Oh gosh, that is very difficult. So, was he put on Prozac because of OCD (the washing of hands)? And what do you mean shredding his clothes. Some more details would be helpful. How is he doing in school? Who does he live with? What other symptoms does he have? If behavioral and cognitive therapy isn't being given by the prescribing psychiatrist, perhaps you can research psychologists yourself and start that process? I take matters into my own hands when I need to. But more information would be helpful.
Your grandson is in crisis. If you are dissatisfied with 'some' person or whatever medical facility, doctors office or organization you took him to . . . time to begin again to get better answers. He's suffering emotionally. This is a significant downward spiral. I don't know the extent of it but kids of this age can become suicidal quickly. No one can tell you that he will or won't be on an antidepressant until college. I wouldn't focus on that. Maybe that is their way of saying this is a long term problem which mental health issues usually are.
WHO does he live with? What are they saying?
He sees a doctor next week? That's great! Get a list of ALL the questions you can think of and don't leave the office until they are answered. He may be going down the road of needing inpatient care. I'm not trying to scare you but this is a vulnerable age and this boy has a lot going on. I don't know exactly what.
the way mental health disorders are diagnosed is by symptom reporting from the teen, their family and their teachers. The doctor also gives them questionnaires. There is no blood test or absolutes to diagnosing--- evidence of what is going on in the child's life is used. Sometimes the specific name is not important but that it is treated. Several disorders such as depression, ocd and anxiety are treated with similar medications (Prozac being one of them) while other things like bipolar are treated with different medications. But with the level of what is going on with his daily life, I think you need immediate help and intervention for him.
I'd have his parent call the school and inform them of the situation. Hopefully they are empathetic and will make accommodations as he balances out his mental health.
What type of doctor does he see next week? And again, they may not personally provide cognitive behavioral therapy . . . but you CAN still get that for him yourself (or his parents). Some psychiatrists work with psychologists, some don't. Make some calls to PHD psychologists in your area for therapy. Let me know how this goes!! I'm worried about you all!
Well, this sounds like it is going in a positive direction. Please keep us informed!