Blog

Trigger Warning: The following story contains references to self-harm. 

Nate’s Journey with Care Management Entity (CME) at The Buckeye Ranch 

For Nate, growing up meant navigating overwhelming mental health challenges and traumatic events that left childhood feeling anything but typical. At seven years old, Nate began counseling at The Buckeye Ranch. His challenges continued to grow, and by age 14, threat of expulsion from school loomed large. But through courage, creativity, and personalized mental health support from our Care Management Entity (CME) program, Nate’s story transformed into one of self-advocacy, healing, and rediscovered identity.  

Today, Nate is living in Minnesota, completing his GED, planning for college, smiling at his own reflection, and stepping boldly into who he has always been. 

Nate’s story is a powerful testament to what can happen when a young person has access to individualized mental health support, a compassionate team, and the space to grow. 

What is CME and Why Does it Matter? 

The Buckeye Ranch serves as a Care Management Entity within the OhioRISE program, a specialized Medicaid-managed care initiative designed for children and youth facing complex behavioral health challenges, including mental health and substance use disorders, as well as multi-system needs. As an official CME in the state of Ohio, The Buckeye Ranch provides Care Coordination services to all families eligible for OhioRISE. 

Care Coordination is a unique, wraparound approach to behavioral health care that brings together various providers and groups to make sure that youth and families get the help they need. Children and youth with complex mental health needs are often part of multiple systems, like juvenile justice, child welfare, and education. OhioRISE connects these systems to create a personalized mental health support care plan for each individual’s behavioral health journey. 

Care Coordination provides therapy linkage, access to community resources, crisis support, family coaching, flex funding for individualized needs, and consistent, compassionate advocacy. For many families, CME builds the bridge between surviving and truly thriving. 

Difficult Beginnings 

When Nate was connected to services at The Buckeye Ranch, he had experienced more than any young person should. Living in a traumatic home environment, Nate was struggling with depression, impulsivity, attention deficit hyperactivity disorder (ADHD), and borderline personality disorder (BPD). He lacked structure and struggled with acting out and self-harm. He had yet to find a counselor or therapist that he truly felt comfortable opening up to.  

A Turning Point

At age 14, Nate was connected to CME. Katie, Nate’s CME Care Coordinator, met him in one of the most difficult seasons of his life. He was experiencing mental health hospitalizations, acting out at school, and feeling directionless. Residential Treatment Services seemed like the only course of action available. 

But something shifted when Nate and Katie began working together. “Katie kept checking in, even though I didn’t want to talk. She kept asking what I needed. That consistency really helped me feel comfortable,” Nate shared. As their relationship grew, Nate finally started communicating, attending counseling consistently, engaging in community programs like Kaleidoscope Youth Center, and participating in structured activities that mirrored what life in residential treatment might look like—only from home, with support. 

“He started talking more, telling us what he needed – advocating for himself,” Katie shared. “It was a real turning point.” After months of progress, residential treatment came off the table, and hope was finally on the horizon. 

Finding Grounding in SCUBA, Art, and Self-Expression 

One of Nate’s greatest breakthroughs came through unexpected experiences funded by CME flex funds. For Nate, SCUBA lessons became an instrumental grounding practice and source of healing. “When you’re underwater, you have to remember what you’ve been taught,” Nate explained. “It’s the breathwork. It keeps you safe and present.” 

Flex funds also supported art supplies for Nate, special interest camps, weekend activities, and therapeutic outlets that gave him a renewed sense of identity and purpose. “We just started filling out Nate’s schedule. We realized what he needed was structure, and things to do that could be an outlet for him that felt meaningful,” Katie explained. Through these activities, Nate recovered his sense of self, and his outlook on life began to brighten.

Healing Through Art

Perhaps one of the most transformative experiences came when Nate decided he was ready to cover his self-harm scars. Katie connected him with Hummingbird Tattoo Studio, where artist Michael Prickett offered to do the work for free. Michael and Nate talked about Nate’s vision, and together they chose lightning and thunderstorms—powerful symbols of cleansing and renewal in the Native culture Michael belongs to.  

Connecting with Michael over the course of several tattoo sessions was a deeply healing experience for Nate. Nate was struggling to feel a sense of acceptance in his identity as a transgender man. Michael shared a powerful perspective from his Native heritage, sharing that gender fluid individuals have been known to Native communities for a long time, and are held in high regard for their unique perspective – an insight that brought Nate a great deal of comfort. “It was a great experience. After the last session, he gave me a shirt and sweetgrass,” Nate said. “Burning it represents a new beginning.” Feeling easier in his body, Nate was ready for a fresh start.

A Fresh Start in Minnesota

Not long after the tattoos were complete, Nate and his mom made the move to l Minnesota as they didn’t feel safe in Ohio as a trans youth and family.  

Since moving, Nate secured a job and has completed his GED courses with plans to attend Minnesota State’s Radiology Technician program in the near future. He’s feeling happier in his body, growing more independent, and finally feeling safe in his community. “Change can be good and necessary,” Nate reflected. 

After receiving the personalized mental health support he needed, Nate is finally excited about his future. Most importantly, he’s become the person his younger self always hoped he’d be. “One of my biggest successes is remaining myself at my core — learning to care for myself, set boundaries, and respect my own time,” he shared.  

Nate’s support system today includes his parents and grandmother, his boyfriend Arlo, a new counselor and psychiatrist, and his music instructor Megan—who creates a safe and healing space to talk about life, music, and their shared LGBTQIA+ identity. 

Nate’s mom, Rhonda, reflected on her own healing that happened alongside Nate’s: “Trauma is intergenerational. When you are never taught to regulate, you pass that on to your kids. It’s hard to watch. OhioRISE and CME helped ease that. We can communicate better now. Katie was our safe middle ground—validating, honest, and always advocating for what Nate needed.” 

What Healing Means to Nate 

Through his journey, Nate has become a powerful mental health advocate, engaging in activism and expressing himself through art. “Mental health is just as important, if not more important, than physical health,” Nate says. “People can change. When you take care of yourself, you become more empathetic and considerate. You get mentally fit.” 

When asked what he would say to his younger self if given the chance, he had this to share: “Listen to the corny advice. Believe people when they show you who they are. Sit in the good moments. Community matters. If you have people who love you, and you remember you are loved, it’s enough to fight to the next level. It does get better if you just allow yourself to live.” 

He also shared wise words for those unsure about reaching out for help with their mental health, “It only takes a second to say ‘help.’ Push yourself to be honest.” 

With courage, community, and the personalized mental health support of CME at The Buckeye Ranch, Nate’s journey transformed from one of survival to empowerment. Today, he stands not as a victim of his past, but as the author of his future—resilient, creative, and full of hope. His clinician Katie summed it up best: “Nate went from victim to survivor so quickly. Watching him take ownership of his mental health was amazing.” 

To learn more about CME, visit our website. To learn more about OhioRISE click here. To get/ started with services at The Buckeye Ranch or make a referral click here, or call us directly at 614-875-2371 for more information.