Trails Carolina Buys Stone Mountain School Property

Trails Carolina announced the acquisition of a new property to host the Trails Family Institute. The property in located in Black Mountain, NC on the former Stone Mountain School site. The Trails Family Institute will be led by Jason McKeown, Director of Family Services. Trails Family Institute will be a 5 Day add-on to the Trails Carolina program and focus on extended lessons and skills from traditional wilderness programming into the family context. Screen Shot 2015-08-25 at 11.57.53 AM

Trails Carolina, Trails Academy and Trails Family Institute are ‘partnered’ with Family Help and Wellness, a parent company based in Salem, Oregon. They oversee many other treatment facilities such as the following:

  • Asheville Academy for Girls 
  • Blue Fire   
  • Elevations  
  • The Journey Home
  • Red Mountain
  • Sedona Sky 
  • Seven Stars
  • Solstice  
  • Solstice East 
  • Talisman Camp 
  • Timbersong Academy  (This is a school that operates solely for residents of Solstice East and Asheville Academy for Girls.  
  • Viewpoint Center 
  • Wingate Wilderness  

Odyssey Behavioral Healthcare Buys Pasadena Villa and Lifeskills

Odyssey Behavioral Healthcare, a partnership between Nautic Partners, LLC and CEO Scott Kardenetz, announced it completed the acquisition of residential/outpatient mental health and addictions treatment providers Pasadena Villa (TN, FL) and Lifeskills South Florida (FL). Screen Shot 2015-08-22 at 9.23.56 AM

Odyssey, headquartered in Brentwood, TN, was formed to build a diverse platform of behavioral healthcare facilities across the treatment spectrum in psychiatric and addiction care.  Scott Kardenetz is a 25-year veteran with former leadership positions at Ardent Health Services, Psychiatric Solutions and Universal Health Services. Nautic and Odyssey plan to invest $50 million of equity capital to support its strategy of growth.

Behavioral Health mergers and acquisitions experts expect this trend to continue, with a growing emphasis on the development of a full continuum of services and settings which promises to be an even bigger market than the strictly luxury-leaning residential programs that historically been the focus of consolidation. 

About Odyssey Behavioral Healthcare

Odyssey Behavioral Healthcare was formed in 2015 as a partnership between Nautic Partners and Scott Kardenetz. Odyssey’s treatment centers include Pasadena Villa and Lifeskills, which provide adult residential treatment care in three primary facilities and outpatient care in Tennessee and Florida. Odyssey will seek to expand the platform through new development and acquisition. In developing its platform, Odyssey seeks to acquire and develop treatment facility leaders in their therapeutic niche and that can benefit from senior management leadership and support.

Why Entrepreneurs Kill Themselves

First of all, a disclosure: I’m a therapist. I work with individuals and families. I meet with people in their homes and offices. Many of my clients from around the country are entrepreneurs. Many are high income earners. A few are on the post-exit side, financially comfortable but bored as hell. I’m also an entrepreneur. I consider my behavioral health agency a business with a product. I consider my patients as customers and treat them as such. I’m not sure which came first, entrepreneurship or being a therapist. Both have existed since I can remember (though not always tied together). When I hear about another entrepreneur’s suicide (referring to Austen Heinz), I cringe. I react as an entrepreneur and I react as a therapist who knows how to stop this. I also beat my head against the wall trying to figure out how to get those hurting to connect with those, like me, that can help. 

Entrepreneurs are a unique bunch. They (…we?) have large egos, low self-esteem (when no one is looking), we work stupid hours, are running from fear, elated when the needle moves slightly in our favor, we are hard to live with, have unrealistic expectations, are judgmental of others (more so of ourselves). There’s a ton of research that affirms this (borrowed from FeldThoughts):

Of the 242 entrepreneurs surveyed, 49% reported having a mental-health condition. Depression was the No. 1 reported condition among them and was present in 30% of all entrepreneurs, followed by ADHD (29%) and anxiety problems (27%). That’s a much higher percentage than the US population at large, where only about 7% identify as depressed.

What’s Helpful? Posting the National Suicide Prevention Hotline (1-800-273-8255) might make some bloggers or journalists feel like they are contributing to the solution. A few folks reading articles might actually call and some might find some solace. But for most entrepreneurs, it’s way more complicated. I’d also like to dispel another myth that most, if not only, tech entrepreneurs struggling with launching a product and desperately reaching to become the next unicorn, are the ones hurting. Not true. You do not need millions of dollars from a VC to have anxiety, depression, imposter syndrome, fears that at any moment it will all come crashing down and your ego will get sucked down with it. Pain comes from only a few places. The major one I’ve seen as a therapist for years is the gap between our expectations and our reality.  

 

What’s the Problem?

 

Therapists don’t advertise. They don’t connect to the outside world. When was the last time you read coverage of a therapist’s thoughts in Business Insider, Forbes or Inc.com? You don’t because we don’t think about communicating to the outside world. We hide in our comfy offices waiting for nice people with insurance (…or those few souls left that private pay) to trip over our profiles on antiquated therapist database websites. 

Therapists are not well-trained. We have minimum continuing education requirements, most of which are required to be on ethics (Don’t have sex with patients!). Even when we are trained to handle suicide intervention, only a handful of us are available 24/7 unless they work for behavioral health company that requires on-call responsibilities. I’ve been ‘on-call’ my entire professional life. At first it sucked. I felt tethered to my cell phone. But as I matured and as I started and ran my own agency, I understood that being available for those in pain is part of my business. It’s not only me being a good person, it’s a good business model and excellent customer service. 

No One Talks Prevention. Let’s get real. In the world of entrepreneurship, whether you are in tech, making widgets, or busting it out with an Etsy project, there are no systematic behavioral health solutions that cut across industries. Closest thing is Employee Assistance Plans (EAPs), but those are for large companies and tend to be low quality perks. There are a handful of VCs that provide informal emotional support to companies. There are some incubators that do the same. But overall, there is little formal or informal discussion about behavioral health prevention, intervention and resiliency. 

 

Solutions 

 

Yes, there are very real things we can do beyond just herding cattle towards the anemic volunteer force at the Suicide Prevention Hotline. 

1. StartUp: We need someone (maybe I’ll do it…) to start a biz which is the QuickBooks equivalent for mental health. Small/medium size business pays small monthly fee for ongoing support with behavioral health issues. Bizarre? I can think of a ton of services I first thought were stupid that soon became popular and financially successful. Either a platform or solution that cuts across industries, is inexpensive, super user friendly and deeply effective at preventing AND intervening with mental health and substance abuse problems. I imagine it being like a cool version of EAPs, but focused on startups and freelancers hoping to break through. 

2. Conferences: We need therapists to get invited to startup conferences and talk about how to reduce anxiety, depression and feeling like an imposter. Therapists also need to reach out to conference organizers and offer to speak. It’s great marketing for the therapist, it’s great value for participants and creates an opportunity for some cross-pollination between industries. 

3. Go to Therapy!: All entrepreneurs that have a history of depression, anxiety, substance use or other significant mental health issue should go and simply connect with a therapist while they are starting a business. Don’t give the bullshit line about not having the money. If you have enough money for an iPhone 6, you can find the money for a few sessions with a therapist.

4. Find a Qualified Therapist: Find a therapist with entrepreneurs and high achievement folks. You will know them when you first ask about their background. Their blogs will have entrepreneurial language. They will also be able to talk about depression, impostor syndrome, anxiety and money problems – all symptoms of the startup/growth world. Don’t count on finding this info on your basic therapist databases like Psychology Today or Good Therapy.

5. Kill Sacred Cows: You are not going to be a billionaire. Your startup will not change human history. Stop taking yourself so seriously and take a break. Learn to stop work at a certain time each day. Stop lying to yourself, families and friends that you are ‘killing it’ with amazing app or product. Get some sleep, eat some healthy food and get your ass moving for some exercise in the Sun (bright thing in sky from 6am-7pm). You get zero bonus points for how much you (and your family) have sacrificed. Chill out. 

Got your own experiences with entrepreneurship and how it affected your life or family? Email me and I’ll put together a ‘Part II’ of this post on entrepreneurship and behavioral health.  

Sunspire Health Acquired by Private Equity Firm


Kohlberg & Company
Sunspire Health (a private equity firm based in New York) has acquired majority ownership of Sunspire Health a provider of behavioral health services for the treatment of substance abuse and other co-occurring disorders. Headquartered in Lyndhurst, NJ, Sunspire operates a portfolio of independently branded treatment centers in five locations – California, Florida, Massachusetts, and Oregon, with another three locations opening in the second half of 2015. New facilities will be opening in Hilton Head Island, S.C., Gilman, Ill., and Key Largo, Fla..

Acadia Healthcare Set to Buy Belmont Behavioral Health

Acadia Healthcare announced an agreement to purchase Belmont Behavioral Health located in Philadelphia, Pennsylvania. Belmont is part of the not-for-profit Einstein Healthcare Network

Upon completion, the sale totaling $145 million, will include all inpatient and outpatient programs and support departments on the campus of Belmont Center for Comprehensive Treatment, a 147-bed facility located at 4200 Monument Road; Belmont Northeast, located at 10360 Drummond Road; and the Community Outpatient Program for the Elderly (COPE) Germantown Outpatient Program, located at One Penn Boulevard. 

Acadia is a provider of inpatient behavioral health services. Acadia operates a network of 224 behavioral health facilities with approximately 9,000 beds in 37 states, the United Kingdom and Puerto Rico. Acadia provides psychiatric and chemical dependency services to its patients in a variety of settings, including inpatient psychiatric hospitals, residential treatment centers, outpatient clinics and therapeutic school-based programs.

 

Insider’s Guide: List of Mental Health Diagnoses, Codes and Categories

So often it seems like there is this secret world behind the therapist’s note pad. A world made up of CPT codes, NPI numbers, billing forms and diagnoses. In a previous post, I discussed the importance of CPT codes and how they impact behavioral health treatment. In this post, we’ll examine a fairly comprehensive list of all the mental health diagnoses a therapist could use for a client. 

In the first column you’ll see the diagnostic code. The diagnostic coding, as discussed last year in our DSM post is a language that communicates a lot of info in just a few numbers (read the DSM post if you want to learn more about what it’s communicating).

In the middle column, you’ll see the diagnosis title or name. This is what you’ll typically hear discussed by your therapist (…ok, maybe), on the television or in the kitchen during Thanksgiving dinner about that crazy aunt.

The third column is the clinical category in which the diagnosis is found within the DSM-V (yet another post we have buried somewhere). 

Now, what you will not see below is the explanation for each diagnosis and what criteria need to be met to be diagnosed (or what we think of as the ‘constellation of symptoms’). While we’ll slowly tackle that in future posts, it’s best for now to talk with your therapist. They’ll have the time and knowledge to go into detail about your unique circumstances.

   
308.3 Acute Stress Disorder Anxiety Disorders
309.9 Adjustment Disorder Unspecified Adjustment Disorders
309.24 Adjustment Disorder with Anxiety Adjustment Disorders
309.0 Adjustment Disorder with Depressed
Mood
Adjustment Disorders
309.3 Adjustment Disorder with
Disturbance of Conduct
Adjustment Disorders
309.28 Adjustment Disorder with Mixed
Anxiety and Depressed Mood
Adjustment Disorders
309.4 Adjustment Disorder with Mixed
Disturbance of Emotions and Conduct
Adjustment Disorders
300.22 Agoraphobia without History of
Panic Disorder
Anxiety Disorders
307.1 Anorexia Nervosa Eating Disorders
301.7 Antisocial Personality Disorder Personality Disorders
293.89 Anxiety Disorder Due to Medical
Condition
Anxiety Disorders
300 Anxiety Disorder, NOS Anxiety Disorders
301.82 Avoidant Personality Disorder Personality Disorders
296.8 Bipolar Disorder NOS Mood Disorders
296.56 Bipolar
I Disorder, Most Recent
Episode Depressed, In Full Remission
Mood Disorders
296.55 Bipolar
I Disorder, Most Recent
Episode Depressed, In Partial Remission
Mood Disorders
296.51 Bipolar
I Disorder, Most Recent
Episode Depressed, Mild
Mood Disorders
296.52 Bipolar
I Disorder, Most Recent
Episode Depressed, Moderate
Mood Disorders
296.54 Bipolar
I Disorder, Most Recent
Episode Depressed, Severe With Psychotic Features
Mood Disorders
296.53 Bipolar
I Disorder, Most Recent
Episode Depressed, Severe Without Psychotic Features
Mood Disorders
296.50 Bipolar
I Disorder, Most Recent
Episode Depressed, Unspecified
Mood Disorders
296.46 Bipolar
I Disorder, Most Recent
Episode Manic, In Full Remission
Mood Disorders
296.45 Bipolar
I Disorder, Most Recent
Episode Manic, In Partial Remission
Mood Disorders
296.41 Bipolar
I Disorder, Most Recent
Episode Manic, Mild
Mood Disorders
296.42 Bipolar
I Disorder, Most Recent
Episode Manic, Moderate
Mood Disorders
296.44 Bipolar
I Disorder, Most Recent
Episode Manic, Severe With Psychotic Features
Mood Disorders
296.43 Bipolar
I Disorder, Most Recent
Episode Manic, Severe Without Psychotic Features
Mood Disorders
296.40 Bipolar
I Disorder, Most Recent
Episode Manic, Unspecified
Mood Disorders
296.66 Bipolar
I Disorder, Most Recent
Episode Mixed, In Full Remission
Mood Disorders
296.65 Bipolar
I Disorder, Most Recent
Episode Mixed, In Partial Remission
Mood Disorders
296.61 Bipolar
I Disorder, Most Recent
Episode Mixed, Mild
Mood Disorders
296.62 Bipolar
I Disorder, Most Recent
Episode Mixed, Moderate
Mood Disorders
296.64 Bipolar
I Disorder, Most Recent
Episode Mixed, Severe With Psychotic Features
Mood Disorders
296.63 Bipolar
I Disorder, Most Recent
Episode Mixed, Severe Without Psychotic Features
Mood Disorders
296.60 Bipolar
I Disorder, Most Recent
Episode Mixed, Unspecified
Mood Disorders
296.7 Bipolar
I Disorder, Most Recent
Episode Unspecified
Mood Disorders
296.40 Bipolar I Disorder, Most Recent
Episode Hypomanic
Mood Disorders
296.06 Bipolar I Disorder, Single Manic
Episode, In Full Remission
Mood Disorders
296.05 Bipolar I Disorder, Single Manic
Episode, In Partial Remission
Mood Disorders
296.01 Bipolar I Disorder, Single Manic
Episode, Mild
Mood Disorders
296.02 Bipolar I Disorder, Single Manic
Episode, Moderate
Mood Disorders
296.04 Bipolar I Disorder, Single Manic
Episode, Severe With Psychotic Features
Mood Disorders
296.03 Bipolar I Disorder, Single Manic
Episode, Severe Without Psychotic Features
Mood Disorders
296.00 Bipolar I Disorder, Single Manic
Episode, Unspecified
Mood Disorders
296.89 Bipolar II Disorder Mood Disorders
300.7 Body Dysmorphic Disorder Somatoform Disorders
301.83 Borderline Personality Disorder Personality Disorders
780.59 Breathing-Related Sleep Disorder Sleep Disorders, Dyssomnias
298.8 Brief Psychotic Disorder Psychotic Disorders
307.51 Bulimia Nervosa Eating Disorders
307.45 Circadian Rhythm Sleep Disorder Sleep Disorders, Dyssomnias
300.11 Conversion Disorder Somatoform Disorders
301.13 Cyclothymic Disorder Mood Disorders
297.1 Delusional Disorder Psychotic Disorders
301.6 Dependent Personality Disorder Personality Disorders
300.6 Depersonalization Disorder Dissociative Disorders
311 Depressive
Disorder NOS
Mood Disorders
300.12 Dissociative Amnesia Dissociative Disorders
300.15 Dissociative Disorder NOS Dissociative Disorders
300.13 Dissociative Fugue Dissociative Disorders
300.14 Dissociative Identity Disorder Dissociative Disorders
302.76 Dyspareunia Sexual Disorders, Sexual
Dysfunctions
307.47 Dyssomnia NOS Sleep Disorders, Dyssomnias
307.44 Dyssomnia Related to (Another
Disorder)
Sleep Disorders
300.4 Dysthymic Disorder Mood Disorders
307.5 Eating Disorder NOS Eating Disorders
302.4 Exhibitionism Sexual Disorders, Paraphilias
625 Female
Dyspareunia Due to Medical
Condition
Sexual Disorders, Sexual
Dysfunctions
625.8 Female Hypoactive Sexual Desire
Disorder Due to Medical Condition
Sexual Disorders, Sexual
Dysfunctions
302.73 Female Orgasmic Disorder Sexual Disorders, Sexual
Dysfunctions
302.72 Female Sexual Arousal Disorder Sexual Disorders, Sexual
Dysfunctions
302.81 Fetishism Sexual Disorders, Paraphilias
302.89 Frotteurism Sexual Disorders, Paraphilias
302.85 Gender Identity Disorder in
Adolescents or Adults
Sexual Disorders, Gender Identity
Disorder
302.6 Gender Identity Disorder in
Children
Sexual Disorders, Gender Identity
Disorder
302.6 Gender Identity Disorder NOS Sexual Disorders, Gender Identity
Disorder
300.02 Generalized Anxiety Disorder Anxiety Disorders
301.50 Histrionic Personality Disorder Personality Disorders
302.71 Hypoactive Sexual Desire Disorder Sexual Disorders, Sexual
Dysfunctions
300.7 Hypochondriasis Somatoform Disorders
312.3 Impulse -Control Disorder NOS Impulse-Control Disorders
307.42 Insomnia Related to (Another
Disorder)
Sleep Disorders
312.34 Intermittent Explosive Disorder Impulse-Control Disorders
312.32 Kleptomania Impulse-Control Disorders
296.36 Major Depressive Disorder,
Recurrent, In Full Remission
Mood Disorders
296.35 Major Depressive Disorder,
Recurrent, In Partial Remission
Mood Disorders
296.31 Major Depressive Disorder,
Recurrent, Mild
Mood Disorders
296.32 Major Depressive Disorder,
Recurrent, Moderate
Mood Disorders
296.34 Major Depressive Disorder,
Recurrent, Severe With Psychotic Features
Mood Disorders
296.33 Major Depressive Disorder,
Recurrent, Severe Without Psychotic Features
Mood Disorders
296.30 Major Depressive Disorder,
Recurrent, Unspecified
Mood Disorders
296.26 Major Depressive Disorder, Single
Episode, In Full Remission
Mood Disorders
296.25 Major Depressive Disorder, Single
Episode, In Partial Remission
Mood Disorders
296.21 Major Depressive Disorder, Single
Episode, Mild
Mood Disorders
296.22 Major Depressive Disorder, Single
Episode, Moderate
Mood Disorders
296.24 Major Depressive Disorder, Single
Episode, Severe With Psychotic Features
Mood Disorders
296.23 Major Depressive Disorder, Single
Episode, Severe Without Psychotic Features
Mood Disorders
296.20 Major Depressive Disorder, Single
Episode, Unspecified
Mood Disorders
608.89 Male
Dyspareunia Due to Medical
Condition
Sexual Disorders, Sexual
Dysfunctions
302.72 Male Erectile Disorder Sexual Disorders, Sexual
Dysfunctions
607.84 Male Erectile Disorder Due to
Medical Condition
Sexual Disorders, Sexual
Dysfunctions
608.89 Male Hypoactive Sexual Desire
Disorder Due to Medical Condition
Sexual Disorders, Sexual
Dysfunctions
302.74 Male Orgasmic Disorder Sexual Disorders, Sexual
Dysfunctions
293.83 Mood Disorder Due to Medical
Condition
Mood Disorders
301.81 Narcissistic Personality Disorder Personality Disorders
347 Narcolepsy Sleep Disorders, Dyssomnias
307.47 Nightmare Disorder Sleep Disorders, Parasomnias
300.3 Obsessive Compulsive Disorder Anxiety Disorders
301.4 Obsessive-Compulsive Personality
Disorder
Personality Disorders
625.8 Other Female Sexual Dysfunction
Due to Medical Condition
Sexual Disorders, Sexual
Dysfunctions
608.89 Other Male Sexual Dysfunction Due
to Medical Condition
Sexual Disorders, Sexual
Dysfunctions
307.89 Pain Disorder Associated with both
Psychological Factors and Medical Conditions
Somatoform Disorders
307.8 Pain Disorder Associated with
Psychological Features
Somatoform Disorders
300.21 Panic Disorder with Agoraphobia Anxiety Disorders
300.01 Panic Disorder without Agoraphobia Anxiety Disorders
301.0 Paranoid Personality Disorder Personality Disorders
302.9 Paraphilia, NOS Sexual Disorders, Paraphilias
307.47 Parasomnia NOS Sleep Disorders, Parasomnias
312.31 Pathological Gambling Impulse-Control Disorders
302.2 Pedophilia Sexual Disorders, Paraphilias
301.9 Personality Disorder NOS Personality Disorders
309.81 Posttraumatic Stress Disorder Anxiety Disorders
302.75 Premature Ejaculation Sexual Disorders, Sexual
Dysfunctions
307.44 Primary Hypersomnia Sleep Disorders, Dyssomnias
307.42 Primary Insomnia Sleep Disorders, Dyssomnias
293.81 Psychotic Disorder Due to Medical
Condition, with Delusions
Psychotic Disorders
293.82 Psychotic Disorder Due to Medical
Condition, with Hallucinations
Psychotic Disorders
298.9 Psychotic Disorder, NOS Psychotic Disorders
312.33 Pyromania Impulse-Control Disorders
295.70 Schizoaffective Disorder Psychotic Disorders
301.20 Schizoid Personality Disorder Personality Disorders
295.20 Schizophrenia, Catatonic Type Psychotic Disorders
295.10 Schizophrenia, Disorganized Type Psychotic Disorders
295.30 Schizophrenia, Paranoid Type Psychotic Disorders
295.60 Schizophrenia, Residual Type Psychotic Disorders
295.90 Schizophrenia, Undifferentiated
Type
Psychotic Disorders
295.40 Schizophreniform Disorder Psychotic Disorders
301.22 Schizotypal Personality Disorder Personality Disorders
302.79 Sexual Aversion Disorder Sexual Disorders, Sexual
Dysfunctions
302.9 Sexual Disorder NOS Sexual Disorders
302.7 Sexual Dysfunction NOS Sexual Disorders, Sexual
Dysfunctions
302.83 Sexual Masochism Sexual Disorders, Paraphilias
302.84 Sexual Sadism Sexual Disorders, Paraphilias
297.3 Shared Psychotic Disorder Psychotic Disorders
780.54 Sleep Disorder Due to A Medical
Condition, Hypersomnia Type
Sleep Disorders
780.52 Sleep Disorder Due to A Medical
Condition, Insomnia Type
Sleep Disorders
780.59 Sleep Disorder Due to A Medical
Condition, Mixed Type
Sleep Disorders
780.59 Sleep Disorder Due to A Medical
Condition, Parasomnia Type
Sleep Disorders
307.46 Sleep Terror Disorder Sleep Disorders, Parasomnias
307.46 Sleepwalking Disorder Sleep Disorders, Parasomnias
300.23 Social Phobia Anxiety Disorders
300.81 Somatization
Disorder
Somatoform Disorders
300.81 Somatoform Disorder NOS Somatoform Disorders
300.29 Specific Phobia Anxiety Disorders
302.3 Transvestic Fetishism Sexual Disorders, Paraphilias
312.39 Trichotillomania Impulse-Control Disorders
300.81 Undifferentiated Somatoform
Disorder
Somatoform Disorders
306.51 Vaginismus Sexual Disorders, Sexual
Dysfunctions
302.82 Voyeurism Sexual Disorders, Paraphilias

So why post all this? As a therapist, part of my job is to provide a transparent process of clinical intervention, if not resolution. Huh? Basically, I want clients to know what’s happening behind the scenes regarding their diagnoses, their insurance, their medical files and anything else that impacts them. I’m ultimately trying to work myself out of a job. 

Muir Wood Expands… Reaching for Alta Mira Recovery

Scott Sowle, the founder and executive director of Muir Wood Adolescent & Family Services (Sonoma County, CA) teamed up with private investors to acquire the residential and outpatient addiction and co-occurring disorders treatment organization from Constellation Behavioral Health. Constellation Behavioral Health operates Alta Mira Recovery Programs in California.

Muir Wood will operate as a stand-alone program focused on youth treatment, run by founder and executive director Scott Sowle. They will be expanding their residential treatment capacity by adding a residential campus for adolescent girls program. Constellation Behavioral Health operates Alta Mira Recovery Programs in California. Muir Wood will expand its residential treatment capacity for young males from its present 6 beds to 10. The adolescent male program, housed on a six-acre campus, includes weekly family programming, experiential therapies, and an accredited academic program.

NPR Exclusive: New Meds Block Heroin Craving, But Reporter Finds Treatment Centers Don’t Use Them

Police and public health officials in the U.S. have been struggling in recent years with the dramatic rise in heroin addiction and fatal overdoses from the drug. The Centers for Disease Control and Prevention reported that more than 8,000 people died from heroin overdoses in 2013 – a 39% increase over the year before.

Kentucky emerged in the last few years as especially hard hit, where heroin deaths increased by 550% between 2011 and 2012 and have continued to climb steadily. That’s where investigative reporter Jason Cherkis spent more than a year looking into heroin addiction and treatment. He says there’s a growing consensus among medical experts that the most effective treatment for addicts is a combination of counseling and new medications, especially the drug Suboxone, which blocks the craving for heroin. But Cherkis reports most drug treatment facilities rely on an abstinence-based approach, which rejects the use of these new medications. The result, he says, is high rates of failure for addicts trying to get clean and, all too often, fatal overdoses when they relapse.

Jason Cherkis is a national investigative reporter for The Huffington Post. His series about heroin addiction and treatment called “Dying To Be Free” was published last week.
The interview and Cherkis’ work is not without debate. Many professionals and former/current addicts challenged Cherkis’ reporting as over-simplistic and failing to discuss many of the other treatments and treatment programs that are showing promise.

Here is a link to the interview with  FRESH AIR contributor Dave Davies.

Elements Behavioral Health Expanding

Elements Behavioral Health has been actively expanding as evidenced by the purchase of  Park Bench Group Counseling in New Jersey and the opening of Brightwater Landing in Pennsylvania right outside Harrisburg and Hershey.

Elements portfolio are also ramping up programs to meet increased market demands. Centers in Texas and Tennessee are adding new services, and a detox program in Florida launching in the first quarter of the year.

On The Market?

Within all this activity, observers are reporting that Elements is for sale. Reuters reported in December 2014 that private equity and venture capital firm Frazier Healthcare is potentially looking to sell Elements, and that  investment bank Jefferies Group LLC has been retained to facilitate the next steps. Across the entire industry, valuations are up, and the market is ripe for activity.

Elements has been estimated to be worth $30 million in EBITDA (earnings before interest, taxes, depreciation, and amortization) and get 10x more in actual negotiations.

Acquisitions!

Founded by two clinicians in 2006 the newly acquired Park Bench in New Jersey provides day treatment and intensive outpatient services, including an individualized aftercare program (…often a big missing piece in substance abuse treatment).

Elements was targeting the Northeast for some time, particularly in the New York/New Jersey Tristate area because of population density and the need for young adult treatment. The services they’re providing, which are addiction and co-occurring disorders, fit with the Elements family of programs.

Elements has an existing property in York, Pa., and this month, it added a new location, Brightwater Landing in Lancaster County – west of Philadelphia. The center is on a 150-acre campus that lends itself to treatment interventions that require more outdoor space as well as landscape features appropriate to experiential and adventure-based therapies.

Treatment at Brightwater will include equine therapy and a ropes course to enable clients to process the emotional and behavioral parts of their addiction. The experiences will address not just the substance-use disorders but also the underlying trauma that contributes to using. The center will offer primary psychiatric and active mental health models of care – early on-ramp for those seeking treatment for the first time. 

Elements Behavioral Health is part of a trend within the industry where small mom and pop outpatient and treatment centers built over the last few decades are being gobbled up by some big players. We expect more merger and acquisition activity in 2015.

Insider’s Guide: How to Pay for Therapeutic Boarding School (UPDATED for 2015!)

Before we dive into understanding the options for Therapeutic Boarding Schools, let’s quickly review what they are

The Rise of Therapeutic Boarding Schools

As public schools across the country have slowly been pruned back by state legislatures, funding for behavioral, emotional and academic support have nearly dried up. Therefore, it’s not surprising private institutions like boarding schools and private schools have exploded. One of the fastest growing kinds of boarding schools is called Therapeutic Boarding Schools. Therapeutic boarding schools maintain the advantages of traditional boarding schools such as intimate class sizes, individual attention, great academics, developing student self-reliance, and the fun of living with peers in a completely “child-friendly” environment.

Some therapeutic boarding schools specialize in helping teens overcome certain psychological problems such as Attention Deficit Disorder, Bipolar, Asperger’s and even Depression. Others have programs for overcoming substance abuse problems or achieving weight loss. Some specialize in helping students who lack motivation get a fresh start in a nurturing environment. Most have some sort of family or parent involvement piece to ensure a team approach (ie. Weekly family therapy via phone or Skype).

Expense or Investment?

Parents often find themselves in a desperate situation with a troubled teenager. Their daughter runs away from home again, gets caught with the dealer down the street, crashes another car, and has yet another arrest. Parents become afraid for their teen’s lives as their teen’s risk-taking and lifestyle keeps becoming more extreme as the parents’ ability to set boundaries and expectations seemingly erodes.

It’s hard to think clearly and find solutions at times like this. Therapeutic boarding schools and therapeutic wilderness programs can provide answers, but they come at a price, with some programs running upwards of $50,000 a year.

But cost doesn’t have to be an insurmountable obstacle in getting your teen the help they need. We have helped countless parents in similar situations come up with creative ways to finance therapeutic boarding school, knowing that their child desperately needs an intervention. Therapeutic boarding schools are no longer exclusively the domain of the wealthy.

Top 10 Ways to Pay for Therapeutic Boarding School

Here are 10 ways families just like yours found to finance their teen’s therapeutic program:

1.   Hire a Case Manager: Say what? More money? Yes. Just like a good tax professional can save you big time when filing, a good case manager can be well worth their weight in gold. Make sure they are UNAFFILIATED with any program and have the clinical expertise to help advise and guide your family through the whole process. Some clinical educational consultants that specialize are able to handle this. A great case manager will be able to create a treatment plan, explain the process for getting a comprehensive psychological evaluation, walk with you through the intake process, support you while your teen is in the therapeutic boarding school, and coordinate discharge planning to ensure a seamless transition back to home or college. The last piece is essential – making sure your teen has everything they need to succeed after they return. Great case managers also know how to secure reimbursement from insurance providers for teens that attend therapeutic boarding schools. There are definitely some tricks (eg. Hire a case manager that’s also a licensed professional counselor and much of their work could be paid for by insurance) and inside knowledge necessary to make this happen.
Typical cost: $95 – 350/hr (some charge a flat fee of several thousand). 

2. Find the Program’s Financial Aid Officer: The private school or wilderness program should have a financial aid officer who can advise you about how to finance your child’s education. You should ask this person what programs, loans, discounts, or financial aid the school offers. Find out exactly what is included in the tuition and board bills, and if there are additional expenses such as buying uniforms or paying special fees for sports.
Typical Cost: Nothing – programs provide this to try to entice you into signing up. Beware of anything that sounds too good to be true – verify any claims they make about coverage from insurance, student grants/scholarships or loans. 

3.  Public School Funding: You may qualify for a loan through a kindergarten through 12th grade educational loan program. These loans work the same way as college loans, in that you pay what you can while your child is enrolled in the private school, and pay the rest off later. The terms of some loans let you spread out payments over 10 or 20 years. Your credit history will be a factor in securing a loan. Your school’s financial aid officer should be able to help you find such a loan.
Typical Cost: Your sanity – they will drive you crazy with the bureaucracy and take loads of time during your work day since everything in public school shuts down by 3:30pm. 

4.  Discounts for Upfront Payment: Some schools offer discounts if you pay by the year, instead of by the month. The average student stays at a therapeutic boarding school for less than two years, and wilderness programs are even shorter.
Typical Cost: More money upfront but no other associated costs. 

5. Tap 529: Consider using your child’s college fund first. Think of the therapeutic program as a way to get your child back on the right path toward college. Without intervention, she won’t have the grades or motivation to get through college and use her fund.
Typical Cost: Make sure there are no withdrawal penalties for use for therapeutic boarding school. 

6. Put it On Plastic: When you enroll your child in these therapeutic programs, there will be upfront expenses such as processing fees and deposits. Some parents borrow these initial payments from credit cards, especially ones that offer “frequent flier” miles. This way their child is immediately enrolled. They use their free mileage for transportation to and from the school.
Typical Cost: Beware of high interest rates if you don’t pay off your balance in full. 

7. Angel Investing: Some parents borrow the necessary funds from employers or relatives, and pay them back after securing educational loans or home equity loans.
Typical Cost: If you go through a peer-to-peer or crowdfunding site like The Lending Club or Kickstarter, count on a 5% fee for total amount funded. 

8. Health Insurance Reimbursement: Your health insurance policy may cover part of the cost of a therapeutic program as a medical expense. When you hire a case manager, they will be able to tell you how to file the paperwork and what you need from the program to ensure a speedy reimbursement.
Typical Cost: Sanity… totally lost if your insurer are jerks that don’t reimburse when and how they should. You are attempting to pull money from their cold, dead hands. Expect a fight.

9. Consult Your CPA: Some expenses for therapeutic schools and wilderness programs can be deducted from your income tax return as medical expenses. If you own your own business, you likely have WAY more creative options for deducting medical expenses. 
Typical Cost: $200/hr for a good CPA to walk you through if and how to deduct from taxes. 

10. Tap Home Equity: Parents have taken out second mortgages or home equity loans and then deducted their interest payments on their income tax returns.
Typical Cost: Fees, closing costs total 2-6%. It also bumps the timeframe for paying off that home back several years.

11. Public School Funding: We lied – there turns out to be 11 ways to pay for therapeutic boarding school. Is your child enrolled in public special education classes because of problems like attention deficit disorder and learning disabilities? Does your child have an “Individual Education Plan” at a public school? Do you suspect your child has learning problems that the public school cannot address? In certain cases, public school districts have to reimburse parents for private school tuitions. The Supreme Court ruled on June 22, 2009, that an Oregon school district had to reimburse a family for private school costs because the child in question could not achieve a free and appropriate education within the district. The child had not been enrolled in special education classes but was diagnosed later with attention deficit disorder.

When it comes to what matters most parents are unstoppable in finding ways to get the services and support they need. Don’t let cost be the determining factor. If your teen needs help, speak with a case manager, your trusted CPA as well as a therapeutic boarding school you’re considering and work together to find a way to get your teen back on track.