This story by Nora Doyle-Burr was published by the Valley News on July 30.
[W]HITE RIVER JUNCTION — As public awareness of the signs and symptoms of addiction grows, health officials say more adolescents are receiving outpatient treatment for addiction, but school mental health workers say some teens still are falling through the cracks.
Vermont health officials earlier this month said fewer adolescents in Vermont and around the country are seeking inpatient care for substance use disorders because they are getting that treatment on an outpatient basis in their communities, which often is preferred to sending patients away for treatment.
Valley Vista Bradford, a for-profit provider of residential addiction treatment, has asked the Green Mountain Care Board’s to approve converting 14 beds from serving older teens and young men to serving adult men, citing lower demand among the younger age group.
Some mental health professionals were surprised to hear about Valley Vista pointing to lack of demand from adolescents.
“Are you kidding me?” asked Courtney Porter, a social worker at the Claremont Middle School. “They just don’t know how to reach the adolescents.”
Second Growth, a White River Junction-based provider of clinical therapy related to substance use, has seen an increase of 20% in each of the last two years in clients ages 12 to 25, according to the nonprofit’s director, Heidi Postupack.
“As a community, we are so afraid of what has been happening,” she said, referring to deaths resulting from the opioid epidemic.
Postupack said she interprets the increase in those receiving counseling at Second Growth, which also does prevention work in Upper Valley schools, as a positive sign that parents and school officials are recognizing the signs and symptoms of addiction. The adolescents arriving to Second Growth for treatment are coming at an earlier stage of substance use, which allows clinicians to work with teens to prevent experimentation with drugs and alcohol from growing into an addiction, Postupack said.
“To me, that’s a wonderful turn of events,” she said.
But mental health providers who work in Upper Valley schools like Porter say there are still adolescents with addictions going undiagnosed and untreated, and they called for more mental health providers and treatment resources.
In Claremont, where roughly 10% of students are homeless and 60% of students qualify for free or reduced-price lunch, some teens live in their cars with their own children, struggle from mental illnesses and drop out of school, Porter said.
“I think there is a hidden epidemic of need for mental health supports for our youth,” she said.
Jennifer Smith, director of children, youth and family services for the Springfield-based Health Care & Rehabilitation Services, also said that she believes the reason Valley Vista may not be seeing a demand for beds is because some adolescents struggling with addiction aren’t being identified as easily as they have been in the past.
“The need hasn’t gone away; it appears to simply have ‘gone undercover’ temporarily,” Smith said in an email last week.
Phone and email messages sent to Valley Vista this week were not returned. A spokesman declined to comment for an earlier story about the application to convert the beds.
Smith said the hidden need may be because providers are busy helping infants and toddlers whose parents are affected by addiction.
“Likely these same adolescents will show up as adults in need of treatment, either voluntarily or through the legal system,” she said.
One way young people attempt to relieve their stress and treat their mental illness is by turning to substance use, said Porter, who is president of the New Hampshire School Social Workers Association.
While Porter said there are some resources available to help identify students who struggle with mental illness or addiction, more are needed. Until this coming school year, Porter has been the only school social worker in SAU 6. There are about 150 licensed school social workers in New Hampshire, but she estimated fewer than half of them are currently working as such. There are 43 licensed school social workers in Vermont, according to the Vermont Agency of Education.
While school counselors are well-equipped to help students with their academic needs and plans, they are less adept at assessing students’ mental health needs, Porter said. As a result, educators may not always recognize that students who are missing class and acting out may be students who are exhibiting symptoms of an illness, she said.
She said she recently returned from a lobbying trip to Washington, D.C., where she advocated for more social workers in schools to help identify struggling students.
The schools need “more trained mental health professionals to say (kids are) not just lazy, not just teenagers giving you an attitude,” she said.
Cynthia Collea, a social worker for the Mascoma Valley Regional School District, said she also feels there are insufficient resources for teens in need of treatment for addiction to substances — which she said primarily include alcohol, marijuana and prescription drugs — and for teens in need of mental health counseling, which can be related or unrelated to their substance use.
Collea said in an email last week that the challenges of addiction and mental illness should be seen within a broader context.
“Increasingly, families are coming under enormous stress,” Collea said in her email. “Substance misuse is not a standalone challenge. Lack of affordable housing, the rising cost of health care, food insecurity and the multiple traumas the families experience are complicated issues.”
Emily Zanleoni, a licensed clinical mental health counselor who has worked in both the Hartford and Lebanon school districts, said the stigma related to drug and alcohol use often can be a barrier to treatment for adolescents.
“Families are not often willing to face that their children have such an extreme problem in adolescence,” she wrote in an email.
Even so, she said, “I have never heard, ‘Our adolescent beds don’t get used.’ More often we hear about how long the waitlist is for an open bed or there are no adolescent beds to start with.”
Donlon Wade, a private practice Lebanon-based licensed alcohol and drug counselor who also works with at-risk kids in the Mascoma Valley Regional School District, called for more treatment options and counselors.
Wade, who co-founded Headrest in the 1970s, said he used to be able to send kids who needed residential treatment to Phoenix House in Dublin, N.H., but Phoenix stopped providing treatment to adolescents. An emailed inquiry to Phoenix House was not returned by press time.
“There’s nobody left,” Wade said of residential programs in the area.
For families of means who can pay out of pocket for inpatient treatment or who have good insurance, he can recommend the Minnesota-based program Hazelden Betty Ford Foundation. For those without, one suggestion was Teen Challenge, a free Christian program that operates a residential center for teen girls in Massachusetts.
“This becomes a class issue, as anyone with cash can pay for treatment while others have to battle and understand the system,” Zanleoni said.
