Teens and children facing more mental illness
Telegram & Gazette - 10/27/2018
Oct. 27--Demand for mental and behavioral health services for children and adolescents has risen dramatically in recent years. But finding treatment -- particularly in outlying communities -- is a growing challenge, health care providers, educators and law enforcement personnel discussed at a community forum Thursday.
The regional forum, held at Blackstone Valley Regional Vocational Technical High School in Upton and co-hosted by Riverside Community Care, highlighted the need for more services to address the gap. Underlying mental health issues have been linked to substance use disorders, suicide and violence, among other problems.
"The amount of stress kids are feeling today, the world has changed. Symptoms of anxiety are appearing younger and younger," said Julie Greiner-Ferris, a social worker who directs Riverside Community Care's outpatient center in Upton.
According to an adolescent health survey conducted by Education Development Center and funded by the MetroWest Health Foundation, more than one in three, 35.8 percent, of high school students in 25 MetroWest and Central Massachusetts communities reported in 2016 that life was "very" stressful in the past 30 days. That prevalence has increased from 27.9 percent in 2006.
Among middle school students in Grades 7 and 8, 15.6 percent reported being very stressed in 2016, compared to 13.3 percent in 2006.
More than 12 percent of high school students, and nearly 11 percent of middle school students, had ever considered suicide, according to the 2016 survey. Four percent of high school students and 2.7 percent of middle school students reported having attempted suicide.
"The biggest concern in the Blackstone Valley is the shortage of providers in the area," Ms. Greiner-Ferris said.
Families often have to travel to Worcester or Framingham to receive care, because local community mental health services are full or private providers won't accept MassHealth reimbursement, which they say is too low.
It's particularly hard to find mental health providers for non-English speaking patients. Ms. Greiner-Ferris said it took six months to recruit a Spanish-speaking specialist to locate at the Edward M. Kennedy Community Health Center in Milford.
Scott Bock, Riverside's executive director, said his agency turns away approximately 100 kids a month because they don't have capacity. He said his colleagues at Wayside Youth and Family Support Network and Family Continuity are also full. The three agencies even developed their own app to try to coordinate available services.
Riverside is planning to expand and better coordinate its services by moving its entire outpatient center in Upton, along with its children's services, to a new integrated behavioral health center, which it is building on property it owns housing the Crossroads Clubhouse on the Milford-Hopedale line.
According to Riverside representatives, the building will increase capacity for pediatric mental health services, bring all its regional mental health services under one roof, and allow for easy access to 24-hour emergency services, Riverside's school and life skills day program for adolescents with serious psychiatric diagnoses, and its in-home therapy program.
And, in an attempt to reduce the stigma of receiving mental health services, it will have a child-and-youth-friendly feel, with a separate entrance for young patients.
Educators and child care providers at the forum expressed frustration with the overwhelming amount of mental health issues they're seeing now, issues they don't know how to identify or address.
Heather Elster, executive director of the Whitin Community Center, which operates Blackstone Valley Children's Place, a child care, preschool and school-age program in Northbridge, said staff are seeing a "significant increase" in children as young as toddlers affected by trauma, substance abuse or suicide in their family, as well as some having serious psychiatric diagnoses such as bipolar disease.
"Our teachers are trained as teachers, not mental health specialists," she said.
She asked whether community training or resource networks for educators and youth program providers might be available.
Dr. Karen Peterson, an internal medicine physician at Tri-River Family Health Center in Uxbridge, said she sees adult patients who are struggling to deal with a child's mental illness.
She called for increased reimbursement for pediatric mental health services and better coordination so parents can more quickly get their kids the help they need.
State Sen. Ryan C. Fattman, R-Sutton, said his office gets calls from desperate parents seeking services all the time.
"Fifty-four percent of people in Massachusetts (who need mental health services) will actually get services," he said, "which means 46 percent don't. That is stunning."
Several school districts have started offering mental health awareness and suicide prevention programs to students.
Blackstone Valley Tech has a school-based health center in which a Riverside counselor is available five days a week, a situation that is not the norm at most schools.
In addition to the health center, the school offers a Break Free from Depression program, starting with freshmen in their career enhancement class, according to Alyson Turner, a school adjustment counselor.
The week-long program, which is offered each year through 12th grade, introduces different levels of curriculum including identifying depression, coping strategies and how to get help. At the end of the week, all students undergo a mental health screening and may be referred for services.
Students are also taught 10-minute mindfulness modules, where they learn to calm themselves and manage stress through such practices as breathing exercises and yoga.
"They absolutely love it," Ms. Turner said.
Franklin public schools offer universal screening at the elementary level to identify students needing mental or behavioral health services, a district representative said.
Norman Gorin, vice president of Screening for Mental Health, a service of Riverside Community Care, said the Signs of Suicide program, a nationally used evidence-based prevention program, has been offered at six schools in the area, including Nipmuc Regional High School in Upton.
Signs of Suicide, or SOS, is built on three core steps to increase empathy and empower youths to prevent harmful behavior. The steps are summarized in the acronym ACT, which stands for acknowledge that you see a warning sign and that it is serious; let your friend know you care about them; and tell a trusted adult that you are worried about your friend.
Mr. Gorin said that controlled studies found the SOS program reduces suicide attempts by 40 percent to 64 percent.
"The earlier you can identify someone in challenge, the better the outcome," Mr. Gorin said. "Our program saves lives. It's an inoculation."
Participants at the regional forum agreed to meet again to target gaps in services and advocate for potential solutions, including better state reimbursement and more opportunities for telemedicine consultations.
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