Parents of Cottonwood patients worry about future

It's easy for passers-by to miss the simple tan buildings on North Sprigg Street that make up the Cottonwood Residential Treatment Facility. On the outside, it doesn't look like a place to receive help and healing, or a place many consider home.

"They give them hope there, whenever there really isn't much hope sometimes," Crystal Parmer of Ste. Genevieve, Missouri, said of the Cottonwood staff.

Her 13-year-old daughter Kristin has been at the facility since December. It's her second time at the facility. She left the first time to receive acute care at another facility because Cottonwood does not have acute-care beds.

If Cottonwood closes at the end of the year because of state budget cuts, Parmer said her daughter would be one of the hardest children to place at another facility. She has multiple diagnoses, including reactive attachment disorder in which children have difficulty forming a healthy, emotional attachment with caregivers.

Kristin, Parmer's adopted daughter, was the victim of sexual abuse at a young age. While she is still working through many behavioral issues, Parmer said she's seen the most significant improvements during her daughter's time at Cottonwood.

She's been to other facilities, including Hawthorn Children's Psychiatric Hospital in St. Louis, which would be the only remaining state-operated children's mental-health facility if Cottonwood closes. Parmer said she's been encouraged to send Kristin back to Hawthorn before Cottonwood's possible final day of Dec. 31.

But she said her daughter will return to the other state facility. The last time her daughter was there, she was assaulted by another resident, and Parmer said she wasn't informed of it until long after it occurred. She also doesn't believe Kristin would benefit from being in a facility with a hospital setting, compared to Cottonwood's homelike setting with toys, sandboxes and even a church.

Parmer also said she enjoys an open line of communication with the Cottonwood staff. They frequently contact her to give her updates on Kristin. She said that helps put her mind at ease.

"I can go to sleep at night, and I don't worry about her. I know she's safe," said Parmer.

Her husband also transferred from St. Louis to work in Cape Girardeau to be near his daughter. Parmer said it's comforting -- to her and her daughter -- to know he's nearby in the event of an emergency. If Cottonwood closes, Kristin would be placed at a facility at least two hours from the family, meaning it would be nearly impossible to visit regularly.

Most facilities have strict rules about visits. The resident may be allowed to participate in family visits only if he or she has exhibited good behavior. If that was the case at Cottonwood, Parmer said she might seldom get to see her daughter. She's thankful the facility believes, as she does, that allowing families to stay connected is in the child's best interest.

If Kristin is forced to transfer to another facility, "it would tear our family apart, basically," said Parmer.

Her concerns and praises have been echoed by other parents, including those with children who no longer reside in the facility. Chrissy Hitt's 11-year-old son Josh received treatment at Cottonwood from March 2013 to April 2014.

Hitt said before her son's treatment at Cottonwood, he was hospitalized several times and spent time at a boys' home. None of the other facilities seemed to help, she said.

"Each place he went to, he came back worse or just overly medicated, where he was just ... almost like a zombie," said Hitt.

At many other places, she said she felt Josh and other residents were "herded like cattle." Rather than work with him on improving, Hitt said the solution at many facilities seemed to be stronger medication.

At Cottonwood, she said she noticed an improvement in her son within weeks. He was happier, too, because he could see his family regularly. Hitt lives in Cape Girardeau and was able to see her son on the weekends.

Like Parmer, she talked regularly with the Cottonwood staff. They not only informed her of concerns they would have with Josh, but they called to let her know of his improvements or whether he accomplished something positive.

"It was probably the best decision I ever made, sending him to Cottonwood," she said. "I got more of my son back than I ever had."

Before he was accepted at Cottonwood, Josh had diagnoses that included attention deficit disorder, attention deficit hyperactivity disorder, oppositional defiant disorder, reactive attachment disorder and bipolar disorder. After months of observation and testing, the Cottonwood staff gave him a new diagnosis of high-functioning Asperger syndrome and put him on a new medication regimen.

Hitt said the staff made the switch because they did not believe his bipolar diagnosis was correct. Not only did the new diagnosis and new medication lead to improvement, Hitt said it might have saved her son from severe health issues. Physicians later found the medicine he took for his bipolar diagnosis was damaging his heart and liver. Josh had to stay in the hospital as he was eased from the medication.

"If they hadn't stepped in and got him extra help ... I don't know," said Hitt, unable to complete the thought.

Staff members took the time to speak with her to gather her thoughts and observations and spoke to Josh one-on-one. She credits the personal interaction for her son's improvement. He now is at home with his family and started attending school this year. Cottonwood helped the family with the transition, and Hitt said things are going well. While Josh does not attend a full day of school, she said she's happy knowing her son is able to focus on his education.

Hitt said she remains active in efforts to raise awareness about the benefits of Cottonwood and help keep the facility open.

"A lot of the kids in there don't have families or people to care about them. The only people they can rely on are the staff there [at Cottonwood]," she said. "Those kids didn't ask for the diagnoses they have, and they're not asking for the place to be shut down."

Parmer said many of the children at Cottonwood are scared of what will happen if the facility closes. It's a place of last resort for most children, she said, and it's a place where they feel secure.

But the facility's impending closure and uncertainty as to where her daughter will be placed has caused so much worry that Parmer said she's been prescribed a new medication just for the anxiety. As government leaders haggle over budget problems, the children at Cottonwood are suffering, she said.

"This isn't fair to these kids," Parmer said. "These kids shouldn't have to be worried about where they'll stay."

Local state Reps. Kathy Swan and Donna Lichtenegger have worked with Cottonwood staff, and new financial plans for the facility have been submitted to the Missouri Department of Mental Health for review. The plans call for increasing revenue by restructuring the admissions to increase census and look for areas to cut costs. If the department approves the plans -- its announcement is expected this week -- it will ask Gov. Jay Nixon to reconsider closing the facility.

Cottonwood was slated for closure this summer after Nixon made more than $1 billion in cuts to the state budget, citing the move as financially necessary after legislators passed tax-cutting bills. He vetoed the 10 bills that would have created sales tax cuts for Laundromats, fast-food restaurants and other industries. Nixon said at a Thursday news conference if his vetoes on the budget and the bills stand after the veto session, which begins Wednesday, he first would unfreeze spending for education, followed by mental-health programs.

Closing Cottonwood would save the state an estimated $1.3 million, but Swan said if the plan she submitted to the state is approved, it has the potential to not only make Cottonwood self-sufficient, but bring in additional funds. Her plan in part calls for adding acute care beds, adding programs for patients older than age 17 and increasing the per diem rate.

srinehart@semissourian.com

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