Connie MacDonald works for the U.S. consulate in Jeddah, Saudi Arabia and she currently resides abroad with her two sons. Unfortunately, her 8-year-old son began displaying aggressive behavior, leading to him being diagnosed with attention-deficit/hyperactivity disorder and disruptive mood dysregulation disorder. Due to the severity of his conduct, the American International School of Jeddah determined that her son would not be able to return to school. MacDonald was determined to find a solution and discovered a residential treatment program in Montana called Intermountain, which specializes in addressing emotional dysregulation in young children.
After sending her son to Intermountain, MacDonald observed a remarkable improvement in his behavior and is now hopeful for his son's future. Intermountain is one of the limited long-term behavioral health treatment options available for children under 10 in the United States. Situated in Helena, the facility has a rich history of over a century in treating children, primarily focusing on emotional disorders, behavioral issues, and various mental health concerns. When other treatment methods have not been effective, families often seek out Intermountain as a last resort.
Uncovering the root causes of a child's behavior and establishing trust takes time, and Intermountain's dedicated staff works diligently to develop effective long-term treatment plans. However, the facility recently announced its intention to shut down due to staffing shortages, sparking outcry from parents who advocate for the completion of the treatment of the remaining children. Responding to the concerns raised, Intermountain reversed its decision and now plans to downsize in an effort to remain operational. Nevertheless, questions about the facility's long-term future persist, leaving its ultimate fate uncertain. A significant shift is occurring in long-term facilities, as they are transitioning to shorter-term, intensive outpatient programs that are more easily reimbursed by insurance, according to comments made by Stokes. She indicated that she is aware of 11 programs designed for children aged 14 and below, which have switched to offering only brief stays that range from 30 to 90 days.
Stokes further explained that short-term programs are not only more cost-effective but also receive faster payment from insurance companies. By treating a larger number of patients within a year compared to long-term residential facilities, these programs are proving to be more profitable to operate.
However, there are potential drawbacks associated with these short-term programs, particularly for children needing to leave Intermountain. In fact, these programs could potentially cause harm to these children. Stokes stated that the issue arises when a child does not thrive in the shorter-term program or initially shows progress but lacks the necessary skills to sustain it in the long run. Consequently, the child may be mislabeled as treatment-resistant, even if they were initially responsive to treatment.
Children labeled as treatment-resistant may subsequently be excluded from other short-term programs.
At present, parents of children at Intermountain are seeking alternative treatment options due to the uncertain future of the facility. Parents have reported to NPR and KFF Health News that they have been forced to join waitlists that can take a year or longer to clear for the limited number of programs accepting children aged 10 and under. Finding a facility willing to provide treatment for their children can also be challenging.
For example, Stacy Ballard has been unable to find a facility that will treat her 10-year-old adoptive son with reactive attachment disorder, who is currently receiving treatment at Intermountain. This disorder impairs a child's ability to form attachments within their family and can lead to severe violent behavior.
Facilities catering to children his age typically do not treat those diagnosed with reactive attachment disorder due to its association with severe emotional and behavioral problems.
Another parent, MacDonald, is also struggling to secure another facility as an alternative for her son, who was supposed to complete another 14 months of treatment at Intermountain. With the uncertainty surrounding the facility's future, MacDonald cannot take the risk of keeping her son there. As a result, she is making plans to leave Jeddah and return to the US, taking a leave of absence from her job.
"I will take him to my family's home in South Carolina until I am able to find another place for him," she stated.