A dumb question

I am writing out of concern for a family member (pseudonym 'Pat') who is reaching the end of the standard list of treatment options following a major crash in December after tapering off Paxil.

Pat's currently at an out-of-state facility that can administer ECT. They are only about 4 treatments in, and while the first 2 seemed promising, Pat's been drowning in suicidal thoughts for the 5 following days straight, including the most recent 2 days (which included the most recent treatments). There is a tiny blip after an ECT session that lasts for a few hours, and then a crash that lasts until the next treatment.

We are trying to collectively work out how to think about "what's next" if this course of treatments doesn't prove effective.

My dumb question is: is there a specific facility or region of the country where we could consider going that would be considered to have a strong approach to working through this very difficult road?

From reviewing a lot of posts here and extensive Google sessions, I'm not getting the sense that there is such a place or region. Maybe the Mayo Clinic in Minnesota?

Pat's in Montana, and we have family in Arizona, Washington, and Indiana.

None of us feel that we've been able to trust a single professional we've found yet so far.

Any thoughts or discussion are welcome.

starflywings Hello and welcome to PC.

I was taught that there is no such thing as a dumb question so you are ok. The Mayo Clinic has a lot of experience with research on different treatments for depression. I have depression as well. I don't think ECT is for me even when I get such low bouts of depression with some psychotic features. I do know that ECT has helped many but I am just against it for me. I would do some calling around and look on the internet for some resources. I think university areas have better treatment providers. I hope that others can chime in and help.

If you need any help in navigating this site feel free to ask a community liaison or moderator.

I searched for top ten best psych hospitals in the US.

http://www.medscape.com/viewarticle/828290

1. Massachusetts General Hospital, Boston
2. New York–Presbyterian University Hospital of Columbia and Cornell, New York City
3. Johns Hopkins Hospital, Baltimore, Maryland
4. McLean Hospital, Belmont, Massachusetts
5. Menninger Clinic, Houston, Texas
6. Sheppard and Enoch Pratt Hospital, Baltimore, Maryland
7. Mayo Clinic, Rochester, Minnesota
8. Resnick Neuropsychiatric Hospital at UCLA, Los Angeles, California
9. Austen Riggs Center, Stockbridge, Massachusetts
10. UPMC–University of Pittsburgh Medical Center, Pennsylvania

Heard good things about McLean. Don't recall why, commonly named hospital. Worth researching each on that list, to begin with. Interview, ask questions, even talk with nursing staff.

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Excellent question! I bet you have already been burning up the internet in searches, but here is another link to check out.
https://treatment.psychologytoday.co...e/Arizona.html

If insurance helps pay, the company will have strong input about where your family member can go next. Getting into research trials might be an option. https://clinicaltrials.gov

Good luck! And thank you for advocating for your daily member. I hope for comfort.

I have been an inpatient three times and I agree with this comment you made. "None of us feel that we've been able to trust a single professional we've found yet so far." I have been "treated" by five doctors and only one was excellent. There are so many bad ones it is amazing. Good luck with your search, I hope someone here can help you find a great doctor.