Jun 26, 2016 11 min read

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Five years ago, Alexandria Taylor was “very defiant.”

“I wanted to do what I wanted to do, and I didn’t want anybody to stop me,” said Taylor, now 18. “I knew I needed help but …”

“She was reluctant,” finished her mother, Nichole Petrus, of Grindstone.

Taylor was dealing with the aftermath of abuse at the hands of a close relative. Diagnosed with depression, post-traumatic stress disorder and anxiety, she was hospitalized twice in psychiatric centers.

I had a lot of trouble controlling my emotions,” Taylor said. “I was acting out. I had a lot of scarring from what happened – a lot of things I needed to work out from that.”

Taylor had a caseworker at Centerville Clinics who told her of a new program at Bentworth School District – a “partial program” that provides the opportunity to participate in general education as well as receive mental health support.

As a student of the program, Taylor thrived. She earned straight A’s and was the president of a school club, SkillsUSA. A high school graduate as of June 2, she received a scholarship to attend Robert Morris University in the fall, where she’ll study computer information systems.

Taylor credits Bentworth’s unique program for her progress.

“It was like a little family,” she said. “I’m not a different kid for my problems. They knew that, and they accepted that. Working from the emotional mess I was into a normal kid again – They helped me more than I can even begin to imagine.”

It is an encouraging story at a time when an increasing number of children are being treated for psychiatric problems.

According to the National Alliance on Mental Illness, approximately 1 in 5 youth aged 13 to 18 experiences a severe mental disorder at some point during their life. For children aged 8 to 15, the estimate is 13.3 percent.

Additionally, a 2015 report from the Children’s Mental Health Report, compiled by the Child Mind Institute in New York, estimates that 17.1 million children in the United States have or have had a diagnosable psychiatric disorder.

“It is a national crisis,” said Megan Van Fossan, director of special education at McGuffey School District. “There are students who commit suicide, there are students who spend their time in and out of adolescent psychiatric hospitals, and we need to do a better job of reaching out to them.”

Children and adolescents face a number of mental health issues, including depression, attention deficit hyperactivity disorder and bipolar disorder. Dr. Jeanine Herdman, board certified child and adolescent psychiatrist practicing in Peters Township, said a lot of her patients have anxiety disorders, which, she said, is “almost always genetic.”

She’s optimistic that treating psychiatric issues early offers children a better chance for positive outcomes.

“The majority of the time, if you can identify something early on, it becomes a non-issue, as opposed to defining someone’s life,” she said.

Among the many impediments to appropriate care is the fact that many doctors in training choose not to go into child psychiatry.

Herdman said there are about 8,000 board-certified child and adolescent psychiatrists in the United States – not enough to meet the need.

Sometimes the process is delayed by families receiving help from those whose only training in psychiatry was an eight-week rotation in medical school.

“By the time somebody sees me, they’ve been through a lot of providers who have mischaracterized it or, unfortunately, done some work that is not helpful,” Herdman said. “And I have to apologize and build trust and start from square one … and that takes a long time.”

The role of schools to meet the mental health needs of youths – spotting kids who need help, preventing emotional and behavioral problems and pointing them toward professionals and programs that can help them – has expanded in recent years.

Because teachers and other school staff have contact every day with children, they often are in a position to identify students who are struggling and who could benefit from professional intervention.

But there are gaps and challenges to meeting the mental health care needs of children and youth and their families, including a dire shortage of child mental health providers, and long wait times and difficulty getting in to see quality mental health professionals close to home.

“There are enormous difficulties in delivering mental health care in rural counties, including Greene County. Greene County has limited access to specialized services,” said Karen Bennett, administrator for Greene County Department of Human Services. “We don’t have any specialists here, really. Even for psychologists to do psychological evaluations, we have one person, Scott Roberts, and he’s booked. As for beds, Southwood is full all the time, and these kids can’t be on waiting lists. We have to do a bed search, and that’s led us to facilities that are hundreds of miles away, like Clarion Psychiatric Center in Clarion and The Meadows, past State College. So transportation becomes an issue. And it all goes back to the lack of professional mental health services.”

Donna Dire, a licensed clinical social worker for Intermediate Unit 1, said when she started her career as a therapist, she was told she would encounter children with ADHD and, perhaps, some family issues.

“Today, the severity of mental health issues is astounding. We’re no longer dealing with just ADHD,” said Dire.

In a recent survey conducted by Van Fossan and completed by Washington County building principals and guidance counselors, 94.4 percent of respondents indicated students had unmet mental health needs. Only 33 percent of the respondents felt there was sufficient communication between outside mental health service providers that serve students in schools and the schools the students attend.

Elaina Zitney, program director for Charleroi Area School District, worries that students who return to school after receiving mental health treatment often do not inform the school district why they were absent.

“So my biggest concern is that when they come back, we don’t have any services in place as an after-treatment and they get lost in the cracks,” said Zitney. “Anything they gained through treatment while hospitalized, the ball is dropped.”

Said Van Fossan, “All of the stakeholders have to join forces to provide effective coordination of care for all children.”

While local experts concede getting a child with mental illness the care he or she needs can be a difficult and cumbersome task – complicated by the fact that at age 14, children are legally responsible to make their own mental health decisions and can refuse or accept treatment – Washington and Greene counties have implemented many successful, county-funded programs and initiatives that can help identify and treat children who need help.

“There’s not a system that works perfectly, no matter how hard you try. But we have a plethora of services of different type and levels for both kids and adults,” said Jan Taper, administrator of Washington County Behavioral Health and Developmental Services.

Most recently, Washington County was one of three counties in Pennsylvania chosen to participate in the Substance Abuse and Mental Health Services Administration “Now Is the Time: Healthy Transitions” grant.

The program promotes awareness and early identification of individuals ages 16 to 25 with, or at risk of, serious mental health conditions, and improves access to services and supports.

According to the BHDS, 17 percent of transition-age youth in Pennsylvania have a serious mental illness, making it critical to screen for problems and to intervene.

One ambitious approach for treating children, the Raider Wellness Program, has been adopted in Central Greene School District. The program, a collaboration between the school district and Greene County Human Services, removes the barriers that often keep children from getting the help they need, such as transportation to and from appointments, dealing with insurance companies and lengthy waits for appointments.

Tammy Mandich, director of special education at Central Greene, said her goal was “figuring out how to bring services to the students.”

The school district parted ways with its mental health care provider and hired Family Behavior Resources to provide mental health services, including a psychiatrist who visits the schools monthly to manage students’ medication and conduct psychiatric evaluations. It hired an engagement specialist to help parents with insurance and billing issues, and provided program specialists to conduct classroom presentations on mental health, drugs and alcohol.

As many as 30 people attend monthly meetings about the program’s progress; among them are Bennett, school district administrators and service providers including specialists and therapists.

Bennett said the Raider Wellness Program is a model comprehensive program that will be expanded into other Greene County school districts next year.

Navigating the juvenile mental health system isn’t easy.

“It’s incredibly complicated. You’re already in crisis: Your kid tried to kill himself or your kid tried to kill someone else, and so when you’re sitting down to a form that’s three pages long and complex, and you have limited education, it looks like Chinese,” said Mandich. “There’s so much to it, so if you’re already distraught, how do you get through all of that to get paperwork done?”

Another successful project is a peer support program called the Common Ground Teen Center, a gathering place for Washington County youth operated by the Academy for Adolescent Health and partially funded by Washington County BHDS.

On a recent Thursday, 25 teens and young adults, some with mental health diagnoses, showed up at the Teen Center, where the guidelines are “to respect everybody, don’t call names, don’t talk over people and assume goodwill.”

Director Mary Jo Podgurski has turned the center into a safe haven for young people, regardless of disability, economic status, ethnicity, gender, race, religion or sexual orientation.

Said a McGuffey high school student diagnosed with bipolar disorder and ADHD, who attends Common Ground regularly, “Before I came here, I struggled a lot in school, and I had a hard time. But when I come here, I feel so much better. I feel like I can relax, and the other teens here have helped me a lot. I’d rather be here than anywhere else.”  

Families, too, often need support.

Kevin Morris, whose 21-year-old son, Eric, has spent nearly half his life in and out of residential treatment facilities and adolescent psychiatric hospitals, and Barb Ruschak, a retired fourth-grade teacher, are launching a support group for families and friends with mentally ill loved ones.

Eric has been diagnosed with at least half a dozen mental illnesses over the past decade – bipolar disorder, schizoaffective disorder, borderline personality disorder, major depression and anxiety.

Morris said Bennett and the Greene County Department of Human Services have done “an excellent job” with helping him connect with services over the years, but he was surprised at how hard it was to find a local, ongoing support group that he could attend. 

The closest support group is NAMI PA of Washington/Greene Counties, which meets monthly at Courthouse Square in Washington and organizes many programs and events, including the annual Walk to End Stigma.

“There was really nothing for me right here, and it would have made a difference. I’m passionate about this, about providing a group in Waynesburg where other parents and loved ones of a person with mental illness can get together and share their experiences and help each other through this,” said Morris, a member of System of Care County Implementation Team who has received his counseling certification. “These people have been through the same things; they’ve experienced it.”

Despite the best efforts of parents and specialists, there are no guarantees for success. But the good news, Herdman said, is that generally, children respond well to appropriate treatment and prosper.

Morris isn’t giving up hope that his son can find the treatment and medication to help him lead a normal, productive life.

“I live my whole life trying to get him fixed, to where he needs to be. This is just so devastating, and I just want him to have a good life,” said Morris. “I will keep trying. I believe anything is possible.”