
Intermountain Residential in Helena, Montana, stands as one of the few programs in the United States dedicated to providing extended behavioral health treatment for children under 10. However, recent challenges loom over its mission as administrators announce a substantial downsizing from 32 beds to just 8, with the facility's closure becoming a distinct possibility due to staffing shortages.
The impact of this shortage is deeply felt by families like Connie MacDonald's. Working for the U.S. consulate in Jeddah, Saudi Arabia, MacDonald faced the heartbreaking reality of her 8-year-old son's escalating aggression, initially believed to be ADHD. Eventually diagnosed with attention-deficit/hyperactivity disorder (ADHD) and disruptive mood dysregulation disorder, her son struggled to control his emotions, leading to severe behavioral challenges. MacDonald's quest for effective residential treatment brought her to Intermountain Residential in Montana, a unique facility specializing in addressing emotional dysregulation in young children.
The story is a familiar one for parents seeking comprehensive care for their children facing severe emotional disorders. Intermountain Residential, with its intensive behavioral therapy programs lasting up to 18 months, stands as a beacon of hope for families dealing with the complexities of emotional dysregulation in young children. Yet, the threat of downsizing and potential closure due to staffing shortages casts a shadow over the critical services it provides.
Intermountain Residential is among a limited number of programs in the country offering long-term behavioral health treatment for children under 10, tackling issues rooted in mental illness, trauma, and emotional disorders. As these facilities grapple with staffing challenges, families like MacDonald's find themselves at the mercy of an increasingly scarce resource.
The shortage not only jeopardizes the continuity of care for current residents but also restricts the options available for families seeking specialized treatment for their young children. The urgent need to address staffing challenges in facilities like Intermountain Residential underscores the importance of prioritizing mental health resources for the most vulnerable members of society, ensuring that essential services remain accessible for children in crisis.
Intermountain, a vital long-term behavioral health treatment program in Helena, Montana, finds itself at a critical crossroads, grappling with the imminent threat of closure due to staffing shortages. Families seeking support for children grappling with self-harm, severe depression, or violent outbursts have turned to Intermountain as a last resort after exhausting medication, outpatient therapy, and short-term residential treatments without success.
Meegan Bryce, the manager of Intermountain's residential program, sheds light on the intricate process of aiding children with severe mental and behavioral health issues. The journey begins with establishing trust, particularly for children who have experienced trauma or abuse, leaving them deeply wary of adult interactions. Intermountain staff invest time in building this trust before delving into the root causes of a child's behavior, creating a foundation for effective long-term treatment plans centered on intensive behavioral therapy and relationship building.
However, the abrupt announcement of Intermountain's impending closure sent shockwaves through its community. Parents and staff were taken aback, prompting legal action from some parents who argued for the facility's contractual obligation to complete treatment for the children still in residence. In response, Intermountain revised its decision, opting to downsize from 32 beds to eight in an attempt to stave off closure. Despite this effort, spokesperson Erin Benedict acknowledges the uncertainty surrounding the facility's long-term viability.
Megan Stokes, former executive director of the National Association of Therapeutic Schools and Programs, provides a broader perspective, suggesting that staffing shortages may not be the sole factor influencing Intermountain's challenges. Stokes points to a trend among long-term facilities shifting towards shorter stays, ranging from 30 to 90 days, under the banner of short-term, intensive outpatient programs, driven by easier access to insurance funding.
As Intermountain faces a precarious future, the plight of long-term residential treatment programs for children comes to the forefront. The delicate balance between providing crucial, comprehensive care and navigating systemic challenges raises questions about the evolving landscape of mental health services for the most vulnerable members of our society.
The landscape of pediatric mental health treatment is undergoing a significant shift, with short-term programs gaining prominence due to their cost-effectiveness and swift insurance coverage. Megan Stokes, formerly of the National Association of Therapeutic Schools and Programs, highlights the financial allure of short-term programs, emphasizing their ability to treat more patients over a year compared to long-term residential facilities. However, this shift poses challenges for children in need of the specialized care provided by facilities like Intermountain.
While short-term programs may offer financial advantages, their suitability for pediatric patients treated at Intermountain is questionable. Stokes warns of potential harm, explaining that if a child doesn't fare well in a shorter-term stay, or if they struggle later on without the necessary tools, they risk being labeled as treatment-resistant. This label can subsequently lead to rejections from other short-term programs, creating a detrimental cycle for vulnerable patients.
As Intermountain faces uncertainty, parents are left scrambling for alternative treatment options. Some share stories of signing up for waitlists, some lasting a year or more, for the limited programs accepting children aged 10 and younger. Stacy Ballard, whose 10-year-old son is at Intermountain for reactive attachment disorder, faces the challenge of finding a facility willing to treat his specific diagnosis, given its association with severe emotional and behavioral problems.
Connie MacDonald, a State Department employee, confronts a similar dilemma for her son, uncertain about the future of Intermountain. Faced with the prospect of its closure, MacDonald prepares to leave her job in Jeddah, returning to the U.S. to seek alternative care for her son.
The evolving landscape of pediatric mental health treatment raises crucial questions about accessibility, suitability, and the need for specialized care. As families navigate uncertainties and grapple with limited options, the broader healthcare system must address these challenges to ensure that vulnerable children receive the tailored and sustained support they require. This article is part of NPR's health reporting collaboration with MTPR and KFF Health News.
The current upheaval in pediatric mental health care, marked by the prominence of short-term programs, prompts profound reflections on the well-being of vulnerable children and the challenges faced by facilities like Intermountain. While short-term programs offer financial expediency, the potential harm they pose to certain pediatric patients is a cause for concern, particularly for those requiring the specialized care provided by long-term residential facilities.
As Intermountain grapples with uncertainties and the threat of downsizing, parents find themselves in a desperate quest for alternative treatment options. Stories of lengthy waitlists and the struggle to secure suitable care underscore the urgency of addressing systemic issues in the pediatric mental health landscape.
Stacy Ballard's search for a facility willing to treat her 10-year-old son, diagnosed with reactive attachment disorder, and Connie MacDonald's dilemma over the future of her son's treatment at Intermountain, illustrate the profound impact of shifting trends on families in crisis. The decision to leave jobs and travel across borders in search of adequate care reflects the depth of the challenges families face in accessing essential mental health services.
This narrative serves as a poignant reminder of the imperative to prioritize and fortify pediatric mental health care systems. Ensuring that comprehensive, tailored care remains accessible to all children, regardless of diagnosis or financial considerations, is a collective responsibility. As the landscape evolves, addressing the needs of the most vulnerable among us must remain at the forefront of healthcare priorities. This article emerges from NPR's collaborative health reporting with MTPR and KFF Health News, shedding light on the complex realities families confront in their pursuit of healing for their children.