HELENA, Mont. 鈥 Connie MacDonald works for the State Department at the U.S. consulate in Jeddah, Saudi Arabia. It鈥檚 a dream job, and she loved living abroad with her two sons.
But earlier this year, MacDonald said, her 8-year-old son started to become aggressive. At first the family thought it was ADHD. Her son was indeed eventually diagnosed with attention-deficit/hyperactivity disorder 鈥 as well as disruptive mood dysregulation disorder, which makes it difficult for her son to control his emotions, particularly anger.
鈥淗e 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,鈥 she said.
The American International School of Jeddah told her that her son couldn鈥檛 come back. His behavior was so severe that MacDonald started to look for residential treatment back in the U.S.
She found in Montana. Children in the Intermountain program learn to build healthy relationships through intense behavioral therapy over the course of up to 18 months.
Intermountain Residential is one of the only facilities in the U.S. that serves young children with emotional dysregulation, like her son.
MacDonald remembers crying hysterically when she dropped him off in June, but tears gave way to hope as his violent outbursts decreased over the weeks and months afterward.
鈥淣ow when we have our weekly calls, it鈥檚 very normal. It鈥檚 like talking to your child again. It鈥檚 wonderful,鈥 she said.
Intermountain is one of about a dozen programs in the nation that provide long-term behavioral health treatment for kids under 10, according to the . It鈥檚 one of the only options for kids as young as 4.
Intermountain is tucked away in a quiet neighborhood in Helena and has been treating children for over 100 years. The children Intermountain treats have emotional disorders, behavioral issues stemming from mental illness or trauma, and other issues. They struggle with self-harm, severe depression, or violent outbursts that can lead to attacking other people or animals. Most families that come to Intermountain have tried medication, outpatient therapy, or even short-term residential treatment, all without success.
Long-term treatment programs like the one Intermountain offers are often a last resort for families.
It can take months before kids with severe mental and behavioral health issues feel safe enough to open up to Intermountain staff, said , who manages the residential program. Some kids have been traumatized or abused while adults were supposed to be caring for them, she said. Living through that can leave them deeply scared of or resistant to adult interaction, even once they鈥檙e living in a safe environment. Bryce said that Intermountain staff have to gain a patient鈥檚 trust before working to figure out the root cause of the child鈥檚 behavior. It takes time before they can make an effective long-term treatment plan based on intensive behavioral therapy and building healthy relationships.
Intermountain parents and staff were shocked when the facility that it would close its doors this fall, blaming staffing shortages.
Some parents threatened to sue. A law firm representing them argued in a to Intermountain鈥檚 board that it has a contractual responsibility to finish treating children who remain at its residential facility.
Intermountain then reversed course, saying it would downsize in an attempt to keep the program open. But spokesperson said it鈥檚 no guarantee Intermountain can keep its doors open long-term. Intermountain plans to decrease its capacity from 32 beds to eight.
, until recently executive director of NATSAP, thinks staffing shortages are not the full story of Intermountain鈥檚 troubles.
鈥淲e are seeing a lot of long-term facilities moving to what they call the short-term, intensive outpatient. You鈥檙e able to get insurance money easier,鈥 she explained. Stokes said she knows of 11 long-term programs for kids 14 and younger that have shifted to offering only shorter stays, of 30 to 90 days.
Short-term programs are cheaper and insurance companies will pay for them more quickly, Stokes said. Over the course of a year, short-term programs can treat more patients than long-term residential facilities. That can make them more lucrative to run.
But those programs aren鈥檛 likely to help kids who might have to leave Intermountain. In fact, short-term programs could cause them harm.
鈥淭he problem is if that kid bombs out of that shorter-term stay, or they do well and maybe six months down the road they don鈥檛 have the tools in their toolkit to continue that, and now you鈥檙e labeled as treatment-resistant, when that kid wasn鈥檛 treatment-resistant,鈥 Stokes said.
Kids labeled treatment-resistant can then be rejected from other short-term programs.
For now, parents of kids at Intermountain are looking for other treatment options because of the uncertainty over whether Intermountain will remain open. Parents told NPR and 素人色情片Health News they鈥檝e had to sign up for waitlists that can take a year or longer to clear for the few programs that take kids 10 and younger. That鈥檚 if they can find facilities that would accept their kids at all.
Stacy Ballard hasn鈥檛 been able to find a facility willing to treat her 10-year-old adoptive son with reactive attachment disorder who is currently at Intermountain. The condition can make it hard for kids to form an attachment with their family. Ballard said her son can be extremely violent.
鈥淗e was walking around our house at night thinking about killing all of us, and he said it was almost nightly that he was doing that,鈥 Ballard explained.
Facilities that treat children his age generally won鈥檛 treat kids with a reactive attachment disorder diagnosis, which often is associated with severe emotional and behavioral problems.
MacDonald also can鈥檛 find another facility that could be a backup option for her son. He was supposed to complete 14 more months of treatment at Intermountain.
She said she can鈥檛 gamble on keeping her son at Intermountain because of the uncertainty over whether it will remain open.
So, she鈥檚 getting ready to leave Jeddah and fly back to the U.S., taking a leave of absence from her job.
鈥淚鈥檒l take him to my family鈥檚 place in South Carolina until I can find another place for him,鈥 she said.
This article is from a partnership that includes , , and 素人色情片Health News.
