Look for JoCo on the Go where you regularly listen to podcasts.

Time	Subject
00:27	Introduction
02:02	The purpose of ACT
04:02	Types of substances children are encountering
07:01	A holistic approach to recovery
13:37	Additional supports after receiving treatment at ACT
16:23	What parents can watch for

Follow us on Podbean.

Theresa Freed  00:00

Johnson County Mental Health Center is helping change lives in a big way for youth throughout the state. On this episode here how the adolescent center for treatment is empowering young people with the tools they need to succeed.

Announcer  00:12

Whether you live in or just love Johnson County, Kansas, JoCo on the Go has everything Johnson County, here's what's happening and what's coming up in the community you call home.

Theresa Freed  00:27

Thanks for joining us for JoCo on the Go, I'm your host Theresa Freed, a Johnson County resident and employee of Johnson County government. Last week, we talked about mental health first aid for us and part two of our podcast series on youth. We're focusing on Johnson county mental health centers, adolescence center for treatment and the great work that's happening there. Also have a special focus on gratitude ahead of the Thanksgiving holiday. Here to talk more about that, as Kevin Kufeldt with the ACT.

Kevin Kufeldt  00:53

Oh, that's right. I'm Kevin Kufeldt with Johnson County Mental Health, and the adolescent center for treatment. I'm the program director for ACT and also the program manager for the adolescent outpatient and addiction services here at Johnson County Mental Health.

Theresa Freed  01:07

All right, well, thanks for being here with us to talk about the center and all the great work that's happening there. Can you tell us a little bit about what your role is there? So what kind of work are you doing?

Kevin Kufeldt  01:19

Sure, so at ACT, I'm the program manager and director. So I oversee all the clinical staff and supervise another BHS staff member, which is the direct care to the youth of ACT. So I'm also the program manager for the adolescent outpatient program. So provide all the clinical supports and supervision for the clinical staff for all of our outpatient kids. So my role primarily is the oversight of the day to day operations and making sure everything runs smoothly. And the care for the kids is meets the state standards, as well as our local and mental health center protocols, and providing just care for kids who needed additional supports outside of the home environment.

Theresa Freed  02:02

All right, and so many people probably don't really know what the center is all about and what its purpose is. So if you can talk about that.

Kevin Kufeldt  02:11

Sure. So the adolescent center for treatment was started about 35 years ago here in Johnson County. And the role of ACT is to provide residential substance abuse treatment for youth ages 12 to 18. We serve the entire state of Kansas, although we do put a priority on Johnson County Youth, we also serve kids from across the entire state. So many of our kids come to us with severe substance use disorders, along with mental health conditions such as depression, and bipolar and a lot of trauma history with our kids as well, with ACT, because we're the only one in the state of Kansas, we have kids coming from, you know, probation, the court services, they're in state custody, we also just get kids that are coming that families have concerns about their child's substance use involvement. So really providing a comprehensive level of care for all kids, and also focusing on their mental health conditions as well.

Theresa Freed  03:07

And so when you talk about that age range, going all the way down to 12. It's kind of hard to believe that that children that young are encountering this issue. So can you talk a little bit about that?

Kevin Kufeldt  03:17

Sure. So the average age of first use in the state of Kansas for any substance is 12 years old. So we're talking middle school kids, we're talking sixth grade, going into seventh grade. So the average age of first use continues to go lower and lower, as we see the stigmatism attached to cannabis use going on going away the availability of vape devices and electronic e cigarettes So kids are using at an earlier age. And we're seeing that we need to now provide more preventive strategies into the middle schools and also start kind of educating folks at the at the elementary level too. So what once was targeting high school kids with substance use prevention and treatment? Well, now we're starting to narrow that scope down to a younger age as well.

Theresa Freed  04:02

And so what kinds of substances are children encountering.

Kevin Kufeldt  04:06

So the number one drug of choice throughout the state of Kansas would be nicotine. So that'd be number one. But then, when you pull nicotine and vaping out of the equation, we're looking at marijuana and alcohols being number two and three. Obviously, marijuana is being legalized across the nation from some medicinal uses, as well as some recreational use from state to state so we are seeing more of an availability of some of those higher potency marijuana components with edibles. The concentrates are kind of hitting the market pretty hard from from DAB devices and oils and concentrates and carts. And then alcohol is always kind of a staple that's available in a lot of our community in our home environments, too. So but then what we're seeing now is a rise in fentanyl abuse with our adolescents and adult population two so a lot of this fentanyl is counterfeit pills. So that appear to be an opioid, kind of like a Percocet or or oxycodone, but they are laced with fentanyl. So we're seeing a drastic increase in Johnson County area with youth abusing fentanyl laced products.

Theresa Freed  05:11

So as part of the work that's done there at the center is that a detox as well or

Kevin Kufeldt  05:17

so ACT is not a detox facility, we do have the adult detox unit located in our facility for adults. But there is not a detox unit in the state of Kansas for kids. So when we do get a kid that admits to our program, and they've been using drugs, they spent about that first day or two really trying to withdraw from some of those products. They're real sleepy, they're agitated, they're not hungry, or they're real hungry. So we work with the youth as they're coming down off of those substances, and get them acclimated to being in treatment, and really kind of assist them and help them get through the next couple of weeks.

Theresa Freed  05:53

And you have a pretty tremendous staff there that can provide that individualized care. So at what angles are you coming? To do that?

Kevin Kufeldt  06:02

Sure. So we do have a wide variety of staff. So we have a full time nursing staff member that is Monday through Friday, that helps with the day to day medical needs, and medication observations and administration. I've got direct care staff that work in shifts from 8am to midnight. So you know, and then midnight to 8am. So lots of staff doing lots of different tasks and roles a lot of has to go in terms of life skills, training and behavior management. I've got licensed staff that provide group facilitation. And then I've got clinical staff that provide day to day individual therapy, group therapy, family therapy, and so doing a lot there with the emotional behavioral piece along with the substance use piece. And then I've got administrative staff that are here to help out with access to care and getting them into our program and providing some of those needed help or needed supports to families that are seeking services.

Theresa Freed  07:01

And then I know you're focused both on the physical well being and mental well being in one of those components is is getting exercise and learning the basic life skills. So can you talk about how that's worked into the center?

Kevin Kufeldt  07:14

Yeah, certainly we do a really a holistic approach to recovery. So you know, we have community members that volunteer their time to come into our program. Twice a week, we have a yoga instructor that shows up does a lot with the youth on breathing techniques, and stretching and just really kind of that Mind, Body Spirit kind of mentality. We do a lot with, you know, educating the kids on proper hygiene, and proper food intake and not drinking a bunch of Dr. Pepper every single day and eating a bunch of junk food. We have volunteers that come in that assistance with anger management with the kids, we have partnerships with the Johnson County Library. So teaching kids about reading skills, we do a lot with journaling. So just really kind of helping them learn different strategies and different ways of coping with not only the stress of life, their individual depression and anxiety, but then also, how do I deal with the triggers to wanting to use How do I deal with my environment, the family component and working with my family and having open and honest conversations. So when I say holistic, we do mind body spirit, it's all in captured, while we're talking about the support for kids at ACT.

Theresa Freed  08:21

And it's also pretty impressive how packed the days are, too. So can you talk about what it looks like from the moment they wake up until they go to bed?

Kevin Kufeldt  08:31

Certainly. So we're huge on routine, we're huge on structure and supervision. So on a typical day, a youth wakes up around 630 in the morning to kind of get themselves moving around a little bit, we get them out in the day area for some breakfast. And then after breakfast, we have a morning community meeting which is client driven. So it's really kind of taking a look at what my goals are for today. What I'm working on. After that community meeting, we transitioned him up to school. And because we are in the Shawnee Mission School District, we've contracted with the Shawnee Mission schools to provide academic instruction. So the kids go to school for three hours. After that academic block time they go into a recovery counseling hour with one of my licensed staff members. And throughout all that time, they're also meeting with their clinician for individual and family therapy. And then they go into some lunchtime and some free time. And then after that we hit him up with some more recovery, counseling and relapse prevention groups. And then after that we have some physical activity time where kids are outside shooting hoops playing badminton, playing some volleyball, we've partnered up with the Maryam community center that they can go out to the community center and work out lift some weights, get on the elliptical machines, shoot some hoops. And then we come on back to the facility. And we do whether we have a volunteer coming from the community. We have presenters that come in and share their stories of recovery. And then we do some additional recovery hours during the evening and then we kind of start to wind down the night. We don't do A lot of technology late at night because we really want their minds to kind of come at ease. We do kind of a rest and reflect kind of our there's some meditation music going on, they can do some yoga, they can do some journaling, and then we kind of we wind the night up, get them back in their rooms, and we start all over again the next day.

Theresa Freed  10:17

All right, and then can you talk a little bit about the food service that you receive as well,

Kevin Kufeldt  10:21

Certainly, so we've partnered up with HyVee, so HyVee brings in our lunch and our dinner options for the kids, it comes fully heated, ready to be served. And that way, you know, we really tried to emphasize the importance of good nutritional health as well, a lot of folks who are coming to us having been abusing drugs, and alcohol, they haven't been taking very good care of their bodies. So a lot goes into the nutritional aspects of, of what we serve the kids, we also utilize Positive Behavioral Supports, where they're able to purchase additional snack items throughout the day in the evening. You know, what we found is that if you have a healthier person, both from the calorie intake and also from asleep, they're able to adjust much better to treatment, they're awake throughout the day, they're well rested, they're energized, and they're able to kind of focus on their individual recovery throughout the time that they're here.

Theresa Freed  11:12

There's probably some good advice for parents in general there about just making sure that kids get a good night's sleep and healthy foods so that they're also more engaged maybe at school or in more receptive to, to parenting rules and things like that as well. Sure,

Kevin Kufeldt  11:28

And you know, we emphasize, you know, kind of like a family eating style. So the kids are all eating together at the same time with the staff. And I think that, like you said, Theresa, even carry that over to the home life, developing structure, but eating together as a family and having those conversations because too often we get stuck with our face and our phone, or we're bouncing around from activity, really taking the time to sit with your family, have those family conversations, asking questions about what your day looks like, where did you go? What do you do for fun? Who were you with? So just being an involved parent, asking questions, and keeping in mind, you are a parent, you're not a friend, and really asking those important questions. So you can help raise your kids to be strong, productive members of society too.

Theresa Freed  12:11

Great, great advice there for sure. So what is the average stay for those who are staying there?

Kevin Kufeldt  12:17

Sure. So a youth coming into ACT stays for about anywhere from three to four weeks on average. So it's about 24 days, but we are designed, kind of from a curriculum standpoint to be four weeks, when a youth first arrives and treatment like kind of mentioned earlier, they may be withdrawing from their substances. So the first couple days really are a foundational point of services, kind of getting them acclimated, but then also kind of teaching them some of those early recovery skills. And then as treatment kind of progresses on, we see their mind kind of return back to a homeostasis kind of level. And they're able to kind of start thinking a little bit more rationally, they're able to engage in conversation a bit better with their clinician, start focusing more on what the relapse prevention is going to look like. And really start honing in on some of those skills to better assist them is when they return back to their home community. So by about that four week, stance, you know, what once looked like resistance to coming to treatment, because a lot of times the kids aren't asking to come to ACT, you sit kind of see their mind morph into this, oh, my gosh, now I have to go home, I have to go back to that environment. So they really kind of be a little bit more anxious about leaving. So it's really great to see them invest in their own time and their own energy when they get to a CT and really start making some identification of what they need to do differently with life.

Theresa Freed  13:37

And are there supports available after they leave to make sure that they you know, don't relapse and don't need the center’s help again?

Kevin Kufeldt  13:43

Certainly because we do serve the entire state, we do a lot of coordination with different communities. But for instance, with Johnson County specifically, we do recommend a lower level of care once they complete treatment with us because we are the highest level of care, it's only appropriate that we send them back down to an outpatient level of care. So with Johnson County Mental Health, we have our ALS program that I oversee. So we'll make some recommendations that the families and the kids that they continue with outpatient treatment. And my program specifically provides the individual family and group along with case management services. And we also kind of partner up with, with our providers in the mental health center to continue with medication management. So and we also partner up with the school districts. So when the kids are here, we're communicating with them so that when they do go back home, they know that they have an avenue to communicate with us as well. And the school district have really been great about allowing my outpatient case managers to come into the school, provide some of those supports or even pull them from the school hour and just kind of help them throughout the day because school is oftentimes a very stressful time for a youth in recovery.

Theresa Freed  14:51

That makes sense. Well, I know that you know not every person leaves there with amazing outcomes, but you've been able to witness something pretty impressive outcomes. And so can you talk about some of the youth that you've touched their lives and they've actually expressed gratitude or appreciation for the work?

Kevin Kufeldt  15:11

Certainly, yeah, you know, going along with your theme of gratitude, we do have Thanksgiving coming up. And I've pointed out before, I can always say how grateful I am and appreciative I am to be working for the county and to have the job I have and working with the people I work with. But my favorite part of the gratitude piece is when we discharge a youth, they oftentimes leave a little bit letters, a little letters for staff in their rooms, and some of these letters that we get to read and share with each other, just talk about the amount of care that they received, and how grateful they are that they actually came to treatment. They talk oftentimes about the seeds that they that my staff have planted in them to, to flourish and be successful in life and to, to live a life of recovery. They talked about learning skills that they didn't think that they possess, whether it was leadership, or compassion, or just caring about other people, we hear from the families about how we've ultimately kind of saved the lives of their children that they were so worried about their kids in their the spiral X that they're going through in their lives, but now they have an opportunity to get their kids back to, to hug their children to enjoy their time with them. So really, that's the gratitude that we appreciate is hearing from the kids that we've provided care to.

Theresa Freed  16:23

That's awesome. And I am sure quite a morale booster for staff as well. So just kind of finally, you know, as we're talking to a broader audience here through the podcast, you know, What should parents be looking for? You know, at what point should they be seeking services through you guys?

Kevin Kufeldt  16:41

Sure, you know, there's a lot of times that we say there's a lot of red flags that come up, they're sometimes tough to see as a parent, because when you're in the middle of it, but when you start to see your child kind of declining from what their typical level of achievement look like, if they're not doing well in school, if they're no longer playing sports, if their social circle of peers have drastically changed, that you don't see the old friends anymore. Maybe the hygiene is starting to decline that they're not dressing as nicely as they once were. They smell a bit differently. They leave the house wearing one outfit coming back in a different outfit. So all these little things that you start to take a closer look at. But really those that school environment, the grades or getting fired from a job, or those are all pretty strong signs that things aren't going well for them. They're more argumentative in the home. Maybe they're sleeping all day. I mean, yes, it's common for teenagers to want to take naps, but they're sleeping all day. They're up all night, they're sneaking out at night, all these little things that you're going to be like, Man, this is, this isn't like what my son and daughter used to be like. So when you start to see those things, really reaching out for some supports, obviously, the county has the mental health center that provides a lot of supports from a case management perspective, from a medication perspective. We have young adult programs, we have pediatric programs, we have the substance use program, so really reaching out to the mental health center and getting some support there. People want to know, do I need to start with outpatient do I need to start with residential, when they call our facility 913-715-7632 that talks to one of my admin staff members, and they'll provide some recommendations for getting an assessment completed. And we do a full psychosocial assessment. It's about a six dimension assessment that will help you identify Does my child need to be an outpatient services or residential services? Now, our current facility AC T is a 10 bed facility. And folks want to know, is that enough to serve Johnson County is it enough to serve the state. And unfortunately, right now we are sitting out a waitlist into March right now. So we know there are a lot of youth out there that are requiring services. So that's why we do sometimes make a recommendation that yes, your child may need residential, but we're going to start them in outpatient services. So we can comprise provide that care to them leading up to residential services. So once the assessment is completed, we make some recommendations, we kind of help the families align with the services that the child will be needing, and we'll help them out with kind of exploring the financial obligations versus insurance purposes and, and what we can do to best help them out.

Theresa Freed  19:24

That's great. certainly sounds like there's plenty of resources here in Johnson County and parents are not alone, it might be a very scary thing to encounter to consider that your child might be using the substances and, and just knowing where to turn and where to go for those initial first steps, I think is a huge thing. So we will of course have more information about how to access services in the show notes of this episode. And Kevin, I just want to thank you for being on here today and sharing information about the center.

Kevin Kufeldt  19:53

Happy to help out Teresa, thank you very much and if there's ever any questions that folks need, do not hesitate to reach out to us and we will do it again.

Theresa Freed  20:00

Sounds good. Alright and thank you for listening.

Announcer  20:03

You just heard JoCo on the Go. Join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCoGov. For more on this podcast, visit jocogov.org/podcast. Thanks for listening.