Kimberly Kirchner, Bennington Banner
Human beings are social creatures. We evolved to work together, to pull from each other’s strengths and cover each other’s weaknesses. Cooperation is what took us from living in caves to building cities, and what carried us through the darkest days of our collective history.
Community is the common thread running through all United Counseling Services’ programs. Their comprehensive services build on our existing social ties — family, friends, school, the workplace — to provide a web of developmental, substance use and mental health supports across Bennington County.
United Counseling Service began serving the Bennington community in 1958, with a staff of six and an annual budget of just $13,000. As the state of Vermont moved towards deinstitutionalization — the process of moving patients with developmental and mental health needs out of state-run facilities and back into their home communities — UCS expanded to provide locally the services that previously had been available only through hospitals and residential programs outside the Bennington area.
While UCS receives a substantial portion of its funding from state and federal grants, it is ultimately a private organization, allowing it to operate more efficiently and with greater flexibility than a government agency. This is especially important in the fields of psychological and developmental services, in which treatment methods are constantly evolving, and community needs can change rapidly. When a new challenge arises — say, a global health crisis — UCS can adapt with expanded programming and new, safe ways to reach clients.
UCS programs cover every stage of life, starting at the very beginning. Bennington County Early Head Start provides licensed care for children aged six weeks to three and a half years. Bennington County Head Start, also under the UCS umbrella, provides a variety of community and center-based learning programs for children ages three to five years old.
Older children have access to UCS services through school-based clinicians, located in the majority of Bennington County’s schools. These clinicians work with school staff to provide daily living skills training, psychotherapy, counseling, crisis response services, family support and other personalized assistance. When a student’s needs extend beyond what can be provided in a school setting, clinicians serve as liaisons to the rest of UCS’s network of programs.
UCS also provides a range of programs geared specifically toward teens and young adults, designed to aid in the transition from childhood to adult life. The Jump on Board for Success (JOBS) program readies young people for the workforce by facilitating career exploration and planning, offering guidance on resumes and cover letters, and building important workplace skills like teamwork and a positive work ethic. In addition, UCS offers outreach services to at-risk young adults, and a transitional living program designed to ready teens and young adults for independent life.
Unfortunately, sometimes immediate intervention is required, and the UCS team has developed a system of emergency services that are specifically designed to meet the needs of children and young adults in crisis. The Psychiatric Urgent Care for Kids (PUCK) program, for example, was created to redirect children exhibiting serious behavioral or mental health issues away from the Emergency Room — a traumatic experience that often only compounds the problem — and into child-oriented programs where they can receive appropriate care.
“PUCK came along as a response to the increased utilization of the Emergency Room in dealing with kids in a mental health crisis,” explained UCS Executive Director Lorna Mattern, via email. “Children were brought to the ER, often by police, often as a result of behavioral issues at school, as the only option when dealing with difficult behaviors or mental health issues.”
Intake data from area hospitals showed that in the fourth quarter of 2018, 294 children and adolescents underwent psychiatric assessments in the ER, with an average stay of 20 hours. In 82% of cases, those patients were discharged without any treatment plan, essentially leaving the problem unaddressed. “We started to imagine what it would take in order for those children to not be sent to the ER in the first place,” Mattern said. Funding from a OneCare Innovation Grant allowed UCS to implement the program.
PUCK has already had a positive impact on trends in ER use for children. Since its inception, the program has served over 130 children, and ER visits by children at Southwestern Vermont Medical Center is down 40%.
Through Family Emergency Services (FES), family and caregivers facing a youth-related crisis can receive assistance via a 24-hour hotline. Trained crisis workers are also available for home visits on weekdays from 8 a.m. to 8 p.m. The FES team is able to perform outreach, refer to intensive family support services and coordinate with schools and community members to address immediate issues.
For long-term support, UCS provides therapeutic case management for children from birth to age 22. Case managers can assess needs, review progress and connect clients with necessary support services within the UCS network and the larger community.
UCS offers a full calendar of support groups for children, teens and families. Most have moved online in response to the pandemic, but the core purpose remains the same: creating a safe space for individuals to interact in a healthy, productive way. “It’s really about socialization, being able to talk to other people, and to hang out and do fun activities,” said Kheya Ganguly, Assistant Director of Youth and Family Services at UCS.
At UCS, services extend beyond the individual child to include family and caregivers, as well. “You can’t treat in isolation. You need to treat the unit,” Ganguly said. “So when kids are in services with UCS, we also provide family support, sibling support, whatever we need. We look at the whole system and we tailor services to what the family needs, because there’s no ‘one size’ program.”
The same is true for the children of adults working with UCS to address their own mental health issues. “Here’s the thing that people don’t often think of: when you have a crisis, those kids all need services because they need the support to process and get through some of the things that they’re experiencing,” Ganguly said.
Sometimes, that means enlisting a mentor to provide a supportive, one-on-one relationship with a caring adult. “It’s really important to be able to access people who are willing to give just an hour a week,” Ganguly said, referring to the standard time commitment for UCS mentors. Mentorships can bring an extra bit of stability to a child’s life, boosting confidence and teaching healthy ways to cope with stress and adversity.
Ganguly stressed that the mentorship program hasn’t stopped because of the pandemic. There is always a need for potential mentors. “We have a lot of kids who are looking for a mentor,” she said. “Contact us. It’s an hour a week to make a difference.”
UCS services extend to adults, as well, addressing both mental health and developmental concerns. Programming for adults with developmental disabilities is extensive and robust, reflecting the diversity of clients’ needs. From job training to residential programs, UCS helps clients stay engaged in their home community.
UCS programs are dynamic, providing varying levels of structure depending on individual needs. The group operates three residential group homes across the state, all licensed by the State of Vermont Department of Aging and Disabilities. Far from the crowded, restrictive group homes of generations past, UCS homes provide each resident with their own private bedroom, and the freedom to dictate their own care and living situation. Additional support services are provided based on the client’s individual needs, and are designed to maximize independence.
The Shared Living Program matches clients with contracted home providers, who welcome individuals into their household and serve as 24/7 caregivers. Clients who don’t need full-time care can take advantage of the Supervised Independent Living Program, in which adults are empowered to live on their own with the full backing of UCS’s Direct Support staff.
Families caring for adult relatives with developmental disabilities have resources, too. Along with individual case management services, families can reach out to UCS for respite assistance and help procuring financial assistance. The Bridge Program helps families with children under the age of 22 navigate the transition into adulthood, assessing needs and coordinating an appropriate care plan.
These family support services are especially important now, as the pandemic puts increased pressure on caregivers. “With schools being virtual or closed all together, many families are struggling having their son or daughter home much more while trying to provide increased levels of care and working themselves,” said Dawn Danner, Director of Developmental Services for UCS. “We have worked hard to increase supports to these families as much as possible.”
UCS also provides programs designed to bring individuals with developmental disabilities out into wider society. The Community Supports Program helps individuals with a range of needs develop the social and communication skills necessary to integrate into the community. The Employment Connections Program gives clients all the necessary resources to find and maintain meaningful, paid employment. Services range from job placement assistance and skills training, to job coaches who accompany clients in the workplace to give individualized support and supervision when needed.
With the help of coaches and local business owners, many participants in the Employment Connections Program are able to achieve full self-sufficiency on the job: during the 2019-20 reporting period, 46.8% of program participants were working completely independently, a testament to the impact of the UCS team and its connection with the local businesses who provide supportive workplaces.
Ultimately, the goal is to integrate each client into the larger community in a way that acknowledges their individual needs and potential. “People with disabilities need to know that they are welcome throughout the entire community and not stigmatized or viewed differently,” Danner said. “The individuals served in Developmental Services have so much to offer and their abilities and contributions should be celebrated. Doing so gives everyone a better sense of unity and togetherness and it benefits us all.”
CHALLENGES AND SUCCESS
UCS goes to great lengths to ensure that its programs are accessible to all who need them, when they need them. 100% of individuals who contact UCS or are referred by a provider are offered a same day appointment — no delays, no waitlist. UCS Crisis Services continues to operate 24/7, even as the pandemic has forced staff to adjust their day-to-day operations to meet public health guidelines. PPE, social distancing measures and an increased use of tele-assessment allowed staff to maintain uninterrupted service. Easy access to services may prove especially important in coming months, as the continued stress of the pandemic aggravates the area’s existing struggle with substance abuse. Even before shutdowns started, Bennington County had some of the highest rates of opioid abuse and accidental drug-related deaths in the state.
“Substance use has increased significantly since the pandemic began,” Mattern said. “That is apparent in an increased sales of alcohol (although alcohol use doesn’t get as much press as the opioid crisis, it is still the most significantly and commonly abused substance) to an increase in use of Narcan and overdose deaths … At the very beginning of the pandemic, people seemed to have hunkered down, but as the pandemic continues and anxiety, depression and isolation continues, substance use increases.”
At the same time, demand for UCS services has risen sharply. Since the pandemic began, UCS has seen a 70% increase in crisis assessments in In addition to substance abuse problems, financial hardship, isolation, childcare struggles and the fear of COVID-19 itself have all contributed to collective stress levels, prompting an unprecedented number of people to seek out mental health aid. In the three months between July and September of 2020, UCS received 546 calls inquiring about its services, and performed 178 new client intakes.
There’s a bright side to those numbers. Not all these new clients are reaching out due to problems stemming directly from the pandemic; the move to telehealth counseling, made necessary by social distancing requirements, has drawn in clients who had been reluctant to reach out previously.
“Folks who may have needed to access support before COVID but didn’t call, are calling,” Mattern said. “Folks who were receiving services but not showing up on a regular basis are keeping their appointments. For instance, prior to COVID we had a no-show rate of close to 40%, and now it is 11%.”
There are a few reasons people may be more likely to use virtual services than in-person treatment — convenience, privacy, a sense of security from being in one’s own home — but the end result is a clear rise in the use of UCS resources. In FY 2019-20, the use of telehealth and telephonic services at UCS rose a staggering 300% over the previous year.
To offset some of this new demand, UCS introduced a “warm line” for non-emergency concerns. While other hotlines are meant to address an immediate crisis, the warm line is intended for those who may need support, but not immediate intervention. The warm line “is for people who may not be in a full-on mental health crisis but need to talk with someone,” Mattern said. “The beauty of this is that the person doesn’t need to know what they need, they just know they are not feeling well. We can work together to figure out what is the right course of action. Just like when someone is physically ill. They may not know what is wrong, but they know they can call their doc or urgent care and get some direction. We do the same thing.”
The increased interest in UCS services, while driven by hardship, is ultimately a gain for the community. Every person who reaches out in search of substance abuse treatment, mental health counseling or just a kind, listening ear is one less person suffering in silence. When individuals feel safe, stable and supported, the community as a whole becomes stronger and better equipped to weather any storm that comes its way.