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Closure of Helena facility would leave kids with behavioral health issues in limbo

A screen capture from the Intermountain Residential website on Oct. 09, 2023. The graphic shows the words "We can help" surrounded in a circle by the words "Developmental Trauma", "Grief & Loss", "Emotional Dysregulation", "Poor Peer & Social Relationships", "Academic Difficulties", "Depression & Anxiety" and "Attachment & Relationship Disruptions."
A screen capture from the Intermountain Residential website on Oct. 09, 2023.

Young children with severe behavioral health issues are likely to lose one of the few options they have for long-term residential treatment nationwide.

Intermountain Residential in Helena planned to close next month before parents threatened to sue. The facility says it will try to stay open, but it’s unclear if that’s possible.

It’s one of only five long-term residential treatment programs that take kids ages 8 and under nationwide.

Connie MacDonald works for the U.S. State Department and is based in Saudi Arabia. It was a dream job for her and she loves living abroad with her two sons.

But earlier this year, MacDonald’s eight-year-old son started to become aggressive. He was diagnosed with emotional dysregulation.

“He was hurting me. He was threatening to kill his brother. One of the last straws was they had four people at school holding him down for almost an hour trying to calm him down,” MacDonald says.

The American school in Jeddah said her son couldn’t come back. His behavior was so severe, she started to look for residential treatment back in the states.

She found Intermountain Residential in Helena. Children in the program struggle with self harm or violence. They learn to build healthy relationships through intense behavioral therapy over an 18-month stay at Intermountain.

MacDonald says it was terrifying leaving her kid a world away.

"Part of me knows what’s best for him, and if I want him to have a decent chance of having a good, normal life, this is what I have to do.”

Those tears gave way to hope as her son’s violent outbursts have nearly gone away.

“Now when we have our weekly calls, it’s very normal. It’s like talking to your child again. It’s wonderful.”

The kids Intermountain treats have emotional disorders. They can also have behavioral issues stemming from trauma and or a mental health condition. These issues can’t be solved by medications, out-patient therapy, or even short-term residential treatment.

Meegan Bryce manages the residential program for kids at Intermountain.

“What has happened to them prior to coming has wired their brain to something that keeps them more defended in nature and scared of adult care or control.”

She says it can take months before kids feel safe enough for treatment to be effective. Only then can staff work with the child and their family to help kids learn to build healthy relationships.

Intermountain spokesperson Erin Benedict said the facility was set to close in early October. After parents threatened to sue, the facility said it would attempt to keep eight beds open. It’s unclear whether that will work.

Benedict says staffing shortages make it hard to keep the program going.

But Megan Stokes says that’s probably not the full story. She’s the executive director of the National Association of Therapeutic Schools and Programs.

 “We are seeing a lot of long-term facilities moving to what they call the short-term, intensive outpatient. You’re able to get insurance money easier.”

Intermountain’s board has maintained that it will rebuild its program. But there’s concern it could also shift to a short term model.

Short-term programs are cheaper and insurance companies will pay for them more quickly. Over the course of a year, short-term programs can treat more patients than long-term residential facilities. That makes them more lucrative to run. But short-term treatment isn’t likely to work for kids at Intermountain.

“If that kid bombs out of that shorter-term stay, or they do well and maybe six months down the road, they don’t have the tools in their tool kit to continue that," Stokes says. "And now you’re labeled as treatment resistant, when that kid wasn’t treatment resistant’”

And that means other short-term programs can reject them.

Connie MacDonald’s son was supposed to complete 14 more months of treatment with Intermountain . She says she can’t gamble on whether Intermountain will be able to stay open. So she’s getting ready to fly back from the U.S. Consulate in Jeddah.

“I will be traveling back to the States to pick up my son and take him to my family’s place in South Carolina until I can find another place for him.”

So far, she hasn’t found a program that’s willing to take her son or able to treat his condition.

Aaron graduated from the University of Minnesota School of Journalism in 2015 after interning at Minnesota Public Radio. He landed his first reporting gig in Wrangell, Alaska where he enjoyed the remote Alaskan lifestyle and eventually moved back to the road system as the KBBI News Director in Homer, Alaska. He joined the MTPR team in 2019. Aaron now reports on all things in northwest Montana and statewide health care.
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