Child and Adolescent Services Expand to Meet Growing Needs

Sarah was diagnosed with a confusing series of psychiatric disorders after showing symptoms as early as second grade. At 14, she spent four months rarely getting out of bed. Desperate for help, her parents found McLean’s Adolescent Acute Residential Treatment (ART) Program. Its short-term, intensive focus helps stabilize teens in crisis, and during Sarah’s three-and-a-half week stay, things finally began to change for the better. Thanks to therapy and the right medications, she began down the path to recovery.

Sarah eventually enrolled in the Arlington School, McLean’s therapeutic high school, where she thrived. Now an artist studying in Italy, Sarah says that the staff at ART changed her life, teaching her the skills she needed to become the accomplished and creative young woman she is today.

Sarah is just one of the thousands of young people treated annually through McLean’s child and adolescent programs. They are girls with life-threatening eating disorders, children with crippling obsessive compulsive or anxiety disorders, and youngsters who struggle in schools ill-equipped to deal with autism spectrum disorders. Some have co-occurring substance use, others hurt themselves, and some have dropped out of college. The common denominator is that they are all just beginning their lives.

“For the past 20 years, McLean has been at the forefront of behavioral health care for children and adolescents, as well as a leader in training,” said Joseph Gold, MD, chief of the Nancy and Richard Simches Division of Child and Adolescent Psychiatry and Edward Peabody Lawrence Chair in Psychiatry. “Patients come from all over the world for our innovative, evidence-based treatments.”

Meeting the Need

The growth in McLean’s child and adolescent services has been deliberate and steady. To keep up with the ever-expanding and evolving demand, the hospital has added a new specialized program nearly every year since 2003. But, according to Dr. Gold, there is still an ocean of unmet need out there, and as quickly as the hospital adds capacity, the demand for services outpaces both resources and space.

“Over the years we have hired highly specialized clinicians and developed cutting-edge programs not found anywhere else in the world,” said Gold. “We’ve been nimble and innovative in our commitment to helping these youngsters turn their lives around.”

McLean’s experience is reflected in the national statistics. One in six youth between ages 6 and 17 experience a mental health disorder each year. Like for Sarah, about half of all psychiatric disorders emerge by age 14 and 75% by age 24, making early intervention critical. In recent years, youth suicides have been on the rise and are now the second leading cause of death among teenagers. Along with the rise in need has been the development of more effective treatments, thanks to new skill-building behavioral approaches and improved understanding of the neurobiology of psychiatric illnesses in young people.

The generous support of donors has enabled McLean to both expand existing child and adolescent programs and add new ones. In fact, the entire Center of Excellence was renamed and strengthened thanks to an endowment from Nancy Simches, who, together with her late husband Richard, have been longtime donors to the hospital.

“There is no more important time than childhood to help people affected by mental illness,” said Simches, who was trained as a social worker and knows the value in intervening early. “Dr. Gold is a compassionate leader who always puts children and families first. He and McLean have helped so many, and we are delighted to have played some small role in their efforts.”

McLean’s 3East program, for instance, was launched in 2007 as a treatment setting for early college-age women who exhibit self- harming behaviors and borderline personality disorder (BPD). 3East quickly became a sought-after dialectical behavior therapy (DBT) treatment program and saw astonishing success under the direction of Michael R. Hollander, PhD, Janna Hobbs, LICSW, and Blaise Aguirre, MD.

Then, recognizing a nationwide scarcity of treatment facilities for boys with BPD, McLean recruited Alan Fruzzetti, PhD, an expert in DBT for families, and launched the 3East Boys Intensive Program in 2016. As the impact of past trauma on youth with BPD became more evident, Cynthia S. Kaplan, PhD, stepped in to lead 3East’s blending of trauma treatment and DBT.

More than four million children in the U.S. have diagnosed anxiety disorders and the numbers are increasing. In another example of pivoting to meet a growing need, the hospital established the McLean Anxiety Mastery Program (MAMP) in 2014. MAMP works with children ages 7-19, many of whom are so debilitated by anxiety and OCD that they are no longer attending school and often cannot leave their rooms. Led by Mona Potter, MD, and Kathryn D. Boger, PhD, MAMP takes a multipronged approach to treatment, helping program participants combat anxiety through cognitive behavior therapy skills training and exposure and response prevention therapy, as well as providing parent guidance and medication management.

Amplifying Impact

Another way McLean has sought to scale its services is through training and consultation.

For example, McLean has become one of the national centers of training in several gold-standard treatments for borderline personality disorder, a challenging illness some clinicians are reluctant to take on. McLean also spreads expertise to wider audiences through programs like the School Nurse Liaison Project, which provides mental health consultative services to school nurses and other school staff, and the School Consultation Service, a broader consultative effort for middle and high schools, often at the district level.

“Over the years we have hired highly specialized clinicians and developed cutting-edge programs not found anywhere else in the world. We’ve been nimble and innovative in our commitment to helping these youngsters turn their lives around.”– Dr. Joseph Gold, McLean’s chief medical officer

At the oldest end of the child and adolescent spectrum, McLean’s College Mental Health program offers a growing range of services aimed at helping college students who struggle with mental illness and adjustment issues.

“Philanthropy has enabled us to create new programs, train the best and the brightest, and do the research that will transform treatment,” said Gold. “Our partnerships with donors allow us to meet the changing needs of young people. As we look ahead, we hope our donors will help us address our aging infrastructure and bring our historic campus into the modern era. We need to offer these kids more dignified and better facilities in which to do the hard work of healing.”

If you are interested in supporting McLean’s capital or programmatic priorities for children and adolescents, please contact Lori Etringer at 617.855.3840.