Adolescents Often Safer In Wilderness Than At Home

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According to the Outdoor Behavioral Healthcare Research Cooperative (OBHRC) directed by Dr. Mike Gass, the public perception of outdoor behavioral healthcare programs can be misconstrued as dangerous and unsafe. This perception can often be linked to a lack of knowledge regarding this innovative method of treatment, unfamiliarity with the extensive risk management techniques used in such programs, the inappropriate practices of less developed yet seemingly similar programs, and the vulnerable and problematic states of many of its clients. While no treatment can guarantee the total safety of any child, adolescents participating in Outdoor Behavioral Healthcare Industry Council (OBHIC) programs are actually at less risk than adolescents not participating in these programs. (Gass, Gillis, & Russell, 2012). In fact, in 2011 OBHIC program clients were three times less likely to go to a medical emergency room for an injury than if they were at home. Risk management data has been collected on OBHIC programs for the past 11 years, the longest operating multi-program database in the fields of behavioral healthcare or adventure programming.

The following are their findings.

OBHIC Client Injury Data:
Organizational members of OBHIC served 1,230 clients in 2011, resulting in 70,028 annual client field days and 30,001 annual guide field days in 2011. When injuries requiring OBHIC clients be removed from regular programming for 24 hours or more were counted (including some treated in the field as well as those who were evacuated to emergency rooms/medical attention), the OBHIC injury rate was 0.11 per 1000 days in 2011, or one injury requiring medical attention for every 9,091 client days. The U.S. Center for Disease Control and Prevention estimated the national average rate of injuries for adolescents treated in U.S. hospital emergency rooms was 0.38 per 1000 days in 2010 (WISQARS, 2011). Therefore, in 2011, OBHIC program clients were about three times less likely to go to a medical emergency room for an injury than if they were at home.

Further information on OBHIC Client Illnesses, Therapeutic Holds, and Restraints:
The total client illness rate for OBHIC programs was the lowest it has been since data collection began in 2001, at 0.26 illnesses per 1000 client field days, or one illness for every 3846 client days of programming. On average, illness rates have shown a downward trend since 2001, suggesting that OBHIC member programs continue to be on the forefront of improving healthy living and sanitation practices with clients in the field each year.

The OBHIC therapeutic hold and restraint rate continued to decrease for the fifth consecutive year in 2011, dropping to 1.31 per 1000 client field days, or 1 hold for every 763 client days of programming. For comparison, the average adolescent in US inpatient mental health services was about four and a half times as likely to be restrained as an OBHIC client in 2010 (NASMHPDRI, 2010), while adolescents in inpatient treatment in Ohio were 26 times as likely to be restrained as OBHIC clients in 2010.

Additional Information:
For additional information including a library of other publications and a list of OBHRC contributing research scientists please go to www.obhrc.org. Additional information regarding risk management can be found at: www.obhrc.org/risk-management

References:
Gass, M. A., Gillis, H. L., & Russell, K. (2012). Adventure therapy: Theory, research, & practice. New York, NY: Routledge.

NASMHPDRI. (2010). National Public Rates - Age stratification report restraint hours. National Association of State Mental Health Program Directors Research Institute.

WISQARS. (2011). Overall all injury causes nonfatal injuries and rates per 100,000: 2010, United States, all races, both sexes, ages 13-21. Washington, D.C.: Office of Statistics and Programming, National Center for Injury Prevention and Control, CDC.

OBHIC is a community of leading outdoor behavioral healthcare programs working to advance the field through best practices, effective treatment, and evidence-based research. OBHIC programs include the following organizations: Anasazi Foundation, Legacy Outdoor Adventures, Mountain Homes Youth Ranch, OMNI Youth Services, Open Sky Wilderness Therapy, Outback Therapeutic Expeditions, Redcliff Ascent, Second Nature Cascades, Second Nature Entrada, Soltreks, Summit Achievement, and Wendigo Lake Expeditions.