“It hit me today,” said Paula Buckley as she settled into a couch and a long silence. Sheila Smith, Heidi Glee and Melissa Maendl nod in agreement. For years, they’ve been the backbone of the Sinopah House, a therapeutic group home for adolescent girls that is closing due to steep cuts in state funding for mental health services.
The entrance of Sinopah — more home than house, with an open kitchen and a half-finished puzzle on the table — is full of mid-morning light, but the atmosphere on Friday is solemn. Just that morning, one of Sinopah’s last teenage residents moved out. The $49 million in cuts to the Department of Public Health and Human Services were made in a flurry of budget restructuring during the Montana Legislature’s special session in November. Now, the dust is settling in the Flathead.
By April 1, the last of Sinopah’s adolescent girls will have moved on, and the house — named after the Blackfeet word for “kitfox” — will transition into the Fox Creek Adult Group Home. Sinopah is growing up, employees say, and will still provide group therapy. But after more than two decades serving some of the most vulnerable girls in the Flathead Valley, it’s a tough goodbye. And for the staff who have dedicated years of passionate work to the last adolescent group home in the area, there are few words for the loss.
“I’m sad,” said Buckley, the program director since Sinopah’s founding in 1994. “It’s devastating to think that we’re not going to reach these girls.”
SINOPAH HOUSE developed as a local solution to a gap in mental health care for a particularly vulnerable population: teenage girls. Prior to Sinopah’s founding in 1994, girls dealing with serious mental health issues — often stemming from trauma, abuse or neglect — were traveling hundreds of miles across Montana or out of state to receive sufficient, comprehensive therapy.
Sinopah House provided a local alternative. The house, originally located on Fifth Avenue East in Kalispell, offered eight beds for girls in Flathead, Lake, Lincoln and Sanders counties, and sometimes Glacier County. Girls who arrived at the house were “in trouble,” said Sheila Smith, who oversees Sinopah as executive director of the Flathead branch of Western Montana Mental Health. “They’ve landed in hospitals, they’ve landed in residential treatment facilities.”
The therapy provided by Sinopah was difficult, extensive and deeply involved. The girls arrived from the juvenile justice system, from the custody of Child Protective Services or from families desperate for help. They stayed in the home, working with a full-time staff of three to four therapists, for an average of nine months to a year. And they worked hard at healing — no small task, processing years of pain or trauma on top of the everyday roller coaster of being a teenage girl.
It’s a slow process. “You don’t uncover trauma and do that kind of therapy quickly,” said Smith. “You have to go slowly at it. You can’t just beat all the defenses down and be like, ‘Tell me all about (being abused).’ It’s a process and the kids who are able to do it are amazing kids. They want their lives to turn out differently. They’re pretty brave.”
Their bravery was met by the singular programming and structure provided at Sinopah; it was the only group home in the Flathead to offer in-house therapy and care specifically tailored to the challenges faced by teenage girls.
For starters, the vast majority of Sinopah residents were survivors of sexual abuse. There was a lot of trauma to work through, and quiet shame and pain to unpack. Sinopah provided food, shelter and care like other group homes, but also necessary tools for girlhood — clothing, tampons, support.
“Girls are internalizers,” said Smith. Their pain is often quiet or overlooked. “As a society, we go out and let them self-destruct. And I think that’s wrong.”
Over the years, Sinopah worked closely with teenage girls to develop strategies for addressing their pain. Therapy often focused on building self-confidence. “It’s heartwarming to see their confidence grow, to see them learn to be assertive,” said Maendl, who has worked as a residential care provider at Sinopah for 17 years. The therapy approach, she said, also addressed conflict resolution, relational aggression, daily living skills and working closely with families.
Sinopah facilitated this work by cultivating a strong, intimate group setting. The home moved in 2002 to a house specifically designed for group therapy on Windward Way, part of the Kalispell Regional Healthcare campus.
“Our philosophy is that this needs to take place in a setting that is female only,” said Smith. “It’s a group process — it’s called group home care. A lot of the work is in a group setting, working with those dynamics.
“Adolescent girls learn from their peers, and it makes this a more powerful process.”
But the depth of Sinopah’s resources — therapists on staff full-time, plus all the costs of caring for teenage girls — also made the house vulnerable to Montana’s 2017 budget shortfall. “It was always a program that ran close to the margins,” said Smith. The decrease in the Medicaid reimbursement rate — from $18 to $8 for a 15-minute billable unit — and the cuts to Department of Public Health and Human Services have left Sinopah in an “untenable” position.
With the rising costs, Smith said, “We just couldn’t sustain any longer.”
The end of a long-running, community-based program is “demoralizing,” she said.
Stopping and starting health programs looks clean on paper — a matter of red ink, fact sheets and repeated uses of “budget cuts” without a face. But Smith sees December’s legislative decisions in Helena land on her doorstep, as moving boxes are carried from Sinopah’s therapy rooms to the parking lot.
“It takes decades to build good community health programming. These are nonprofit agencies. It takes time and resources to develop them, to build social services, to hire good people with the health care workforce shortage, to develop relationships,” she said.
Even if the budget situation changes by the time the 2019 session rolls around, Smith predicts that some Flathead girls will have fallen through the gaps. “People’s troubles don’t just go away,” Smith said. Girls who would have stayed at Sinopah will now need to travel out of state or to facilities in Helena or Billings.
“They’re out of the community,” said Buckley, shaking her head.
THOUGH THE girls will go and the name will change, there will still be a home providing therapeutic care to adults in need. The new Fox Creek Group Home will work with adults to address long-standing mental health concerns — encouraging independent living and helping adults to maintain medications and stabilize living situations.
Though Fox Creek will still provide group therapy like at Sinopah, a smaller support staff will allow the facility to operate within budget margins.
With the reduction in case management workers due Health and Humans Services cuts, “We know there’s a need and we’re thinking we can meet that need with another group home,” said Smith.
It’s a “small silver lining,” but a bittersweet one. “It’s really important work but it doesn’t take away from feeling sad for lost opportunities for girls.”
As the final teenage residents move out of the Sinopah House, the staff prepare to say goodbye by reflecting on the home’s legacy.
Not every girl who lived at Sinopah managed to stay on track, but “at least we’ve kept them safe for the time they’ve been here,” said Maendl.
For Buckley, who will stay on as Fox Creek’s program manager, there remains pride in “the many families we have helped heal, the many girls who have made hard decisions to get healthy and to address the trauma that has scarred their lives. These girls are strong individuals who needed guidance and support to get their lives on track.”
She’s inspired by “how much they’ve grown and feel empowered to stick up for themselves, to set boundaries.”
For Heidi Glee, an intensive-level therapist in the home, it’s “seeing them engaging in the trauma piece and then seeing them heal — it’s an amazing process.”
An emotional silence filled the room as Glee, who is leaving Sinopah to continue work with children at another facility, glanced at her coworkers.
“It’s a truly special place.”
Reporter Adrian Horton can be reached at firstname.lastname@example.org or at 758-4439.