be aware of resources for teens with depression or other mental health issues, and they can help put her in touch with those resources. It sounds from your description as though your mother won't stand in the way of your sister's treatment, but she just won't proactively help much in finding it. There are resources available to help match people with therapists. Have your sister start with her school and go from there.
posted by decathecting at 10:40 AM on February 26, 2012

Mom apparently tried to take her back to MHMR, but they won't accept her again.

Can you find out how true this is? Or, if they really wouldn't re-enroll her, why? Because this says:

Child and Adolescent Mental Health Service Criteria

DSHS Children’s Mental Health serves children ages 3 through 17 with a diagnosis of mental illness (excluding a single diagnosis of substance abuse, mental retardation, autism or pervasive development disorder) who exhibit serious emotional, behavioral or mental disorders and who:

Have a serious functional impairment; or
Are at risk of disruption of a preferred living or child care environment due to psychiatric symptoms; or
Are enrolled in a school system’s special education program because of serious emotional disturbance.

Not being your sister's legal guardian may keep you from finding out specifically about why she was disenrolled (if she was), but you may be able to talk with a social worker who can help walk you through the process of getting her help.
posted by rtha at 10:54 AM on February 26, 2012

So far as I can tell, this is the relevant section of Texas law. If that's the only relevant law, then it looks like counseling for depression requires the consent of a guardian (the child can consent to counseling for suicide prevention, drug addiction, or abuse.)

Could you do the legwork on this? If you could get the health insurance info out of your mom, and look into counselors who would accept said insurance, then would your mom stand in the way of it? (Of course, this might require more contact with your mom than you're comfortable with.)
posted by Johnny Assay at 10:58 AM on February 26, 2012

Response by poster: I don't believe my mother would actively stand in the way of Sis getting treatment, but she's definitely not the most proactive person. She might, however, use money as an excuse. (ie; "I can't afford it"). Should she do this, I will, of course, argue that once Sis is stable, she can also get a job. i'm also willing to help with copays if/when I can.

Getting details out of mom (why MHMR won't re-enroll, insurance specifics) might be like pulling crocodile teeth, but my sister's well-being is why I'm on "low-contact" with my mother rather than no-contact. What kind of insurance information would I/Sis need in order to make an appointment? Obviously, provider, but would we need the policy number? I will make sure Sis has her insurance card in her possession for appointments.

Thank you for the legal information; it's good to see that she can at least get help if the worst strikes and she does become suicidal.

I will send my sister to her school's counselor or nurse and see if they can give her any resources more than the typical hot-line numbers (I've already given those to her).

Any other suggestions? Also, if anyone can provide guidance/support on how to have the "Let me help you get my sister help" conversation with my mother, that would be greatly appreciated.
posted by MuChao at 7:52 PM on February 26, 2012

1. You may already have passed this information along to your sister, but in case you haven't: The National Alliance on Mental Illness has a Texas chapter, and they also may be a good resource on legal issues, how to get care, support, talking to your mom, etc.

2. The state has a program for those 17 and under that provides "intensive, in-home, family therapy and related services to children and adolescents as well as their families." The fees are sliding scale, and nobody is turned away because of an inability to pay.

I am not from Texas -- I'm about as far from it as I can be and still be in the continental U.S. -- so I have no idea how helpful these services are, but they are something to check out. Here's the contact information for your sister's part of the state.

3. Also: I have posted this link several times, and it makes me sad that there's such a need for it, but anyway, enough of the philosophizing about the state of the world:

There is a nonprofit called Needymeds whose mission is to direct people to low- or no-cost sources of medication and health care. The site has a searchable database of free/low-cost/sliding-scale clinics nationwide, and the database includes info on each clinic's hours, location, cost, and services.

You're a good sister, and I'm glad that your sib has someone looking out for her. I wish you both well.
posted by virago at 8:16 PM on February 26, 2012

MuChao, you don't absolutely need the policy number to make an appointment. Some offices like to take down insurance information ahead of time so they can process it, but I've never been to any office where they needed this to make an appointment - they do need to know what your carrier is in some cases to be sure they accept it, but they don't need the group and policy numbers (the card) until you show up for the appointment.

Good luck getting your sister some mental health service! You are a great sister!
posted by treehorn+bunny at 7:26 PM on February 27, 2012