Outpatient program supports teens who are managing substance use disorder
Adolescents and teens with mental health and substance use disorder diagnoses need a high level of support and treatment to heal and regain control of their lives. Substance use disorder is a treatable mental disorder that affects a person’s brain and behavior. It can include misuse of prescription medication and uncontrolled use of alcohol or street drugs.
This is something that Nicole Herlofsky, MA, LADC, LPCC, manager of outpatient clinical programs at M Health Fairview, is passionate about. For more than 20 years, she’s brought intensive outpatient care to 12- to 18-year-olds.
“In 2000, the Elk River School District reached out to Fairview, saying they’d had a rash of suicides, were concerned about students’ mental health, and needed support,” Herlofsky said.
Fairview and the school district worked together to bring mental health care to adolescents in their schools. The program recently moved to M Health Fairview Northland Medical Center in Princeton but the close working relationship with Elk River continues.
In addition to the Princeton location, M Health Fairview also has Adolescent Dual-Diagnosis Programmatic Care programs in Crystal and Maplewood. Those are outpatient programs, which means the participants go home each day. Maplewood also has a residential treatment program.
Participants in the intensive outpatient programs spend a typical school day of about six hours at the program, including time for therapy, skill-building, and schooling. While it’s not a full load, their one or two classes keep them engaged in school and earn credits toward graduation.
“Because the programs are adolescent-based and kids have to be in school, we always partner with the local school district to provide two to three hours of education,” Herlofsky said. “They also bring the kids breakfast and lunch.”
The participants get the level of care they need, any necessary medications, and time to navigate the complex issues they’re facing.
The program includes:
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Group therapy focused on skill-building
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Dialectical behavioral therapy
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Cognitive behavioral therapy
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Trauma-informed care
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12-step concepts
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Individual and family therapy
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Psychiatric services
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After-care planning and support
“One way our program is different is that from the beginning, we’re addressing mental health and substance use disorder together,” Herlofsky said. “Some programs separate chemical dependency from mental health from skills group, but everything we do is integrated. We find that’s most effective.”
Participants stay in the program as long as they need. It could be six, eight, or 12 weeks. When they’re ready to leave, the care team refers them to community resources or other support to help them build off the work they did in the program.
Opioid use is affecting adolescents
Since the program started, the Twin Cities area has seen an increase in opioid use. Opioids, like morphine, oxycodone, and fentanyl, are powerful painkillers. They’re often prescribed after surgery or a serious injury – and they’re highly addictive.
“It's frightening how many young people are using fentanyl,” Herlofsky said. “You think of it as a young adult or adult problem, but it is an adolescent problem as well.”
When adolescents are referred to the program, staff members assess their needs and recommend the care they think is best for the individual. Those using opioids might work with the team at the recovery clinic at M Health Fairview Clinic – Riverside, where they can get medication-assisted treatment.
“That clinic really flexed and is willing to see adolescent patients,” Herlofsky said. “They’ve gone above and beyond to help with these kids because everybody’s afraid that they’re going to die. As the staff working with them, that’s always in the back of our head.”
How to get help
Some signs your child might need help include:
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Sudden and extreme changes in mood
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Decline in school performance and/or attendance
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Running away or not coming home at night
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Unexplained spending or money missing from family members
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Decrease in personal hygiene
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Evidence of substance use, such as finding alcohol or drug paraphernalia
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Increased secrecy about who they are seeing or communicating with on their phones
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Self-harm
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Thoughts of suicide or suicide attempts
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Sleeping more or less than usual
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Sudden weight loss
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Loss of interest in activities they used to enjoy
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Changes in friend group
If you’re concerned that your child needs help with substance use disorder and mental health, you can schedule an assessment by calling Fairview Health Services at 800-468-3120 or learn more at Adolescent Mental Health and Addiction Intensive Outpatient Program.
M Health Fairview is the largest provider of mental health care in the upper Midwest. According to the Minnesota Department of Health, overdose deaths surged to 1,286 in 2021, and 835 Minnesotans died by suicide in 2022—many of them young adults and teens.
