Mental health and substance use challenges are often intertwined, especially for young people who are finding their way in the world. In fact, up to 45 percent of adolescents and young adults with mental health disorders have a co-occurring substance use disorder.
In this Q&A, Justin Graham, MD, child, adolescent, and adult psychiatrist as well as PrairieCare’s Chief of Medical Staff and Inpatient Services Co-Medical Director, discusses the importance of co-occurring treatment for substance use in mental healthcare. Dr. Graham treats patients in our inpatient hospital, which provides newly expanded co-occurring substance use treatment, including acute withdrawal care for patients 35 and younger.
Hear from Dr. Graham about our acute withdrawal treatment, the importance of accessing care in young adulthood, and the signs parents and caretakers can watch for.
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In your experience as a psychiatrist, why is addressing substance use so vital in an inpatient hospital?
I’ve been a psychiatrist with PrairieCare for over 13 years, and in that time, I’ve seen that rates of substance use challenges among patients are not improving, especially for the young people we see at our hospital. This need isn’t going away anytime soon. In fact, substances have become more accessible to young people, through methods such as vaping, and these chemicals have a direct impact on their mental health.
That’s why we continue to expand our care to acknowledge and address these challenges so our patients can receive the comprehensive, whole-person care they need. Ultimately, substance use needs to be addressed alongside mental healthcare to ensure our patients have the skills to discharge from our hospital and continue healing.
Why is young adulthood such a pivotal time in addressing co-occurring substance use challenges?
For teens and young adults into their 20s and even beyond, their brains are still developing. During this time, some young people can start to experience challenging mental health symptoms that make it really hard to get through the day. We often see them turning to nicotine, marijuana, and alcohol to cope, but it ends up being a disservice to them.
In addition, this time is all about life transitions. Young people go through a lot, from online schooling to broken family dynamics to college. You’re learning about yourself, your brain is still developing, and you may not make the best decisions. This is one of the most critical times for getting support. The skills learned in mental health treatment can become a lifelong roadmap for coping with inevitable daily challenges as young people take on more responsibilities in their personal life, education, work, and more.
Which patients would be a good fit for the co-occurring substance use program at our inpatient hospital?
The primary patient population we are focused on treating are those who have a primary mental health diagnosis, such as depression, anxiety, bipolar disorder, etc., and who also struggle with substance use to some degree. Our team can treat patients who need medication and therapy interventions for mild to moderate withdrawal symptoms.
How does our team ensure safety for patients experiencing co-occurring substance use issues?
Currently, our admissions team works closely with emergency departments (EDs) to receive medical clearance before patients with a noted substance use challenge are admitted to our inpatient hospital. Once an ED medical provider sends the referral to our team, our admissions experts and a psychiatrist will review the emergency care they have received thus far, and determine if our hospital can safely treat them.
There can be serious complications when someone has substance use concerns, so we work as a team to ensure the patient is treated in a medical environment that is safest for them. Since we are not a medical detox unit, patients who are at risk of adverse outcomes, such as seizures or delirium tremens, would need to be admitted to specialized hospitals suited for that care.
For individuals 35 and younger who need primary mental health support without substance use concerns, we always advise our community to use our Family First initiative. This allows anyone who needs acute psychiatric care to be admitted to our hospital without a prior visit to the ER as long as there are no serious medical concerns that would require stabilization on a medical unit. Either way, our team is available to guide you on the best route to immediate care so you can focus on getting help for yourself or someone close to you.
What happens if a patient is admitted and a substance use issue is uncovered during treatment?
A significant number of the patients I have seen at our hospital do have an underlying substance use concern, even if it’s not initially explained during intake. Although every patient at any age goes through screening criteria that involve substance use questions, patients or their families may not always tell you what they’re experiencing or may not see it as an issue. As we work with patients, we sometimes find out later that they’re drinking every day or maybe using stimulants or other substances to the point that they require specialized care and therapy approaches.
Even for patients who don’t have a substance use issue, we still provide education and awareness of how this may impact their friends or family members. Everyone has people around them who may be fighting their own battles, so we give our patients the tools to cope with what they encounter or to help loved ones find support.
What are the signs a parent or caretaker should watch for that would indicate their loved one needs mental health support?
Overall, watch for changes in their typical schedule and habits. This could include sleeping more or less, changes in appetite, mood shifts, or withdrawing from people or activities they typically enjoy. For substance use, erratic behavior and significant schedule changes can indicate an issue, but many signs can overlap with depression, anxiety, and other conditions.
A substance issue might be a bit tough to identify on its own. But if there are signs of depression, for example, and someone is also consuming large amounts of alcohol, they will not be able to function well. Either way, if someone can’t accomplish daily tasks, it’s vital they get support from a professional.
I encourage families to check in with their children and maintain open communication to create space for meaningful conversations. This can help parents and caretakers gain insight into the friends their kids are hanging out with, what they’re doing in their free time, and even how their daily life has changed.
What message do you have for young people with mental health or substance use challenges?
I often remind my patients that we are all going through battles and can struggle at certain times in life. Mental health issues are common, and we shouldn’t blame ourselves for things that can often be no fault of our own, like genetics and environmental stressors. You’re here getting help, and that’s the most important thing.
Too often, people feel ashamed and alone, but they’re not alone. Friends and family usually want to help, but they don’t know how the person is feeling. Reaching out and trying to be open about what you’re going through can be the key to feeling better. Support from people close to you can help you address the shame and guilt you feel that you don’t need to.
Don’t feel ashamed for needing help. It can be hard to talk about it with mental health professionals you don’t know, but we are here for you.
Co-Occurring Substance Use Treatment in Minnesota
At PrairieCare, we support our patients using a whole-person approach that addresses every aspect of a person’s life. Our expert medical and clinical staff guides patients to heal from primary mental health disorders and co-occurring substance use issues. Our team can also connect PrairieCare patients at any level of care with a Licensed Alcohol and Drug Counselor to complete a chemical dependency evaluation.
Throughout our system of care, we help patients build healthy coping skills, practice stress management, and connect with patients with similar challenges. We provide a full continuum of care for people of all ages throughout Minnesota, so you don’t have to wait to get the support you need. Get started today.
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If you’re ready to start your healing journey, call us at 952-826-8475 to learn more about our services, answer your questions, and access a no-cost mental health screening.
You can also fill out our mental health screening request form, and our team will contact you within one business day. Learn how our screenings work.