Trauma from Logan Thies’ past came flooding back, and all hell broke loose.
“We were having a really, really bad time, and things were just completely falling apart," said Thies' grandmother, Joanette. "I just didn’t know if I could do it. Somebody gave me the (Youth Crisis Diversion Project) name and within" – she snapped her fingers – "that amount of time, I had Youth Dynamics at my door and helping us.”
Today, 15-year-old Logan is a freshman at Big Sky High School and a Special Olympics champ. At the Special Olympics state summer games last year, Logan won first place in the 100-meter dash and first place in the 400-meter run. At the Special Olympics state basketball tournament last year, his team took first place in 3-on-3.
"He had had major traumas that had come back to get him and he and I had a falling out. And we rarely fight, but it had been a battle for a few weeks and it had just come to a point where I had to take him down physically," Joanette Thies said. "It was really hard to get it back together 'cause I didn’t know where to reach out to, and didn’t know what to do.
"I needed somebody that would take us and have it be a fresh start, and they (YCDP) did."
Just as mental illness can’t be classified in black-and-white terms, neither should the response.
That’s why six Missoula community mental health centers – Youth Homes, AWARE, Full Circle, Western Montana Mental Health Center, Youth Dynamics and Partnership for Children – joined forces to fill in the gray. The knee-jerk response, typically, is to throw a kid suffering from a mental illness or emotional disturbance in the hospital.
It harkens back four decades. In 1975, there were 625 runaway kids in the Missoula County jail – it was the only option. Probation officers wanted to cut back, and a year later the Shirley Miller Attention Home was born. It gives short-term care to youth ages 10 to 18 in a crisis.
The idea back then was to give people a choice: jail, shelter or home. Within three years, the number of runaway kids in jail dropped to 30.
Geoff Birnbaum hopes history repeats itself, but in a different setting.
“I would like it to be similar to if someone’s homeless, people know to call The Pov,” said Birnbaum, executive director of Youth Homes. “If someone needs food, they know about the Missoula Food Bank. If a kid or family is struggling, at risk or in a crisis, this (YCDP) is in their conscience and they know where to go.
“The more information we can give to families in this town about what’s available, the better off they are. They know they’re not alone, they know there’s resources out there, they know they have some place to turn.”
That's been the biggest hurdle: making sure people know the Youth Crisis Diversion Project exists.
One solution was creating a website, missoulayouthcrisis.org. It's an information hub for families, "a roadmap for helping youth in crisis."
The first step is calling or being referred to the crisis response team at St. Patrick Hospital's urgent mental health clinic. Anyone can refer a family or child to YCDP: schools, youth court, child welfare, community mental health centers, private therapists and school mental health providers.
Kids coming to YCDP are in a range of crises, said Peter Snyder, regional director of psychiatric services at St. Patrick Hospital: suicidal, physical aggression, non-compliance, depression, anxiety, substance abuse, self-harm, family conflict or runaway.
“Wherever a family turns, they’re going to get service,” said Charlie Wellenstein, a YCDP coordinator and adjunct assistant professor in the University of Montana's Montana Child Welfare Training Partnership.
Historically, families most often showed up in the emergency room because they didn't know where else to go. Today, St. Patrick's crisis response team scoops up the referred kids and rallies a facilitator, who meets with the family to decide what resources they need. Children in crisis are still hospitalized when necessary, but YCDP is available to make sure that's not the only choice.
In YCDP's first two years, 74 children were referred. In the past three months, facilitator Sandy Cummings has already seen more than 30.
"Part of it's the momentum of the project ramping up over the past couple of years," Snyder said. "Part of it is having direct connection with the medical services provided by Providence."
St. Patrick's urgent mental health clinic and assessment referral system were already in place by the time YCDP was formed in 2014.
"It seemed like a natural progression to formally include the Youth Crisis Diversion Project as far as the systems we currently had in place," Snyder said.
The challenges now, he said, are figuring out how the project adapts to increased demand and how to expand it statewide.
“It seems really simple, but again the challenge is all of Montana is a small town, so how do you deliver it in real time?” Birnbaum said. “Because even though we may be a rural state, the problem is immediate.”
The crisis response team works with the family to figure out what's going on. If the family can wait, then in a day or two a facilitator will work with them to figure out whether they need in-home support services (parent coaching, individual therapy, family therapy, etc.), other community services (recreation, daycare, etc.) or crisis stabilization if the situation is still unmanageable.
If the family can't wait, they go straight to crisis-stabilization mode, what Birnbaum calls "slowing everybody down."
For Logan, that was spending a few days at Attention Home. It gave both him and Joanette a chance to calm down, regroup and figure out the next step. From there, they got a family support assistant who works with Logan on his social skills and provides therapy and mentorship. The family has received other in-home services, and a case manager keeps Joanette on top of their schedule.
"I didn't realize how bad I needed the support until they came," she said.
YCDP didn't exist when Logan's older brother, Dallas, needed it several years ago. Instead, he was moved to a group home.
"I do believe that had crisis intervention been here, he wouldn't be (in a group home)," Joanette said. "He'd be at home."
That's YCDP's goal: Disrupt families as little as possible.
“Like any other parts of our lives, the less disruption they have, the better off they are,” Wellenstein said. “If they can stay at the closest place to home, the better off they are. The Attention Home is a step away, versus going to a hospital, which is two steps away. They can still attend school. Families can still visit.”
And it beats hospitalization, project leaders said.
"Traditionally, we go to hospitals," said AWARE service administrator Jake Henderson. "We all know that. We grew up with that. You go to hospitals and doctors if something's wrong.
"But anytime a kid has to go to a hospital setting, they're outside of the home and that's a traumatic event."
This project has also been a chance for local organizations to collaborate in ways they never have before. Henderson said the community benefits from that networking.
"We're all meeting on a quarterly basis and getting updates from other providers that we may not have known about," he said. "We're stuck in our own world, but this is breaking down those silos."
Instead of wearing the "deer-in-headlight look," he said, providers now have a wealth of knowledge to help a family the moment they're in crisis.
"I think they're helpful to me and my family," Logan Thies said. "Even in the tough times, they've helped us.
"They (the public) should know that if you have trouble, they will help you. Not immediately, but when they can, they will find somebody for you. They will."
This isn't unique to Missoula. The state grant was awarded to five projects, in Missoula, Billings, Great Falls, Kalispell and Helena. Montana's Children's Mental Health Bureau wants to see each project identify where gaps exist in children's mental health crisis response services and develop policy recommendations.
Bureau chief Zoe Barnard was enamored with the YCDP website – so much so that creating a website was incorporated into the requirements for the most recent round of funding.
"That is such a fantastic website because rather than being a classic list of services, it's useful information that parents and other concerned adults can go apply before they reach out to a professional," she said. "I'm hoping to have five different crisis websites across the state, and ultimately my dream is to have a clickable map on the Children's Mental Health Bureau website that links to each community that has one."
Looming over this project is the stigma that's still attached to mental illness.
"I think the biggest crime is seeing the need and not doing anything about it," Joanette said. "It's very humiliating, it's very embarrassing. It humble-izes you to a new level. You have to let go of family secrets to get better, but they do it in a way that doesn’t dehumanize you.
"I reached out because I want him to be a really good guy. I don’t want him to fade in the cracks."