Patients Putting Problems to New Test : Palmdale: Mental health program combines traditional therapy with a military obstacle course. Hospital officials say they see dramatic results.

Patients in a mental health program are trying to overcome serious emotional and behavioral problems by mastering such feats as teetering on a high wire 40 feet above the ground, scaling a 12-foot-high wall or swinging from a trapeze.

In conjunction with traditional group therapy, the Palmdale Hospital Medical Center’s Behavioral Health Center uses an outdoor military obstacle course--the Desert Challenge--adjacent to the hospital. On 17 challenges--including ropes, ladders, telephone poles, wooden platforms and a wall for scaling--patients take a physical approach to working out personal problems.

Although the program has raised some eyebrows in the community, hospital officials said this is a well-established form of therapy that works as a catalyst for patients to break through their emotional roadblocks in a short period of time.

Officials said that because they deal with acute-crisis patients who spend an average of two weeks in care, the method is a dramatic way to quickly generate trust and communication skills, and help patients forge a healthier outlook on life.

“Usually patients, especially if they are in the latter stages of a serious depression, are not used to physical activity,” said Jesse Mellor, the health center’s program administrator. “We talk them through (the ropes course) when they become paralyzed by fear and think they can’t do it. They do good work once they learn that they can push that fear back.”

While patients wearing professional climbing gear dangle on a high wire strung between 50-foot telephone poles, two therapists shout out directions.

This part of the therapy uses the ropes as a metaphor for the patients’ problems. For example, one rope will be declared “drugs” and a therapist will challenge the patient not to grab that rope, but to reach for the next one.

Although the program is voluntary, fearful patients are still encouraged to try the obstacle course. “What we ask them to do is not impossible, but it is extremely hard,” Mellor said. “We challenge them to think in a different way.”

Teamwork within the group is emphasized, program therapists said, with members encouraging each other or physically helping one another over obstacles. Of the dozen adult patients and two teen-agers enrolled in the program, most are struggling with chemical dependencies, severe depression, or suicidal thoughts and attempts.

The obstacle course, which cost the hospital $20,000 to set up and staff, has accommodated more than 1,000 patients during the last four years.

It is derived from the Outward Bound wilderness programs, which German educator Kurt Hahn started 53 years ago in Wales when he began training young merchant seamen to survive long stays at sea. Hahn taught the men, who were physically fit but still dying at a higher rate than their older counterparts, the tenacity and teamwork needed to cope with adversity.

In Palmdale, facilitators such as Bruce Berger help counselors monitor a patient on the “static system.” This is more manageable than the Outward Bound wilderness program because all the obstacles are in one place. Also, a facilitator is required to assist patients, Berger said.

“They are scared,” he said. “They feel the fear and do it anyway. You see their facial expressions change and it is amazing.”

Mellor said some teen-agers involved in the program are associated with Palmdale’s street gangs and are referred from the court system.

“For someone with a history of violence, who has been arrested for fighting or vandalism, we look at their frustration level (on the ropes),” Mellor said. “We look at what is under the anger and how they exhibit it.”

As the patient’s frustration level rises with more difficult tasks, Mellor said, the anger comes to the surface and allows therapists to question the patient while the feelings are apparent.

“People are conditioned not to verbalize their feelings,” Mellor said. “But out there (on the course) your body is a dead giveaway.”

Rigidity, clenched fists and fearful facial expressions are some signs therapists look for and will bring up at a later group session.

This is one of the critical components of this type of therapy, said a program director for the national organization Project Adventure.

“Most people who come through the psychiatric community do a very good job at learning what to say in a group therapy situation,” said Mark Murray, who heads programs for the Massachusetts-based organization that uses adventure in a therapeutic setting.

“But when people are working on a physical activity surrounded by peers, there is visible material that therapists can see and use in later sessions--the same behavior that is created during real-life situations,” Murray said. “It’s hard to hide it.”

That turned out to be true for Mellor himself. Because staff members and hospital administrators are required to go through the obstacle course, Mellor was forced to confront his own fear of heights.

“I had sweaty palms,” Mellor said, laughing. “I thought, ‘Climb up there and do what?’ But you do it. It’s part of the training, part of a team concept.”

The obstacle course has drawn attention from the public. Neighbors have inquired about the telephone poles protruding from the fence that surrounds the course. Local youths have broken in and entertained themselves behind the gate--resulting in the “No Trespassing” sign just outside the fence.

“A lot of people get real interested in it,” Mellor said. “When we tour groups (through the hospital), one of the first questions people ask is, ‘What is that out there?’ ”

Besides a few bumps and splinters, there have been no serious injuries on the course. All patients who participate have their blood pressure monitored and physical condition checked. Patients with a condition that prohibits them from participating are allowed on the course to cheer on participants.

But physical problems haven’t stopped some patients. A man in his 70s with a hip replacement successfully faced his fears on the course, as did a man who recalled a suppressed childhood near-drowning experience, Berger said. Some suicidal patients have been afraid of falling down, he said, evidence that the course allows patients to get in touch with emotions.

For Berger, who regularly goes through the course, the obstacles represent choices in life.

“Life is either a challenge, a risk, or an adventure,” he said. “They (patients) decide how they are going to look at their lives and where they will go.”