Where we're headed

. . . . and all I do is miss you and the way we used to be . . .

It's looking like the Butner chapter of this journey may be coming to a close. Since Elizabeth has been back there, the push has been to get her out quickly before she gets too comfortable. She likes Butner and she feels safe there. Hell, I feel safe there too. It's hard for both of us to leave. Again.

We have been looking at PRTFs, psychiatric residential treatment facilities for those lucky enough not to need that particular acronym. There aren't enough anyhow, and the situation is complicated by the fact that a Virginia PRTF that had 113 NC kids lost their NC funding, and so those kids bounced back into the already overcrowded NC system. Some PRTFs have turned her down, based on her high level of need. I have the world's best Child and Family Team (CFT) and they, along with our Butner social worker, work long hours calling, submitting applications, and calling some more. Finally two accept her, both in eastern NC.

Yesterday I drove down to visit the one in Kinston. It's a haul, over two hours or three Dire Straits albums away. My heart remains in the mountains even though I've lived in central NC for 23 years, and so this flat dusty land feels especially alien and alienating. Why are there so many RV sales lots on this road? I pass Cleo's Concrete Creations, Chosen Vessel Ministries, and lots of Christian academies. Yellow signs with red spray painted words sprout like weeds all over the roadside: peaches, tomatoes, yorkies. Yorkies? I check again. Yep, yorkies. Do I really want her in a town that boasts the 2nd AMEN ment Gun Shop? I'm suddenly very homesick for Chapel Hill.

I continue along Hwy 70, cut off on 268 and find my way to the facility. Road construction debris fills a vacant lot next to it. The place itself looks like a prison, with a fence around it and several low buildings. I stop and sit in the car for a couple of moments, my mood matched by the heartrending strains of a Mark Knopfler guitar solo, the notes echoing the words of the last verse: rockaway, rockaway. In my mind it sounds a lot like walk away, walk away, but I resist. The song ends and I get out.

A staff member is walking with a obviously upset and indignant girl, who cries and tells her side of the story. The staff member listens and makes sympathetic sounds. The girl calms down and I can no longer hear her voice. That's positive. I am directed to the administration building. Kim is perky and upbeat, obviously excited about this new unit. She points out that a new unit is different from a new program. They already have 24 beds for kids ages 7 to 17. This new unit will house 18 more kids. Elizabeth is being offered a bed in a pod for six girls, most of them 12 and 13.

We go to the new building which is in that final stage that all teachers know from the week before school starts. Floors are shiny new, bedspreads are on the bed, but the computer lab is empty. Boxes are stacked in the hall. The building is light-filled and attractive. She would be in a three girl living area, with three bedrooms, a kitchenette, one bathroom and a sitting area. As I look around, I suddenly see all the things that I didn't know to look for in the last PRTF, signs that tell me that perhaps this place can handle someone with her level of need. The TV is behind glass. There are no visible projectiles. There is one seclusion room for every three kids. Kim tells me that even when they are asleep, there are four people assigned to a six bed unit. Okay, that's good.

We find an empty office and sit, and I fire questions at her. I'm going to tell her just how bad my kid is, making sure she knows what they are in for. I thought I had told the last PRTF that, but somehow they didn't get it. I'd rather tell them now than have THEM tell me later. "Are you sure you can handle her?" I demand. Kim smiles. "That's what we do here," she says. "I could tell you stories about kids that make your child look easy. They deserve to be helped too. We can handle her." I ask how many kids they have kicked out in the four years they have been open. None, she tells me. My kid can get kicked out of just about anything, I brag. She's been kicked out of schools, camps for mentally ill kids, PRTFs, and psych wards. There's a first for everything. "Are you scared yet?" I ask. "No," she says. "That is what we do," she says again.

I tell her I'll let her know something on Tuesday and head back home. I call members of my CFT team. We talk about good points and bad. I realize most of what I object to is due to my snobbishness: eastern North Carolina, the gun shop, the fact that Kim mispronounces words. But I'm mostly stuck because I no longer trust my gut, a real handicap for someone who makes most decisions by what feels right. I loved the last PRTF; I loved that it was a working farm on 400 acres. They had a cat, for God's sake. There is no cat here. It was in the mountains. I liked the people at the old PRTF. But bucolic and nice didn't work so well. I need competent more than I need lovely.

At our treatment team meeting today, the social worker and psychiatrist sit and listen as I babble, even though they are pushed for time. They are in their best therapeutic mode, patiently asking hard questions to help me clarify what I want to do. Finally Mr. G, our social worker, asks, "What do you need from us?" "Tell me what to do," I say. They hesitate and look at each other, knowing they aren't supposed to impose their views or wishes, and then turn back. "Take it," they say in unison. Finally—certainty from someone! They talk about why they like it and their reasons are good. They point out that she is in far better shape than the last time she left Butner. And we've learned from the mistakes that we made in her last discharge plan.

We make a plan: Mr. G will have her decide what she needs to do to say goodbye. They'll make a list and check things off. Butner will transport her down there; I won't go. She isn't allowed visitors for 30 days, but I can call. It won't be easy; she refuses to come to this treatment team meeting and hangs up on me twice when I try to tell her about the place. If I'm having trouble trusting, how much harder for her? On June 3, she and the other five girls will arrive at the facility together. That's not much time.

One bright point: our seminarian (a student priest to those not liturgically inclined) will be assigned to a church in Kinston. The Holy Family diaspora, which served us so well in Baptist, comes to the rescue yet again. Tom agrees to visit her and I feel better knowing another pair of eyes are on her.

If they do what they say they can do, she will spend the next one to two years there. They will do medication management, therapy and something they call ART—aggression replacement therapy. She'll get schooling and she can earn trips into town, and eventually even home visits. The assumption is that she will leave there and come home because our system naively assumes that a few months of services will cure mental illness.

I would like that but I no longer count on it. It's a long, winding road our family is traveling. This part is dusty and flat. I hope for a more scenic route someday, but that might not be where we're heading. When the things that you hold /Can fall and be shattered/Or run through your fingers like dust. . . I turn up the volume, hoping it will cover the conversation in my head. Right now my job is to get to this next turnoff and hope it's one that leads somewhere good.