Northeast and Northwest respond to community behavioral health crisis

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Mural outside Cayuga Youth and Family Center on Humboldt Street, Rochester

NOTE: this article first appeared in the Democrat and Chronicle.  Due to a server change, some of the pictures are missing.

• July 1, 2014

In recent years, unfortunately, community behavioral health supports for young people have been shrinking.  For example, there are fewer beds available in day treatment and residential programs both private and state run, such as Hillside, the Villa of Hope (formerly St. Joseph’s Villa) and Monroe Community Hospital and other youth group homes. Rather than sending city school students off to “be fixed” at an out-of-district placement, students are now instead expected to attend district schools daily, thus putting additional strain on an already overextended system.

Anyone could easily see this issue demanded immediate attention. As such, Northwest Principal Mary Aronson reached out to the Greater Rochester Health Foundation, who in turn connected her with Cayuga Centers, a social services agency with a long history of helping children and families. Aronson and Cayuga collaborated to secure funding through the GRHF to address this crisis in the making.  As she states, “When students aren’t receiving the appropriate behavioral health supports, they frequently express their frustrations in a number of negative ways that can impact the entire school community.”

In the program conducted from March 2013 through May 2014, Cayuga Centers placed a licensed therapist at the Northeast/Northwest Douglass Campus to provide individual psychotherapy sessions, group psychotherapy and Functional Family Therapy (FFT), an Evidence-Based intervention.  Leah Piels, LMSW, provided intensive in-home and school-based interventions including family therapy, group and individual. Additionally, Piels facilitated referrals to specialized mental health services as needed.leah piels

The FFT is an intervention designed to work with families with at-risk adolescents, ages 11-18 with the goal of reducing maladaptive behaviors in school, the community, and at home. Youth selected for the program were identified as needing clinical services by school personnel including teachers, counselors and administrators.

Without question, the program benefited students and families who might not have received help, often facing issues associated with urban poverty.

In one case,  Piels was introduced to a family currently in crisis. The 15 year-old daughter had recently lost a baby when the infant was only 4 months old.  Understandably, the family was struggling with this loss.  The daughter no longer attended school regularly and was failing all her classes.  She was in individual counseling but had recently stopped.  Her mother did not know what else to do. How could she help her hurting child while dealing with her own difficulties as well, especially the challenges of raising her other two much younger children?

When Piels met the family, they were no longer communicating. Through the program, Piels helped family members begin assimilate some of the grief and loss they were experiencing.  She constructed safe ways to take the private time one needs to regroup and ways to ask for help even it was difficult to use words.  By the end of the intervention, the family was better able to speak with each other about their concerns and worries.  Piels helped the family get involved with individual therapy for both the mother and the daughter.  The family also created a long term plan for the summer and the upcoming school year to get the daughter back on track.

In another situation, through individual therapy  Piels worked with a 14 year old male who referred himself to the program and explained that he was feeling depressed and using marijuana excessively.

During the intervention, Piels helped him recognize and communicate his feelings of abandonment by his biological mother.  Piels also learned that he had a twin brother who was not living with him at his foster home but instead had been placed at Hillside Residential.  They considered the impact of the loss of these two important people in his life.  He learned to express his feelings in more constructive ways and worked on his self-image and self-esteem.  He learned coping skills to deal with all the different changes in his life instead of relying on marijuana use.  At the end of the intervention, the student’s grades increased as well as his attendance.  His marijuana use significantly reduced to almost none at all. He stated he feels more like himself again, is able to enjoy things he used to and is now finally sleeping on a regular basis.  He joined the basketball team and planned on running track in the spring.

In one case, Piels helped children and families grieving parental losses. Through group therapy,  Piels worked with two 13 year old girls who each had a parent who had died within the last 3 years.  They were both referred to the program by their remaining parent.  One parent stated that he was concerned about his daughter’s anxiety, especially in settings with a lot of people such as a classroom.  He also stated that she never really had the chance to grieve for her mother. Since her mother’s passing, he has noticed a decrease in social activities as well as a decrease in academic performance.

During the intervention, Piels helped the girls explore different techniques to deal with depression and anxiety and discussed several ways of communicating feelings and advocating for self needs at home and within the school setting.  Towards the end of the intervention both students’ mental health symptoms were reduced.  This has been demonstrated by a reduction of in-school anxiety attacks and decreased unexcused absences.  One student transferred into honor roll classes while the other student’s grades increased as well.  They both joined the school volleyball team and planned on playing softball in the spring.

When you look at these cases, it is easy to see young people quickly veering down the path of the three D’s: disengagement, disruption and dropping out.

Furthermore, the program improved the overall school climate. According to Aronson, the faculty saw an increase in family participation with school personnel where there had not been engagement previously. Additionally, once the teachers at the school were educated on the role and services Piels provided, there were changes on how the teachers viewed the students and a reduction in the frequency of student removal from class.

Now that the initial grant has ended, the future of the program is still cloudy.  But Aronson is optimistic funding can be found. Programs like this are essential.  As she says, it is much better for everyone–children, families and schools–that students get professional help at the first sign of distress rather than waiting until that next possible and unfortunate stage: involvement in the penal system.