Wilderness therapy program forges 2nd life after budget cuts

Posted at 4:45 PM, May 17, 2018
and last updated 2018-07-05 14:56:46-04

MISSOULA – Funding cuts at the state level caused a ripple effect through organizations that slashed programs to adjust their budgets.

This is why Youth Homes Inc. in Missoula had to eliminate their wilderness therapy program, Inner Roads, according to their director Beth Cogswell.

Inner Roads staff decided to relaunch the program into an independent nonprofit, keeping the same staff and wilderness therapy model.

Wilderness therapy programs teach teens outdoor survival skills while providing treatment for a variety of mental and behavioral health issues.

The Missoula-based program, while it operated under the umbrella of Youth Homes, accepted young adults from all over the country on a rolling basis through the summer months. The participants are taken the Selway-Bitterroot wilderness for six to eight weeks, and the new Inner Roads program hopes to continue working the same way under the same name.

Zeke Arledge went through the program in summer 2017 and still uses the skills he learned to get through difficult times in life. He says he was on probation when he entered the Inner Roads program, and with the help of his family he gained life skills and emotional intelligence.

“When I got out I got back into school,” he said. “I have a nice job. I have a home with my mom. I’ve got a really nice friend group. It’s much better.”

Brie Shulman has been the Inner Roads therapist for several years. But when the program was dropped by Youth Homes she decided to take on forming a new nonprofit.

One of the skills participants learn is how to build a fire using only friction and materials found in nature, called “fire-busting.” Alredge said it is a skill that takes patience and persistence.

“You’re problem solving. You’re putting pieces together,” Shulman said. “You’re looking into the future, and you’re looking back and assessing ‘Why isn’t this working?’ ‘What could I do differently?’ In addition to that, the social part is, ‘When is it appropriate to ask for help?’ ‘How far am I gonna go down in kind of my own emotional hell before I am willing to ask somebody if they have another idea?”

With the help of other staff members who are volunteering for now to keep the program running this summer, Shulman hopes they will be able to continue with a slightly more limited program for now.

The Wilderness Therapy treatment model is considered a cost-effective and less restrictive way to provide treatment to youth, while improving their likelihood of success.

There are two main routes for a juvenile exhibiting behavioral or mental health issues, who may end up in the court system or need higher levels of mental health care: Incarceration and inpatient or residential treatment.

According to a study by U.S. News and World Report, 75 percent of incarcerated youth in the US have criminal records that are considered nonviolent. Those individuals could be in treatment, which is proven to be a far more cost-effective option.

University of Montana graduate student Erica Forzley compared the cost of incarceration for Montana youth to wilderness therapy costs. For an eight-week stay for a youth at a Montana state detention center, taxpayers pay $23,000 to $31,000. Their typical time spent incarcerated is about 12 months.

For youth living with serious behavioral or mental health issues, Medicaid can help fund hospitalization and residential treatment. For example, Medicaid pays for hospitalization for major depressive disorder, which is largely associated with suicidal behavior, at a rate of $22,600 for 40 days.

48 days at Inner Roads, while it operated as a Youth Homes program, costs $8,000, and is a proven method to prevent youth from ending up into these high levels of care.

Inner Roads plans to continue in its second life as a nonprofit, but there are for profit models of wilderness therapy available. They are, however, more expensive.

For-profit wilderness therapy programs charge between $20,000 and $30,000 for an eight-week stay.

Shulman says it’s going to be an uphill climb for the program as they figure out how they are going to fund wilderness therapy long-term, but that the community wants the program to remain in Missoula.

Right now, they are still getting more referrals from agencies, providers and the youth court than they have space available.

Shulman says wilderness therapy is becoming more recognized as a good option for young adults with health issues, and that there is now a billable insurance code that can be applied to pay for the treatment. For insurance purposes, it’s called Outdoor Behavioral Health revenue code 1006.

She says the application of the Parity Act, which gives and enforces insurance companies and Medicaid dollars to pay for equal services for people who need mental and behavioral health care, in the same way as physical medical care.

Both of these will allow Inner Roads to hold insurance companies accountable to pay for wilderness therapy as an evidence-based form of mental health treatment.

“And I think that, some of these skills, where they get to take care of themselves and realize that if they put in the energy now, they are what they need,” Shulman says. “And they are worth it. They are worth having here. Ideally, that gives kids the foundation they need to bring that back home and keep going.”

There will be one session from July 9 to August 21 in the Selway-Bitterroot Wilderness this summer.

Shulman says the organization is looking for community support to in order to continue, and will also be funding the program through insurance and grants.

Reporting by Augusta McDonnell for MTN News

Montana budget cuts hitting case workers, clients