It sounds like your granddaughter needs someplace that can treat pain management as well as dual diagnosis issues. "Individuals with both mental and substance abuse disorders are said to be dually diagnosed" (SAMHSA, Uniform Facility Data Set, 1999). At Morningside Recovery, where I work, we are experienced in pain management and treating emotional issues that may be a root cause of behavior. Wherever you decide to place her in treatment, and I do suggest that you get her some treatment as soon as possible, it is important that the facility be a dual diagnosis treatment facility. There are many treatment facilities that claim to be "dual diagnosis", but are not. For a treatment facility to be a true dual diagnosis facility they should have the clients work with both a graduate level therapist (Masters Level or Doctoral Level) and a case manager. Sometimes facilities will have their therapists do case management work, or have their case managers (i.e., addiction counselors) do therapy work. Both are problematic. Make sure the facility's staff includes at least a part-time psychiatrist (MD) and full time clinical psychologists (PsyD, PhD) and/or marriage and family therapists (MFT). If the facility only offers addiction treatment counselors and refers outside of their facility for psychological services, then they are not a true dual diagnosis treatment facility in my opinion. The facility will have to have a full time nursing staff and medication management as well. The facility should also be able to provide a psychological testing battery, which will help in diagnosing your granddaughter. The psychological tests they administer should include a neurological component, because your granddaughter's car accident may have caused some brain damage. What I mean by a neurological component are tests that will assess for traumatic brain injury such as the WMS or Bender Gestalt tests. If your granddaughter is found to have some traumatic brain injury as a result of her accident, then the facility will be able to bring in a neurological psychologist to help her.