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I would like to start off by saying thank you all for your words and advice.  I did not know that there was anywhere for a non custodial father to turn and try to get help. 

My son pulls at my heartstrings because he is such an amazingly kind and compassionate young man that one minute can be very helpful and caring and then something can set him off and he is gripped with anger and frustration at not knowing how to deal with it. 

As sad as it is for me to admit this I am under no false illusion that I would win any kind of custody battle with my ex especially given the state of Massachusetts is such a pro maternal state when it comes to custody amongst the many other strikes I have in this case.  I just want to force her to get him the help he needs.  From 1500 miles away I called and arranged evaluations of therapists, interviewed a half dozen of them before choosing one that seemed as i they would be able to help us, I attended all the appointments remotely via phone when the therapist thought it would be helpful, I kept in constant contact with the therapist, the BM did none of this, she called me the morning of his first appointment, 3 hours before he was supposed to be there and said that she did not feel good and could not bring him.  this happened two more times before my mother, who is just as invested in my sons mental health, offered to drive 120 miles one way in order to make sure he made it to his appointments.  She did this 4 times before Christmas and then after the holidays went on an extended vacation to Florida and we quickly went back to my ex not being available to bring him to the appointments.

My son asked his mother soon after the holidays when he was going back to see the therapist and she told him that he did not need to go anymore because he was doing so much better.  His BM I forgot to mention earlier has been on prescription anti depressants for the last 15 years but follows that vicious cycle of taking them until she feels better and then deciding she does not need them any more, until she crashes and realizes that she needs them again.....

In this type of a situation would the courts mandate her to take him to the therapist if I forced the issue?

Thank you for your thoughts.  He has had some outbursts at school and has atcually been the subject of some bullying this year for the first time which I have spoken to the teachers and principle about.  After the last report card period I contacted the school and requested that I recieve a copy of his report card because no matter how many times I requested to see it, it would never be produced.

My biggest problem is that this is a pattern forming where my son is not getting the attention that he needs.  My daughter is 13 now and she is the oldest but has some activities after scholol and neighborhood friends that take up most of her free/play time.  My son however is not in any after school programs because my ex wife has repeatedly said that she does not have time to bring him to the practices etc because of the two babies she has at home.  My daughter is in softball this spring but replies primarily on her friends parents to bring her to practices and games. 

My son CRAVES attention and needs to be able to participate in sports or other proects but has constantly been shot down because of a lack of time.

He seems to only respond well to me when he is having a hard time or while in the throws of an outburst so I receive calls from my ex constantly demanding that I talk to him and tell him to behave etc. 

If it is so difficult for her to deal with him and the two new babies then I will gladly take custody of him, something that I have repeatedly told them I wanted but that seems to make it more of a reason to not let me obtain custody.

I am very nervous that we are getting to an point with him that if he does not get the help that he needs he will be lost and it seems that although my ex says she agrees she is not willing to do what it would take to get him the help he needs. 

I was wondering inf anyone out there can help me with information on how to handle a difficult issue I have with my ex wife. 

We have been separated since my son was 3 years old and he is now 8, almost 9.  As he has grown up he has had some issues with anger and fixation on certain issues and we both agree that he needs counseling.  I now live 1500 miles away in Kansas and visit every couple of months and then he and his older sister spend the summers with me while not in school.  After last summer and working very hard with my son to manage his issues I then started looking for therapists back in Massachusetts that he could visit so that he could recieve the help he needs.  My ex-wife and her new husband along with my current wife all agreed that we were going to get him in counseling and stay in constant contact about his care, this however lasted less than 2 months after he returned from teh summer with me.  My ex wife ket moving appointments that I had made for his with the therapist and then told me that it was too much for her to bring him becasue she has two younger children with her new husband that are under 2.  It was so difficult to deal with her that my mother would drive 2.5 hours one way just to bring my son to an appointment that was less than 10 minutes from his house.

After Christmas when my mother went on an extended vacation to Florida my ex wife stopped bringing him all together to his appointments saying that he was doing better. 

Unfortunately he has been struggling more and more lately and I recieved cals from my ex wife 3-4 times a week to calm him down and to help him.  I have told my ex-wife and her new husband that I truly believe that it would be in the best interest of my son for him to move here with me so I can help him get the help he needs. 

My ex says that there is no way that she will let him move to KS with me mostly because of the loss of support and then also because of the distance but she is not giving him the care that he needs.  Now we have joint custody so we have equal share of responsility for his medical care but I can not make her bring him to his appointments.  which brings me to my question

Is there any legal precendent in Massachusetts where a non custodial parent can legally make the other parent take a child to medical apoointments, and if not then what do I do to begin the process of changing the parental orders with the court to have my kids move in with me?