Jerry Dillion: He's Hot These Days, Pioneering Alternatives in Adolescent Health Care

Tulsa World

Author: Janet Pearson

It all started back in 1971, with little more than an idea and a small apartment off Riverside Drive. Within a few months, Jerry Dillon doubled the size of that facility, to two apartments, and before long, a duplex became the treatment center for a handful of troubled teens.

Now, Dillon's

., based in Tulsa, is the nation's largest provider of mental health care services for children and adolescents, treating a total of about 1,000 youths in nine states on any given day.

In the vernacular, Jerry Dillon is hot. He is sought after by national media for interviews. "MacNeil-Lehrer News Hour" spent several hours interviewing him at his Phoenix, Ariz., facility. "The Today Show" has called on him to comment, and the Washington Post asked him to do a guest editorial. CBS' "48 Hours" is trying to get him to do an exclusive.

The reason Dillon is hot is because his business - treating troubled youths - is a newsy topic these days. And, he is becoming nationally known as a pioneer of various alternative treatments, approaches he acknowledges are controversial in some circles. In a nutshell, Dillon believes hospitals "were not built for children." "For them to benefit, they have to feel comfortable in the environment," says Dillon. "Not many kids feel comfortable in a hospital."

Because of that philosophy, Dillon has labored tirelessly for nearly two decades creating a small empire designed to treat young people's mental health problems in a variety of accessible and affordable settings. "What we are is an alternative to hospital treatment. Since 1971, we have focused on that," says Dillon.

Standing still does not seem to be among Jerry Dillon's multiple capabilities. While presiding over his multi-state operation, he also remains active in a host of civic organizations - the United Way, Fellowship of Christian Athletes, Fore Tulsa, the Philharmonic, the Greenwood Cultural Center - to name a few.

Century is only one of Dillon's vocational pursuits.

Another is

an adoption agency that since 1972 has placed more than 3,800 Korean children in American homes. Less than 1 percent of those adoptions have failed, according to Dillon.

Dillon, 48, regularly works 12- and 14-hour days, according to an aide, and travels extensively to monitor facilities in other states. Yet he still finds time to play a few rounds of golf each week, and likes for his employees to enjoy the sport as well. In fact, he met assistant Joanne Ames on a golf course. Integrating fun and work, he reasons, is good for not only people, but companies as well.

Yet despite this indefatigable dynamism and an undying commitment to his philosophy, Dillon is not driven to develop his health care system into a huge, nationwide chain. "The most important thing is the families," he says. "Growth is only secondary." Hospitals that have met with demise, he adds, "were bottom-line, profit-driven companies."

Ever vigilant to the changes in health care trends - and to the needs of his clients, both current and prospective - Dillon's facilities are about to change their focus. To make services more accessible, Dillon is developing a couple of new treatment approaches that he thinks will revolutionize adolescent mental health care.

Dillon grew up in Yale, Okla., and had set his sights on a career in music after receiving a degree in music from the University of Tulsa.

But during a trip to New York in the early '60s to visit a brother, that would change. His brother, a professor at Columbia University, took his younger brother to visit New York ghettoes, and the younger Dillon quickly developed an interest in the problems of delinquent and disadvantaged youths. He worked at a community center there, and even frightening attacks by knife-wielding gangs did not dissuade the young Dillon from devoting his life to helping troubled youths. Only the physical scars remain.

Back in Tulsa, Dillon worked as a minister of music at a church and as a part-time counselor for the Tulsa Boys' Home. From 1967-71, he served as director of the boys' home.

In 1971, he set out on his own, establishing Madison Place under the auspices of Dillon Family and Youth Services.

In 1980, he opened Shadow Mountain Institute in south Tulsa, and in '82, High Pointe in Oklahoma City. Currently, Century, which was created in 1982 to administer the facilities in other states, operates through its subsidiaries 17 different programs in nine states. Seven of the programs are joint ventures.

The need for adolescent mental health services is painfully evident. One federal estimate put the number of mentally ill teens at eight million, about 12 percent of the population under age 18. Only a small minority gets treatment. The National Center for Health Statistics reports 180,000 children and adolescents were hospitalized in psychiatric facilities during 1987, a 43 percent increase since 1980.

According to Dillon, 80 percent of the children and adolescents being treated in hospital psychiatric units "are there because there's no alternative." "So what we're about and doing is creating environments for children, adolescents and families to grow in." While at odds with some hospitals - he admits he is not popular with the psychiatric hospital set - he boasts of cooperative relationships with Tulsa hospitals.

"Shadow Mountain would not have happened had we not had the support of Tulsa hospitals," he says. "It is not a competitive issue, because we can't take care of all of them," he adds. "It's a philosophical issue."

Youths will receive one or several of the different types of treatment offered at Century facilities, depending on their diagnosis. The most intensive level of treatment is hospital-like treatment for those with serious problems. This period of treatment should be "short-term and diagnostic," and aimed at stabilizing the youth, whether the problem is medical, physical or psychological.

Dillon says most of the teens who enter Century facilities have a substance abuse problem, "but that's not their primary diagnosis." The substance abuse often is an indication of another problem, so many of these youths end up with a dual diagnosis.

"What we do know and believe is for children who have that, we have to deal with the drug-related problem first," says Dillon. "So control of the environment is very important."

This intensive type of treatment typically should last only 20-40 days. After stabilization, the youth usually is transferred to a less intensive setting.

The next most intensive level is the "sub-acute," or residential level, in which the youth lives at the facility and receives ongoing treatment. "That's where our niche has been up to this point."

In this setting, the environment is structured but less so than in the acute setting. These clients participate in individual and group therapy as well as educational programs.

Because Dillon has perceived a need for yet another type of treatment, Century is beginning to shift its focus to what he terms "transitional living." Century opened its first transitional living facility in Phoenix, Ariz., the first of August. This type of treatment is for youths "who don't need sub-acute treatment, but who aren't able to function and for whom going home is not an option." Youths live at the facility, but are "almost independent," and can come and go for jobs and the like. Therapy is tailored to meet the individual's needs.

Even less intensive is another type of treatment Dillon is adding - day hospital treatment. This type is for youths whose "families are intact, and relationships are manageable," but still need treatment. The youths continue to live at home, but visit the facility regularly and receive treatment on what might be called an outpatient basis.

Yet another treatment approach Dillon is trying out is called in-home treatment. This type is in its early stages of development in Minnesota and Iowa. "It is a very strong, preventive treatment approach," says Dillon. In cases where it's deemed appropriate, a therapist will spend 10 to 20 hours a week in the home, counselling with the whole family.

Dillon hopes to eventually set up in-home programs in each of the states where Century operates. And as with all his approaches, it emphasizes the family. "Everything we do is a family system treatment approach, emphasizing strength in relationships ... No child has a problem independent of the family, in our opinion."

The need for different types of treatment is only one reason Dillon is developing new approaches; cost and access are important reasons as well. "We want to make what we have accessible to the mainstream of American kids," he said. "We're troubled that a small percentage of children has access to what we provide, so we're going to less intensive settings."

To back up his claims of affordability, Dillon provides two bills, one from a competing hospital in the Rocky Mountain region, and another from the Century facility in Phoenix. For about $55,000, an individual could spend 80 days in the hospital at $683 a day, a tab that does not include physician, lab and pharmacy services. For about the same amount, one could receive seven days of hospital treatment, 100 days of residential treatment, and 90 days of day treatment at the Century facility, according to Dillon's figures.

Century does not mandate a profit margin for its facilities, instead allowing each administrator to set his own budget. The typical 10 percent profit comes from "high utilization" of about 80 percent, says Dillon. Also high, according to surveys conducted at three facilities, is client satisifaction. A Shadow Mountain survey found 80 percent of past patients indicated a high level of satisfaction and would recommend the facility.

At Colorado Springs, Colo., three-fourths of the treated families reported positive changes in their child, and 85 percent said they would recommend the program. And at Phoenix, 100 percent of those surveyed said their child had improved and they would recommend the facility. "Parents should expect with all the unknowns in psychiatric treatment today that we will be the best available resource for their child," says Dillon.

Dillon's ambition to be the best at what he does springs in part from an intensely traumatic experience as a parent. His daughter suffered from curvature of the spine as

a child, and seven years of wearing a brace did not correct it. When surgery was recommended, the Dillons spent weeks searching for the facility best equipped to perform that type of operation. They felt they found it in a highly specialized hospital in Houston. "We want to earn a reputation like that hospital down in Houston. Our goal is to be the best in the world at what we do," says Dillon. "We're not there yet. We're not the best. We want to earn that."

(Janet Pearson is a Tulsa World senior reporter.)

Caption:

Jerry Dillon visits with a child in the children's ward at the Shadow Mountain Institute.

(2) Right, Tulsa Country Club pro Rob Brown, in multi-colored shirt, University of Tulsa golf coach Bill Brogden, in shorts, and Jerry Dillon tee off at the Tulsa Country Club. (3) At far left is Jerry Dillon and three youngsters adopted through the Dillon International adoption agency. The children, from left, are J.R. Dobbs, Katie Morrow and Christopher McKee. At immediate left is Tulsa Philharmonic conductor Bernard Rubenstein with Dillon who guest-conducts a work yearly at the Philharmonic's Symphony at Sunset. Dillon's Century HealthCare is a Symphony at Sunset sponsor.

(4) At left with a gesturing Jerry Dillon is Will Williams, president of the North Tulsa Heritage Foundation at the Greenwood Cultural Center. Below, Dillon with wife, Deniese, and daughter, Daniele