Treating disabled modernized in Boulder

By LEVI WORTS/Montana State News

16C—the ward for the most severely mentally disabled at the Boulder River School and Hospital. Infants suffering from large accumulation of fluid in their brains are kept here.  Some do not even have brains, just a brain stem to keep the body functioning on the lowest level.

The facility houses a wide range of persons with intellectually disabilities and mentally illness; the residents include children to adults that vary from completely non-functioning to deaf. Families can show up and drop off persons with mental disabilities for any reason.

This was the state of mental health care in Montana when Gene Haire, the current superintendent of Montana Developmental Center, first arrived in Boulder in the early 70s.

“There were people who should not have been here but were committed because they were deaf,” said Haire. He arrived in Boulder at a time of drastic change in mental health care in Montana. In 1975 Montana legislation changed the rules for committing persons with intellectual disabilities, according to Haire.

The change was due to the Government Operations Unit of 1974, which said, “Institutionalization can do irreparable damage to the developmentally disabled.” They went on to say that, “An institute can never be a substitute for parental love,” according to Montana Development Center’s “A Brief History.”

According to Haire, not only were the practices questionable – the terms were disrespectful. When the institution was first founded in 1893, it was called the Montana Deaf and Dumb Asylum. Since its opening the name has changed over five times, according to the history account.

The term, “mentally disabled” is currently being changed to “intellectually disabled” by the Montana Senate, said Haire. Through the years the terms, as well as the care, given to the intellectually disabled have evolved to become “more respectful and accurate,” he said.

Today, the Montana Developmental Center strives to address why a client has been sent. Then the center’s staff develops an individual treatment plan, to resolve the problems and to create places in the community for them to be discharged, according to Haire.

According to the Montana Developmental Center’s mission statement, the “purpose of the Montana Developmental Center is to provide treatment to people with serious intellectual disabilities who have been determined by a court to pose an imminent risk of serious harm to themselves or others.”

The clients now have to be court ordered, unlike prior to 1975, to the center. Beginning in 2004, the Montana Developmental Center started to commit criminals convicted and sentenced by the courts, according to Haire. To be committed into the center, “The client has to have an IQ of 70 or lower prior to age 18,” he said.

The rehabilitation process starts at the Assessment and Stabilization Unit, according to Haire. The ASU is where all clients are first held and has the “highest structure and limitation.”

Troy Green, a supervisor at the Montana Developmental Center, said that the ASU is only accessible by keys and magnetic keycards.

The clients are kept in the ASU, which has a max capacity of 12, until they began exhibiting behavior that is acceptable to group living, according to Green. “The clients in [the ASU] are the highest risk for suicide and aggressive behavior,” he said.

At the ASU the clients receive their complete psyche and behavioral workups. It is with this information that the individual treatment plans are constructed, according to Haire.

To accomplish this task the center employs a psychiatrist and a medical doctor. The center also employs a full staff of licensed personnel including nurses, Haire said.

After a client has been deemed safe enough, they are moved to group homes on the facility grounds. These houses are numbered 1 through 6 and operate on a two-tiered system, Green said. The first tier is where newly transferred ASU clients are first placed, such as unit 6.

Inside unit six the atmosphere is more relaxed. Doors remain locked, but the clients are free to move around. The living quarters resemble college dorm rooms. In the rooms, clients are allowed to keep personal property, unlike the ASU, according to Green.

The staff has medical records and individual treatment plans for each of the residents, said Green. Each client comes with certain restrictions in place such as “tracking bracelets for clients that are flight risks,” he said.

The group unit’s occupants follow a laid out schedule of events ranging from classes to active treatment time. During active treatment, the staff will “take clients bike riding, play card games or board games with them,” said Green.

After the clients have proven that they can function within the first tier of the group home, they are moved to one of the four other units. In these group homes the clients are being prepared to return to the community, according to Haire.

The Montana Developmental Center conducted an internal assessment of the average stay of clients, according to Haire. “In 2010 the average stay of a client was 88 months. In 2012 the average stay was 40 months. That’s almost half of the time but it’s still not short,” he said.

Haire estimated that this year’s average would drop into the 30-month range. The center has reached an average of two admissions a month and about two discharges a month, according to Haire. The center itself has a max capacity of 56, he said.

The transition from the old ways of handling intellectual disabilities and stigmas is a constant battle for people like Green and Haire. The tide of battle, however, is turning, according to the numbers Haire has produced.

“It’s a hard job,” said Green, “but it’s a rewarding job. The clients see us come back everyday and know that we care.”

– Edited by Autumn Toennis and Matt Parsons


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