Finding Care in a Crisis

Finding Care in a Crisis

Obsessive-compulsive disorder manifested through suicidality meant time wasn’t an option for this patient.

Xander is affectionately known as a “righteous introvert,” by his family. He’s always standing up for his peers, animals and social justice issues. However, in third grade he became more introverted and developed intense headaches in addition to struggling with school and peer interactions. Xander was eventually diagnosed with obsessive-compulsive disorder (OCD) and depression.

“We immediately started seeing a counselor and started him on a low-dose antidepressant,” says Stephanie Simpson, Xander’s mother. “He actually got worse before things got better.”

One of Xander’s compulsions was suicidal thoughts. Unlike other kids with suicide ideation, Xander’s compulsions never ebbed and flowed. They remained constant. He was quickly evaluated for the Intensive Outpatient Program (IOP) at Seattle Children’s, but the wait lists were long.

“My 10-year-old was in the peak of a horrific crisis, and sending him away on his own for an inpatient program was not an option for us,” says Stephanie.

Time was of the essence. At the start of 2020, Xander and his dad went to a partial hospitalization program in California. However, he was only there for a month when the COVID-19 pandemic sent them home to return to weekly psychiatry sessions.

“It just wasn’t enough, so he got back on the wait list for the IOP at Seattle Children’s,” says Stephanie. Eventually, availability opened, and he started the virtual 10-week long sessions.

Three hours a day, four days a week, Xander and one of his parents would go through exposure response therapy. This system trains the parents to help kids and families understand and process OCD, by exposing them to thoughts, images and situations that may act as a trigger.

This can be difficult for everyone involved, especially the patient. However, virtual care meant Xander and his family were doing this in their own space, which added another layer of comfort and required less transition.

Stephanie now advocates for virtual care at the state and federal levels. “These virtual programs expand access across the board,” says Stephanie. “Kids in rural Washington or those without as many resources can still take part in this program.” She says it’s proven to be beneficial and part of the reason Xander’s doing so well a year out. “But to have a child with that level of mental illness was extremely taxing on our family.”

In addition to all the other concerns, having a 10-year-old facing suicidal thoughts was isolating for them. “We don’t give enough credit to families for how hard it is to go through mental health treatment. I want us to get to a point in awareness and understanding where we start bringing casseroles to families whose kids are in mental health treatment, just like we would for children undergoing any other medical care,” says Stephanie.

This crisis has ultimately brought Xander and his family closer together, made them more comfortable talking about behavioral health concerns, and now they are more transparent with one another. They even had a party recently to celebrate the one-year anniversary of Xander’s IOP completion.

While Xander still manages his mental health through medicine and therapy, the program at Seattle Children’s helped him to get to a point where it’s no longer debilitating, or even noticeable. “He was at such a horrific level of distress,” says Stephanie. “We never actually thought this would be feasible.”

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Written By:
Grant Heiman
Writer/Editor, Children's Hospital Association

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