Students Against Destructive Decisions (SADD) and the Wellness teachers welcomed Camila Barrera, a prevention and education coordinator of Middlesex Partnerships for Youth, to talk about substance abuse and its legal consequences on February 28.
SADD members approached advisor Tammy Murphy because they felt that students would benefit from a seminar on substance abuse prevention.
They felt that sophomores would most benefit from it because the eighth and ninth grades already cover substance abuse in their wellness classes.
Tenth grade students who attended the seminar agreed that it was useful. “If I had a friend suffering from drug addiction, it could definitely help them out,” sophomore John Boule said.
Barrera began the seminar by asking what the most abused substance among teens was. The majority of students answered marijuana, but they were shocked to find out it was alcohol. Barrera then pointed out that this is because many teens have easier access to their parents’ alcohol than any other substance.
Boule felt that her discussion of alcohol abuse was important because alcohol is commonly used as a gateway drug.
Barrera then went on to explain how more than 4 in 10 people who begin drinking before age 15 eventually become alcoholics. She also highlighted how alcohol can cause slowed reaction time, dizziness, vomiting, and impaired judgment, which is why many people think they are sober enough to drive under the influence when, in reality, they are not.
She also explained how marijuana can affect parts of the brain like attention, learning, motor coordination, mood, and emotions.
She continued by saying how possession of an ounce or less of marijuana could lead to a fine of $100, and if the offender is under 18 years of age, he or she must complete a drug awareness program within a year of the offense.
At the end of the seminar, SADD members presented real life scenarios in which students were pressured to use drugs, and they explained how to say no in those situations.
Boule had another answer to that problem. “They should hangout with friends that don’t do drugs. Definitely don’t get involved with people who are a bad influence.”
The Hudson ELL department updates a board with the home countries of students. Since the Brazilian economy crashed in 2015 and 2016, a growing number of students from the country have been emigrating to Hudson.
by Dakota Antelman
He wanted to buy more than candy bars with his daily salary. But that’s all he could afford in Brazil even while working at a sushi restaurant.
In October of last year, a male student, who has asked not to be identified by name, and his family decided to leave Brazil, a country marred by nearly a decade of economic depression and political corruption. He was the first to emigrate, landing in this country with only a basic understanding of English and just one family member here.
Meanwhile, the rest of his immediate family is back in Sao Paulo, Brazil, gathering money to join their son in Hudson.
His experiences match those of several Hudson High School students. They come from different parts of Brazil, but the majority of them are here because they saw no economic future for themselves in South America.
“We were trying to live there. My dad has a job at the court, but things were bad because everything is expensive and the payment is low,” the male student said. “My aunt was over here, and she said the life is better here. So we came here and are trying.”
Brazil’s Economy Crashes
While much of the rest of the world was struggling with the Great Recession in 2008, the Brazilian economy was booming. It ranked sixth out of all countries in 2011 after seeing its economy grow by 7.5% the previous year, according to the New York Times.
But in 2014, investigators exposed a then decade-old illicit system of financial kickbacks between the Brazilian government and one of its largest oil companies, Petrobras. Company officials fixed prices, inflated costs and got involved in a series of bribes allegedly worth $3 billion.
At the time, the Brazilian government owned 51% of Petrobras, and the Brazilian president at the time the scandal broke, Dilma Rousseff, had once been the company’s chair. She and other members of her Workers Party used illegal Petrobras money to fund their own campaigns.
The scandal prompted massive protests, violent crowd control measures by government riot police, and, eventually, the impeachment of Rousseff and dozens of other government officials in 2016. But the responses in the streets and courtrooms were not enough to curb the economic devastation the scandal wrought.
Average monthly income in Brazil plummeted to its lowest point in three years according to Trading Economics. The unemployment rate nearly doubled from 6.5% in January 2015 to 12% by the end of 2016 and, between March 2015 and March 2016, the Brazilian Real lost nearly a quarter of its value when compared to the U.S. dollar.
“You just got used to it,” the male student said of the economy. “Everybody has to struggle to pay the bills. Politics are crap too. Everybody [the politicians] steals money. Everybody would go to the street to protest, but that didn’t help. So we just had to keep going. That’s why my dad decided to send me here because he knows that it won’t change.”
Indeed, economists predict the crisis will get worse before it gets better. Trading Economics predicts that the unemployment rate will climb to 12.3% this year, potentially leaving nearly 12.5 million people without work in Brazil.
Brazilian Economy Pushes Teens to Hudson
As the unemployment rate rose in 2015 and finally spiked by nearly 3% in a matter of months in early 2016, many of the teens now studying at HHS saw their lives changed.
A female student who also requested anonymity is one of those teens. She emigrated to the US in August 2015, just as the Petrobras scandal and the subsequent recession began to intensify. Her father had been working in the same job cutting metal in a factory for at least 12 years but was suddenly seeing coworkers laid off or fired at an alarming rate.
“The company was just firing everybody, and my dad got scared because he thought he would be the next person,” she said.
Her mother faced a similar situation. She had been working in the same job for two years after she was laid off in 2013. Before they left Brazil, the female student’s mother saw similar cuts taking place in her workplace.
“My parents had good jobs,” she said. “They had their lives there. But they were scared because the economy was decreasing and decreasing. They knew that there would come a time where they would be fired; they wanted to prevent that by coming here.”
The female student’s parents now work as manual laborers in the region.
“My dad especially, he doesn’t like to stay at home and not work,” she said. “It makes him feel bad, so he got the first job he could here.”
While the male student’s father enjoyed more job security than the female student’s parents, he too was impacted by the struggling economy. In fact, the male student’s family was close to selling their car as a way to make ends meet before his father visited Hudson where his aunt lives.
“My dad came here to visit my aunt, and he saw everything,” he said. “He saw the school, the houses, and my aunt talked to him a lot. He got back and said, ‘We’re going to move to the United States,’ and we said, ‘You’re lying.’ Three months later, I was in an airplane.”
Since arriving in the US, the male student has begun working a weekend job. He now enjoys more economic independence than he did in Brazil.
“Thing are so expensive, so even if I have money in Brazil, I can’t get anything,” he said. “I can just buy candy. Here I can buy a car if I want to.”
Students Adjust to Life in the US
While students are excited to live in the United States, where the economy is better and the political system is more secure, they have not necessarily enjoyed a perfectly smooth landing in their new country.
The female student spent time in three schools in different states at the beginning of the 2015-2016 school year.
“For a person who didn’t speak English, that was really hard,” she said. “I would make a friend and then change everything.”
Both students’ families, likewise, struggled to leave their homes behind.
“My parents had their friends there,” the female student said. “They left my grandma, everybody there. I miss them too, but, my parents, they haven’t made a lot of friends here like they had in Brazil because they lost friends that they had known since elementary school.”
Still, for both students, the benefits of moving to the United States far outweigh the struggles of doing so. The male student said his private school outside of Sao Paulo, Brazil, was roughly the size of the Hudson High School library. It had 300 students.
“Everything here is so organized,” he said. “Everything is awesome. This school is public. If this school was in Brazil, only rich people would go to it.”
The female student hopes to go to college to pursue a career in medicine or teaching.
The male student also wants to go to college. He, however, wants to follow his father’s path into a career in the courts. He wants to be a lawyer.
Students See Futures in the US
Both students had to leave their families and friends behind, and they both had to learn English in a matter of months after their families decided to move.
The male student learned English through a mixture of lessons from his father, who was already mostly fluent, and by watching American movies with their original English dialogue.
Indeed, many of those movies do project a larger-than-life view of America and its society. Having left the economic and political stagnation of Brazil though, he said they have been more accurate than many would expect.
“It’s like a dream,” he said. “Everyone in Brazil dreams of being here. It’s like a movie.”
Fifth and eighth graders throughout the state will be taking the MCAS online this year. Hudson has been preparing for this change for the past couple of years by buying the laptops and desktops that are leased and used by the Hudson teachers once the leases come due. This is a big change for the technology department as each student taking the test needs access to a computer at the same time.
This will be an even bigger issue once the third and fourth grade students take this new MCAS test online, since the elementary schools do not have as many computers. Every classroom in the district has 1 or 2 computers in them. But obviously this is not enough to support the online MCAS testing requirement.
The high school will be properly equipped as there are computer labs, computer classrooms, and the library where students can access computers. There are also mobile labs with computers available. Quinn Middle School has mobile labs with laptops and iPad carts available. All of these computer requirements will impact the school technology budget.
One issue is how to prevent the students from accessing information from the internet while taking the test. The students need to be able to access the test on the internet. The school has software that can monitor the computers and see what they are looking at. Perhaps more teachers will need to be placed in each room where the test is being administered to prevent any cheating. There is also firewall hardware available to block access to certain web sites such as search engines or Wikipedia. School administrators can choose which sites to block and which ones to keep open, so the online test can function properly.
In addition to these changes, eighth graders will no longer take the English MCAS on the same days as the tenth graders. Eighth grade will take the English MCAS on April 5 and 6. However, eighth graders will take the math MCAS on the same days as the tenth graders, May 16 and 17.
Each month, teachers from each department recommend a student to be recognized for their work. Below is a photo of each student and the reason why they were chosen.
Sabastian Frueh – Wellness Department
The Wellness Department’s recipient for the Student Achievement Award is Sabastian Frueh. Sabastian is bright, energetic and an enthusiastic participant in all areas of Wellness, whether in the classroom or in the gym. He is willing to try new things even if they are outside his comfort zone. He is always friendly and outgoing and makes class time fun for those around him. His willingness to participate and share his perspective makes for a great learning environment for his teacher and peers.
William “Bailey” Watts – Science Department
William “Bailey” Watts is a very mature student who very quietly takes responsibility for getting all of his assignments and assessments completed at a very high level. He not only works well with any student he is placed with during lab experiments but also thinks beyond the experiment at a deeper level. Bailey participates very well in class discussions and asks very intriguing questions that further the conversations. Bailey is a respectful student who is a very good role model for others.
Stephen Miranda – Business/Technology Department
The Business/Technology Student Achievement Award recipient is senior student, Stephen Miranda. Stephen is an attentive, cooperative and responsible student. He brings a positive attitude to class every day and works well with his peers. Often one of the first students to speak up and provide answers, Stephen contributes to class discussions while bringing a friendly sense of humor to the classroom. As an aspiring college business student, Stephen is well on his way to a successful, accomplished collegiate career ahead. As he continues on in his final year at Hudson High School, we want to commend him for his hard work, contributions and successful completion of our business classes. Congratulations and all the best in what we know will be success in your future!
Amethyst Beveridge – English Department
The Student Achievement Award for English goes to a junior, Amethyst Beveridge. Amethyst is a gifted poet and writer whose work recognizes the complexity of human existence, and she does not take the easy routes to showing us who we are. Amethyst can make a tonsillectomy the troubled totem of divorce. She can view a sibling with all the complicated love and ire only our sisters and brothers can inspire in us. Amethyst cares about the written word. She writes for her love of saying what is true. She also cares about the writing of others, reads avidly, and edits the work of her peers as Literary Editor of Hudson High’s literary journal, The Scribbler. Keep your eye on Amethyst. She has much to show us about ourselves.
Mackenzie Hay – World Language Department
Mackenzie Hay is a quietly effective student. She is a solid and reliable member of the class. From the moment she takes her binder off the shelf, Mackenzie is on task. Her focus and effort are an example for other students, and her work reflects her ethic—it is creative, accomplished and thoughtful. In group and partner work, Mackenzie is gracious yet quietly assertive. Her classmates listen to her; they turn to her for confirmation that their Spanish is correct and well-spoken; and Mackenzie is calm and encouraging. It is a pleasure to have such a capable, friendly and intelligent student. She raises the bar for us all.
Lily Kinz – Math Department
Lily Kinz is being nominated as the Student Achievement Award recipient in Math. Lily is a model student who always displays tremendous effort in her work. Her math work is always neat and organized, showing a lot of thought. When she does make a mistake, she takes the time to understand her error and learn from it. She will even stay after school to ask questions if she didn’t have time in class. She sees every assignment as a learning opportunity, and not just something to get done. Lily also has realized that learning math is more about understanding the important concepts rather than just following steps.
Alec Yorston – Social Studies Department
Alec Yorston has grown tremendously during his time at Hudson from a somewhat hesitant discussion participant to an active and sophisticated historical thinker who livens up class discussion with insightful analysis of primary sources and the ability to make apt connections between the past and the present. Notably, he is always sure to add quality commentary to class dialogue without dominating the conversation. We commend Alec’s dedication to taking a thoughtful approach to complex issues, and we look forward to seeing what he achieves in the future.
Sean Morton – Performing Arts Department
The Student Achievement Award for Performing Arts goes to Sean Morton. Sean has achieved quite a lot including increasing the rigor and frequency of his personal practice on the french horn; setting larger goals for himself such as becoming a member of the pit orchestra for the musical production of Joseph and the Amazing Technicolor Dreamcoat; and preparing to audition for the 2016-2017 Central District – Massachusetts Music Educators Association Senior Music Festival. His hard work earned him a spot in the music festival, with a performance scheduled in Mechanics Hall in Worcester in January 2017. In addition, he has expanded his learning and application of brass instrument performance techniques by studying and learning to play the trumpet and the trombone.
Julie Burgess – Visual Arts Department
Julie Burgess is a senior in AP Studio Art and is a member of the National Art Honor Society. Julie recently put in countless hours of community service beyond her requirements to help prep for the Downtown Holiday Stroll, missing classes to assist with set up, working the all-day event and aiding in clean up the following day. Julie works equally hard on her class projects and takes work home if she knows she is getting behind in class. She participates in critiques and willingly shares ideas with her classmates, as a way to make everyone’s work better. Julie is a team player, and she understands that people accomplish more and are stronger when their concepts are discussed and people are willing to see other viewpoints.
After reviewing community feedback from a series of focus groups and an online survey, the Hudson School Committee took a major step towards hiring a new superintendent on Tuesday by discussing publicly the qualities they would most like to see in a candidate.
The meeting came nearly two months to the day after current superintendent Jodi Fortuna announced her plans to leave the district at the end of this school year. In that meeting, on October 25, the committee thanked Fortuna for her work and began to schedule the search for her successor.
Tuesday’s meeting was perhaps the biggest milestone reached on that schedule so far as the committee spent nearly 20 minutes revising advertising materials for the position and discussing the information they received from the survey and the focus groups.
“What we’ve seen is that people want to see someone who is going to continue to push the district in the direction we’re going with curriculums and certain pieces of teacher development and staff development,” said committee chairperson Michele Tousignant Dufour of the community feedback.
Over the course of two weeks earlier this month, the Massachusetts Association of School Committees, an outside group contracted by HPS to help run the early stages of the superintendent search, hosted eight focus groups for students, staff, parents and general citizens in conjunction with an online survey.
In the survey and at the focus group meetings, the MASC asked community members which aspects of HPS were strongest and which issues needed addressing under a new superintendent. The survey alone drew 150 responses, a response rate that is, according to Tousignant Dufour, at least 50 responses higher than is typical on these types of surveys.
Emerging from that data was an interest among citizens in improving the HPS special education programs as well as a hope to have the next superintendent come from outside of the district.
“The concept was now that we’ve had an internal [person], let’s look and try to have an outside evaluator type of person,” she said. “But we don’t want someone who will rip down everything we did, which would not be our hope.”
HHS physics teacher Reed Prior shares this interest. Prior to coming to Hudson last year, he taught in the Tahanto and Goffston, New Hampshire, school districts for three years.
“My input on the survey and my input when I went to the focus group for teachers was that I thought the environment I found when I came here was a very warm and encouraging one for students and for faculty, and I just hope it continues to be one,” Prior said.
The School Committee will continue to seek feedback from the community and provide students, parents, staff and general citizens with relevant information throughout the search process. This is intended to prevent a repeat of the controversy about lack of transparency that led Fortuna to ask that the School Committee reopen its search for a superintendent after they initially voted to grant her the job in March of 2014.
“I came on the board at the meeting right before we voted Jodi in, but I was watching from afar at how the situation was handled,” Tousignant Dufour said. “That is not something that I want to see replicated – the speed at which it happened and what I think was a very confusing time for many people, staff and administration involved.”
In the coming weeks and months, the School Committee is expected to form a search committee and begin collecting job applications for the position. MASC will also take the lead on advertising the position, with a posting in Education Week and a brochure, each scheduled to take place within the next three weeks.
“We had hoped to start this process a little sooner, but Jodi wasn’t able to tell us until the end of October so that forced us to push our timeline further,” Tousignant Dufour said. “Our goal is now to get this [advertising] done so that we can be a competitive district and be able to be interviewing candidates by the early spring, which puts us in a better position to get the better candidates.”
As the winter sports season begins, the All-Stars for each fall sport were announced by Midland Wachusett League C. Every year the league chooses a few students from each sport due to their outstanding performance during the season.
Junior Jake Doherty Munro is the only All-Star for both cross country teams. He has been a top runner for HHS in both cross country and track.
Senior Megan Miller is volleyball’s sole Mid-Wach C All-Star. Their record this season was 3-15.
Seniors Liam Marsh and Dan Morton as well as freshman Bailey Watts are the All-Stars for the golf team. The team made it all the way to districts and finished the season 9-9.
Sophomore Emily White is one of two All-Stars for field hockey. She was a key player this year starting almost every game and scoring the most goals on the team.
Junior Elizabeth Cautela was one of the captains of the field hockey team this year. She had the most saves of any goalie in the Mid-Wach C league.
Senior Stephen Miranda was chosen as an All-Star for football. He played almost every game of the season at quarterback and scored many touchdowns himself. He also received the MVP Award at the Turkey Day Game.
Junior Connor Nemerowicz is the defensive player selected as a Mid-Wach C All-Star. Their season record this year was 3-8, but he hopes to do better next year and maybe make it to playoffs.
The girls soccer team had a great season this year with a 9-7-2 record. They made it to playoffs. Five starting varsity players, including all three captains, were selected as All-Stars.
This year Forest Avenue elementary school and Mulready elementary school have introduced a new drama program to their students.
This program, led by Sara Worrest, plans to teach the students about a range of acting techniques. “We are doing some pantomime work. We are doing a lot of really basic storytelling premise, so what makes up a story, how is storytelling and drama the same, what’s different about writing a story versus performing a story. That’s a lot of the curriculum,” Worrest said.
This new class should prepare students for future drama classes as well. “I think what it’s going to do, in terms of the drama programs in the middle school and high school, is it’s going to give a really solid foundation and help to inspire the kids,” Worrest said. “If they have a certain amount of base knowledge from having drama in elementary school, then they would get to go further into things when they are in middle and high school,” Worrest said.
Third grader Kari Flood was one of the many students that was inspired. “Yeah, it is probably one of my favorite classes. I want to be an actress,” Kari Flood said.
Kari’s mom is also happy about this new class and hopes to learn more about it. “I just would like to be able to see what they are doing. I wish there was a chance to get parents in to watch,” Marie Flood said.
Although this class has changed the schedule, the transition has been smooth. “The students have drama during some of what we call common planning time, but the kids know it as their ‘extra special,’ so they have a sixth special during the week, and I am a part of the rotation of the sixth special. Also at Mulready school, I am teaching during their reading block, so I pull small groups of students to do readers theatre as a part of their reading curriculum,” Worrest said.
Worrest presents the curriculum in ways that interest the kids. “We usually play a game, like ‘Who’s Who.’ We are in a circle, and we stand up. We have to nod at each other, and when we get eye contact with each other, we nod our heads, and then we swap places,” Kari Flood said.
The kids, while they don’t perform for families, are in small plays. Worrest wrote a play for the third graders at Mulready elementary school about the first Thanksgiving. The kids used really basic props and costumes and really simple stage directions to put on this short play. The play was a class effort and was part of the drama program.
The kids and parents love the new class, and there is high hopes from the staff. “I work really closely with both Ms. Cherry and Ms. McKenzie, and we’re just giving a really good foundation, that may allow kids to do a little more in middle school and high school, or maybe deeper work as opposed to different work, if they have a certain amount of base knowledge from having drama in elementary school,” Worrest says.
Money, politics, and geography mean some teens and their families struggle to access mental health care.
by Dakota Antelman
By the time she was hospitalized after her second bout with self-harm last year, a current ninth grade student had already spent years struggling to access a complex and, at times, bureaucratic mental health care system.
The student did attend counseling immediately before and after she was discharged from the hospital. While those treatments were not the first she had received, it was the first time she had received care since she was much younger.
She saw a counselor when she was in fifth grade but had to stop when her family’s insurance plan switched from Blue Cross Blue Shield to Tufts, which her counselor did not accept. The student’s mother looked for a new therapist until things “seemed to sort themselves out,” and they stopped looking.
Nevertheless, the student would struggle with undiagnosed depression until eighth grade, only getting her diagnosis during her hospital stay.
While the student’s mother said she “should have done more” to get her daughter into treatment earlier, the struggles she faced in even locating that treatment have, in several cases, proven to be the result of widespread issues within the mental health care system that can lock certain teens out of treatment.
Some insurance companies load so much paperwork onto practices that counselors limit the number of plans they accept. Some counselors have no room in their schedules for new clients at times that fit with their daily lives. And families can even find it difficult to get in contact with counselors who either do not answer their phone calls or call back at times when they cannot answer the phone.
For teens like this current ninth grade student, the existence of these barriers can have grave consequences.
Getting Insurance to Pay
In accessing mental health care and getting it paid for, families either feast or face proverbial famine.
As part of a survey conducted in late September and early October, the Big Red contacted every counselor from Clinton, Sudbury, Marlboro, Stow and Hudson that was listed on a Psychology Today “find a doctor” database at the time. For those who did not respond to the Big Red, the publication used the insurance information provided by counselors in their biographies on the website.
The review of 24 local practices found only 15 who accepted any insurance. Of those, just nine accepted more than two plans.
A number of these practices also accepted the same plans meaning that, while some patients and their families might find it easy to get a therapist, others might find the process extremely difficult. A Blue Cross Blue Shield customer, for example, could choose from 14 local counselors that accept their plan and treat adolescents. Someone with Tufts as their insurance provider would have 10 to choose from according to the same database.
Other plans like Fallon Health, a Massachusetts-based health insurance, offered just three local practices who accepted adolescents at the time of the survey. Beacon Health, another Massachusetts-based health insurance, offered two at the time.
For clients with MassHealth, the state’s public health insurance program that expanded as more clients qualified for it under the Affordable Care Act of 2010, the search process can be complicated. There are 17 local counselors accepting new adolescent patients with MassHealth according to the “find a provider” page on the website of the Massachusetts Behavioral Health Partnership (MBHP). MBHP is the program which handles mental health care for MassHealth, and has its own website.
With the exception of two providers, however, none of these names were listed in the Psychology Today database, which is commonly used by teens and their families in their search for care. If someone on a MassHealth plan did not know where to look, they could have trouble finding care.
Kristen Morris, the mother of another HHS student who has sought mental health care, has observed these issues in trying to get her daughter into treatment.
Their family first started looking for a therapist while they were on a Blue Cross Blue Shield plan. They then switched to Harvard Pilgrim and saw their options narrow. When they switched to MassHealth, Morris said she found just two practices within 15 miles of Hudson that accepted her plan.
“I think that therapists not accepting health insurance is detrimental to people’s well-being,” she wrote in an email to the Big Red. “Once you’ve found someone that sounds like a good fit, it’s not a good feeling to hear that they don’t accept your insurance. It really cuts down on your options.”
Morris’s daughter has been to two different therapists since her family started searching for one when she was nine. Neither worked out for her, however, as she said she didn’t feel comfortable talking with them.
Kristen Morris wrote in the same email that she and her daughter have since decided to stop looking for therapy but will start again if her daughter sees the need.
Therapists Getting Insurances to Pay Them
The problems posed by insurance are nearly as frustrating for providers as they are for patients.
HHS school adjustment counselor Jaime Gravelle sympathizes with therapists who find the process of getting added to insurance panels arduous. Gravelle herself has experience working in residential treatment centers as a social worker and has dealt with the barriers to the mental health care system in her current job.
“There is a lot of red tape for reimbursements and for getting reasonable rates for services provided,” Gravelle said. “The amount of documentation for insurance panels is really extensive, and that can make it challenging for some practitioners to use a certain insurance.”
Several counselors contacted by the Big Red echoed Gravelle’s sentiments. They cited delays in getting reimbursed and low reimbursement rates as reasons to either limit the number of plans they accept or not accept insurance at all.
Brian Cohen, a Hudson-based therapist specializing in the treatment of ADHD, anxiety and mood disorders, listed those same reasons as central in his decision to not accept any insurance. He then went a step further, enumerating a list of other issues he has with the insurance industry.
Cohen explained that he does not like the fact that insurances periodically request copies of his notes for audit-like reviews of him and his patients. To Cohen, these reviews are an issue of patient confidentiality.
Furthermore, Cohen does not like the amount of unpaid time he would have to spend communicating with insurance companies to get reimbursements from them.
“I don’t have a problem talking to your school guidance department on the phone, your parents on the phone, or you on the phone,” he said. “But I do not like spending a half hour or an hour on the phone trying to get in contact with the insurance company and not get reimbursed [for that time].”
Cohen and other professionals in the field said that with public health care plans like MassHealth, these issues are only amplified.
“MassHealth wants to be able to regulate everything — how you’re writing the notes [or] how many sections you’re writing notes in,” Sudbury-based therapist Fred Gerhard said. “They want to regulate everything. That makes them harder to work with.”
A MassHealth representative contacted by the Big Red declined to comment on the record for this article.
The Big Red did determine, however, that MassHealth does require that its providers document in detail how they used time with their clients. This can involve curating a medical record including anything from progress notes to treatment plans. MassHealth also requires its providers to write their notes using language that non-medical professionals can understand. These notes come into play if MassHealth decides to review the records for signs of fraud or other illegal financial activities.
Nevertheless, for families who do not have the money to pay out of pocket for therapy, gaps in insurance coverage, either public or private, can hamper a person’s search for help from day one.
Few In-House Solutions
Mental illness is often triggered by a variety of stresses or incidents in a sufferer’s life. But in the adolescent population, the transition to high school can exacerbate underlying conditions, sometimes turning a manageable anxiety disorder in middle school into a more severe one in high school.
Knowing this, the Hudson Public Schools (HPS) have tried to offer their students coping mechanisms and outlets to address mental illness within their own schools. The high school wellness curriculum now includes units on stress management and mental illness. Some students also have the opportunity to attend Therapeutic Academic Support classes (TAS) where they learn coping and self-advocacy skills while boosting their self-esteem in a classroom environment. Additionally, the Hudson Public Schools have added another social worker like Gravelle at the high school as well as a school psychologist who visits all of the schools to offer help to students dealing with forms of mental illness.
Gravelle notes, however, that this in-house system has its limitations.
“If someone is coming in because they want to work through trauma issues, it wouldn’t be the most helpful thing for them to do that here in the school on a consistent basis and then afterwards have them be put back into the cafeteria where then they have to do lunch and take a math test,” Gravelle said. “It can be done and it doesn’t mean that within my office we never touch on those things, but I don’t think that it’s necessarily ethically in anyone’s best interest to do that in a school setting.”
Currently, Gravelle has 47 students on her caseload. Of those 47 students, she estimates that roughly half are already receiving outside counseling in addition to their meetings with her.
In connecting several of those students with their eventual outside help, Gravelle and her colleagues in the guidance department can take on the role of middlemen, providing students with names and information about local practices.
Indeed, when the Morris family looked for therapy for their then eighth grade daughter, that daughter went to the guidance department and asked for a list of counselors nearby. The department provided her with a list, and she saw a local therapist on that list for roughly two months.
However, that relationship did not work out because the student did not feel comfortable talking with the therapist. She stopped with her treatment and never came back to guidance to follow up.
The student said she still struggles with stress and forms of depression. While she said that she does think a therapist would alleviate some of these strains, she added that she is doing “all right” without one.
For Gravelle, Morris’s story highlights her need to communicate with parents about anything from insurance to issues of whether a student can build a personal connection with a therapist.
“I try to be very forthcoming and say, ‘This is the system. I recognize it has its faults. Here are some of the different ways that we can get your child support right now,’” she said.
When therapy does not work out as quickly as a student or a family might have hoped, Gravelle said she at least tries to provide a temporary solution to problems for which a student needs counseling — even if doing so in the school environment is not ideal.
“In my position it’s a lot of trying to keep up with that, checking in with people and asking, ‘Are you still interested?’” she said. “‘I know they said it will be a while, but can we do something in the school setting? Can I be that band-aid?’”
For many students, Gravelle has been or is that band-aid while they wait for outside help.
Getting Therapists to Pick up the Phone
In getting care outside of the school system, the first thing a student or their family must do is begin contacting counselors. But the length of that process can often vary based on how long counselors take to return a family’s calls.
For the unnamed ninth grade student mentioned earlier, that was just the case as her mom said she had to leave at least 15 messages with counselors before finally scheduling a session for her daughter prior to her hospitalization.
The therapists, many of whom either work in private practices or work in group agencies but manage their own phone calls, would often only call her back when she was at work and unable to talk with them.
“It’s terrible phone tag,” she explained, later concluding. “Trying to actually talk to someone, trying to find an appointment time that’s available on a regular basis that works with your schedule and their schedule is not easy.”
In this case, the student’s mother also feared for her daughter’s privacy when therapists’ answering machine messages asked that she leave a brief description of her reason for contacting them.
“You’re saying this personal information on this voicemail,” she said. “You have no idea who’s listening to it although you’re supposed to have confidence in the system that only the people who are supposed to hear it, hear it.”
For this reason, she would never leave her daughter’s name in the voice message when she called, instead waiting until the therapist called back to divulge that information.
This is an issue that can be exacerbated on public health care plans like MassHealth. Of the 17 providers identified through the search of the MBHP directory, five did not provide basic personal information like their name or gender in their biographies at the time of the search. In those cases, a patient seeking care could realistically be calling a phone number and only know the name of the practice with which a doctor is affiliated.
This family’s experience with therapists not returning their calls is also not unique. Even in reporting this article, roughly 75% of the local therapists contacted by email or phone did not respond to the Big Red’s first requests for information on their practice. They either missed the initial phone call or never replied to the initial email. In 38% of cases, therapists never responded to requests for comment despite two or three calls by the Big Red in the majority of cases.
Without Outpatient Care, Teens Turn to the Emergency Room
If and when someone calling a therapist is directed to leave a message on an answering machine, they would likely hear some form of the following instruction: “If this is an emergency, hang up the phone and either call 9-1-1 or go to your nearest emergency room.”
Indeed, when, for one reason or another, therapy is not available to someone with a mental illness, going to the emergency room is often their only choice.
But while there are emergency rooms near Hudson, with Marlboro Hospital situated just across town lines, the ways many of these emergency rooms process and treat mental health emergencies can put parents and patients in difficult situations.
Before she was admitted to a longer term inpatient center, the ninth grade student went to the emergency room twice in the span of two weeks after intentionally hurting herself. On the first occasion, emergency room staff told her family they would have to stay at the hospital for at least two more days if they wanted to get her into an inpatient program. She contracted for safety, and she and her family went home.
Two weeks later, back in the ER and faced with a similar choice, her family decided to keep her at the hospital and have her admitted to the inpatient center.
“That time I wasn’t taking her home again; I was too scared,” the student’s mother said. “The first time I was torn between ‘Does she really need inpatient care?’ The second time I was like, ‘She needs it. It’s going to be the best thing for her.’ So we insisted that she get admitted.”
The student spent a week in the inpatient center. There she said she learned coping skills that have aided her in her struggles with depression in the months since she was discharged. Insurance also covered the financial costs of her hospitalization, saving her family from treatment costs that can soar past $2,000 per day according to a Becker Hospital review of state-by-state inpatient care costs done in 2013.
But buried in those two emergency room visits was an unavoidable fee that frustrated this student’s mother.
While they initially went to the Emerson Hospital emergency room, the only hospital their insurance would cover at the time was Cambridge Hospital. To get there, they would have to drive 30 minutes from Concord where Emerson Hospital is located to the Cambridge hospital campus in Cambridge. Once they were admitted to Emerson, however, hospital regulations did not allow the family to travel to Cambridge on their own. They had to take an ambulance between the hospitals and subsequently had to pay the bill.
“The only real charge was the ambulance fee, which to me isn’t fair because it’s required,” the mother said. “There’s no choice.”
But while this family did have to pay the ambulance bill, and did face the tough decision of possibly waiting days for a bed in a long-term facility to open up, they avoided some of the other problems that plague emergency rooms.
The wait time for beds in psychiatric hospitals can sometimes be longer than two days. Much of this is due to the decrease in beds statewide, as reported by PBS Newshour in September.
The report revealed that, between 1990 and 2014, the number of beds designated for psychiatric patients had plummeted from 102,307 to 37,450 beds.
That waiting game for a long-term bed can only start, however, once a patient sees a doctor in the emergency room. Gravelle said that even this can often take hours.
“To sit in an emergency room for 10 hours [or] 12 hours to be seen by a clinician to assess you if you’re feeling suicidal, that’s typical, and it is not at all the best treatment for anyone,” she said. “Everyone agrees on that, but the question is, how do we fix it?”
Waiting for just an hour before being seen by a nurse, and seeing a doctor within a half hour of that, the mother of the ninth grade student knows that her family was able to avoid the worst of ER gridlock.
“I used to work in an ER, and part of it just depends on the type of care you need and the volume at that moment,” she said. “We probably just hit some good times in terms of not a long wait.”
Finally, the ninth grade student’s family was able to stay with her, supporting her and keeping her safe while she waited for treatment. For many adults or older adolescents who go to the emergency room alone with suicidal thoughts, a wait for care of any length can be much harder.
Busy Lives Mean Fewer Choices
Even if an adolescent never needs treatment in the emergency room, if their insurance has a variety of therapists on it and if therapists do return their family’s calls, an adolescent in need of mental health care still might have more barriers to work through before they even get in the door of an office.
Therapists, like most other professionals, work during the week. While some offer evening hours and, in some cases, Saturday hours, the bulk of their sessions occur while students are at school. This means that students would not necessarily be able to just choose from the practices that accept their insurance.
Unless they get dismissed from school, a HHS student can only see a counselor after 2:03 p.m. Since only two counselors in Hudson replied with openings in their schedule, one of which was Cohen who accepts no insurance, a student who needs insurance to pay for their counseling would likely need to expand their search outside of their hometown. With working parents, a student could then realistically see his or her options for counseling narrowed to the hours after 5:00 p.m. and still have to deal with the other barriers against getting care.
Such was the case for junior Elizabeth Cautela. Cautela began seeking a therapist last December to treat depression and stress that she was dealing with at the time. When her mother first called local practices, no offices in Hudson had times available for her that fit with Cautela’s varsity and club sports schedules and the schedules of Cautela’s parents, both of whom have full-time day jobs.
One of the therapists Cautela’s mother called did direct her, however, to a colleague that the therapist believed practiced in Marlboro and might have had room for Cautela. The therapist did have room, but she did not practice in Marlboro. Instead, she practiced in Framingham.
Tired of searching, Cautela and her family booked bimonthly sessions with the Framingham therapist.
While she said her therapist has helped her, the 35-minute, one-way commute to her appointments has been difficult for Cautela. Even though she got her driver’s license earlier this year, she does not have access to a car until her mother returns from work. This means she can only see her therapist in the evenings during the week, narrowing her options for the timing of sessions.
But the car is not her only scheduling constraint. During the fall, Cautela was unable to see her therapist at all. Her field hockey practice did not end until 5:30 p.m. each evening. Her therapist’s last regular session started just 30 minutes later, at 6:00 p.m. There would not have been any way for her to get from practice to her therapist before she closed for the day. So, even after finding help, Cautela could not access it as she made the stressful transition to junior year.
“Junior year has been the roughest year of my life; it really has been,” she said. “I’m stuck because I can choose sports, or I can choose therapy. But, if anything, sports cause me more stress because the culture is so intense — if you’re not winning, you’re doing something wrong. So I’m more stressed during sports season, but I don’t have the time to get to the therapist in the first place.”
Debora Franco, a Marlboro-based therapist who treats adolescents, is aware of the problems teens like Cautela encounter with travel times and therapy schedules. She wrote in an email in September that she normally sees teens between 3:00 p.m. and 7:00 p.m. and does, from time to time, offer weekend hours. She added, however, that those openings “might not be [on] the days and [at the] times that teenagers or their parents are available to come for an appointment.”
Elisa Sweig, another Marlboro-based therapist, echoed Franco’s statements in a similar email, writing that her accessibility is dependent on her schedule at a given time. Her patients can also be dependent on their parents to bring them to appointments, limiting openings in their own schedules.
For Cautela, her counseling has been a positive experience. She has been lucky that she has accessed it and is glad to have found a therapist with whom she can have honest conversations. The same cannot be said for many of the students interviewed for this article.
But still, she wishes things were different — both for her and for her classmates.
“I wish she was here in Hudson or the therapists in Hudson had more room because I think it is sort of ridiculous that I have to go 35 minutes to get to my therapist,” Cautela said. “It’s needed, and it’s necessary for kids my age and kids in high school in general. They need to get to a therapist, and when they can’t get to a therapist, what do you do?”
Teens, their parents, and their care providers often find themselves trapped by the government’s approach to certain aspects of the mental health care system.
Social workers can be so bogged down by the problems within the system that they do not return a prospective patient’s calls.
In what Brian Cohen labeled a “bureaucracy,” public health insurance plans demand profuse documentation of services provided. This can push providers off insurance panels, an action that can inadvertently close their doors to lower income teens and their families.
Emergency rooms can, at times, lack the space or staffing to treat patients promptly.
Inpatient centers can be even worse, with prospective patients sometimes waiting days for beds to open up.
In 2010, the federal government attempted to address the insurance barriers by passing the Affordable Care Act (ACA). While that act did increase the amount of people on health insurance, it did not completely eliminate the aforementioned bureaucracies that still limit the effectiveness of public plans like MassHealth.
On a more local level, the 2007 decision in the Rosie D v. Romney lawsuit brought attention to issues with mental health care in Massachusetts and prompted the creation of the Massachusetts Childhood Behavioral Health Initiative (CBHI), among other things. Under the CBHI, the state has worked to increase access to in-home treatments for children with “significant behavioral, emotional and mental health needs” according to the initiative’s page on the Massachusetts Health and Human Services website.
Most recently, the state has tried to deal with these problems through a series of bills proposed in the Massachusetts State Senate and House of Representatives.
For any of these bills to become a Massachusetts state law, they would most likely need to pass through the Joint Committee on Mental Health and Substance Abuse. This committee is made up of six state senators and 11 state representatives and is tasked with reviewing proposed laws regarding drug abuse and mental health.
Since January of last year, the committee has reviewed at least seven pieces of legislation addressing access to mental health care for teens in some way. These proposed bills seek to improve issues ranging from emergency room efficiency to MassHealth coverage. The first batch was referred to the committee on January 20, 2015, while the second was sent to the committee on April 15, 2015. These bills have since circulated through a series of committees, and all now sit in either the Senate or House Committee on Rules attached to a series of study orders from their respective branch of the state legislature according to the Massachusetts Legislature website.
Jaime Eldridge, the state senator representing Hudson and its surrounding towns who also serves on the joint committee for Mental Health and Substance Abuse Awareness, did not comment on these bills or the issues described in this article despite multiple requests from the Big Red.
As a result, the Big Red can only provide information on the bills based off their descriptions on the Massachusetts Legislature website.
This series of bills did include two that addressed issues with MassHealth. One, H.1805, advocated for “equitable access to behavioral health services for MassHealth consumers,” while another, H.1812, added “affordability” to H.1805 while mirroring much of the rest of the bill.
Two other bills dealt with forms of inpatient care with one bill, S.1027, requiring health care coverage for patients visiting ERs with psychiatric issues and another, S.1028, seeking to decrease wait times for inpatient care.
The remaining three bills all sought to improve access to mental health care as well but overlapped in several areas with other bills.
Stuck Behind the Barriers
Every year, teachers and guidance counselors tell students to reach out to get help if they are suffering from mental illness. Yet in many cases, those who try to find help don’t get it.
For Gravelle, who tries to fight through these barriers to the mental health care system on behalf of her students, this system is broken.
“When someone is in that place where they’re open to help, we want to move on something quickly,” she said in an interview earlier this year. “But the system isn’t there to provide that immediately, and I think that’s a huge obstacle. That’s where I think it’s a public health issue of how do we make it possible for people to get the help they need?”
For Cautela, who has battled anxiety and depression as a teen, getting counseling is crucial. Unfortunately, for many teens, there is no way to get that counseling but through the system that can and has shut out many of their classmates and friends.
“Without any guidance at all of how to deal with this stress, you’re stuck wondering, ‘What do I do?’” she said. “You don’t know how to handle it. It consumes you. You don’t know if there’s a way out because it feels like it is all building up on you, and you don’t know how to relieve it.”
Students often know that help exists. They are often aware of the solutions that may lie within their grasp if the system were more streamlined. But, like Gravelle, they say that that system is broken. And, they add, it is in need of fixing.
“Everyone agrees on that,” Gravelle said, speaking on the subject of emergency room inefficiency in particular. “But the question is, how do we fix it?”
This article is the third in an ongoing series on mental illness among adolescents and young children in the Hudson area. To read part one, exploring academic stress among K-7 HPS students, click here. To read part two, exploring the link between mental illness and academic pressures for high school students, click here.
If you have suggestions for additional articles or tips regarding this article in particular, please contact us through this form.
Thirteen students auditioned for the Central Massachusetts District Senior Musical Festival on November 19, and five students were accepted. Seniors Thaya Zalewski and Jack Snow, juniors Garet Mildish and Jacob Doherty Munro, and sophomore Sean Morton have been accepted into Districts, with Snow, Zalewski, and Doherty Munro invited to audition for the All-State Festival.
Students will perform in a concert on January 14 at Mechanics Hall in Worcester.
Around 1400 students audition for the Central MA District Festival each year in 4 separate categories of voice, band, orchestra, and jazz. Only 140 students are selected for voice, 110 for band, 100 for orchestra, and 19 for jazz, according to Caron, who is a member of the Massachusetts Music Educators Association.
The music festival, run by the Massachusetts Music Educators Association (MMEA), has taken place for the past sixty years, and auditioners consider it an honor to be accepted into the festival.
“I’m surprised, excited, and I’ve never been in something this exclusive before,” Mildish said. “I’m proud of that.”
Zalewski, on the other hand, has auditioned for the past four years, has been in the festival three times, and was recommended for All-State last year.
However, during the past summer, Zalewski developed a vocal node from playing the clarinet and speaking too much. Not practicing for two weeks to recover after having surgery to remove the vocal node “was the longest and weirdest two weeks,” Zalewski said. She was able to recover and practice for two months, just in time for the audition.
Band director Jason Caron, who has helped students to prepare for the festival for years, says, “It really is an honor to play in this festival. You get to experience a full concert band that has every instrument, the right amount of instruments, and experience the music from a band repertoire,” Caron said. “You get to experience advanced music played by skilled students, and it can be life changing for the student.”
Two years ago, approximately 68 percent of students said a huge part of their stress comes from school. Reports of self injury have increased by about four percent, and suicidal thoughts have increased from 10.5 percent in 2010 to 14 percent in 2014.
These stats came from the 2014 MetroWest Adolescent Health Survey. Administrators use the survey data as evidence when looking to add personnel or new wellness units to address the harshest revelations from the survey.
Students in grades 6-12 take the survey every other year. Students at the high school just completed the survey on November 22. The survey asks questions about substance use, mental health, bullying, and general health and nutrition. For students in grades 9-12, there are also questions about sexual behaviors. It’s anonymous and voluntary. The main office sends a notice home about a month in advance, so parents are aware of it and can send a part of the notice back to the school asking for their child not to participate in the survey.
In the beginning of the 2011-12 school year, the school hired Jamie Gravelle, the school adjustment counselor, and, this summer, a second school psychologist joined the guidance department. Special education teachers have been added to the therapeutic academic support class, as well, as a result of the survey data.
In the past few years, the wellness teachers have been altering their classes to include more visits in class from the guidance counselors. Since 2011, guidance and wellness teachers have increased the programming around mental health, adding presentations like “Break Free From Depression” in the ninth grade and “Stress and Anxiety” in the eighth grade.
“Those [units] are typically about raising awareness,” Jamie Gravelle, the school adjustment counselor, said. “Helping students to know what the signs, symptoms, resources, [and] the coping skills people can utilize are. For me, it’s really about decreasing stigma [and] normalizing that there’s a pretty high percentage of the population who experiences stress, anxiety, or depression. It happens a lot, and by talking about it in classrooms and normalizing it, it makes it easier for people to get help.”
A ninth grade student, who requested for her name not to be used, has noticed the shift to focusing on mental health and substance abuse in health classes.
“I feel as if it’s important [to talk about] because there are so many people struggling with depression and harming themselves, as well as drinking alcohol and smoking weed,” she said. “I feel like letting people know [the consequences of] doing those things is good. So [when students and their parents] look back [they can’t] say, ‘Wow, it’s the school’s fault for my drug abuse [because they never taught me about it]’ or ‘The school never taught students to [talk to an adult if they know] people who are struggling with depression’ or ‘Wow, nobody taught me about depression. I could’ve done something, but now it’s too late.’”
In addition to the increase in mental health units, the wellness teachers altered the substance abuse curriculums. In 2014, administration noticed an uptick in alcohol abuse.
“To be honest, it wasn’t that we weren’t paying attention to it, didn’t see it as important,” Gravelle said. “I think there had been so much shift to focusing on opioids and marijuana that we had spent less time talking about alcohol. So the data [pointed out] that [alcohol use needed] to continue being a potential concern.”
Junior Spencer Cullen has seen the negative effects of substance abuse on school and the personalities of people he knows. However, he doesn’t think those problems have been addressed very well.
“[I think] more of an upfront and personal stance [would influence students more],” Cullen said. “[Right now] it’s very textbook [based] and not personal.”
Beyond the school system itself, educators have also sought outside help to take action on the survey results.
Using the data, Hudson applies for grants, such as the Hudson Youth Substance Abuse Prevention Coalition. The coalition will help facilitate and implement strategies and activities in Hudson High School and Quinn Middle School. Strategies include supporting the addition of new wellness courses, supporting efforts to increase screening for youth substance use, prevention, intervention, and referrals to treatment.
“It’s not data we just do to get it and then just throw it into a filing cabinet somewhere,” Principal Brian Reagan said. “It’s actually used.”