FY19 ACS Annual Report

acskids.org Helping kids envision and work toward a better future ADOLESCENT CONSULTATION SERVICES FY19 ANNUAL REPORT

Mission Statement Adolescent Consultation Services supports and empowers court-involved children and families by providing mental health prevention and intervention services to help them envision and work toward a better future.

FRAN MILLER BOARD PRESIDENT For 46 years, ACS has been helping children and families involved in the juvenile justice system get back on track and forge a positive path forward. Each year, it seems that the struggles our kids face grow more complex and serious. Despite the increased need and complexity, our highly trained clinicians remain committed to providing the maximum level of support and treatment to the children and families we serve. I am consistently impressed by the dedication and expertise of our clinicians who work tirelessly each day to ensure that every child receives the help and hope they need and deserve. You, our donors and supporters, are the reason we can respond quickly and effectively to the ever-changing needs of our children and families. Many of you have supported ACS for much of our 46 years and deeply understand the importance of our efforts. Thank you for sticking with us and continuing to support our work with some of the most vulnerable children in our community. Simply put, your help makes ACS possible. Gratefully, Frances H. Miller LEAH M. KELLY EXECUTIVE DIRECTOR ACS clinicians help kids face their challenges, get them the help and support they need, and set them and their families on a path toward success. Rarely is it a path free of obstacles and occasional missteps, but one that will eventually get them to where they need to go. Last year, we served over 400 kids and families. About 70% of the kids we see have known histories of trauma, though we know this figure to be higher because kids often don’t disclose distressing experiences. 72% of the kids we served last year had at least one significant mental health or substance use condition, and over 40% have exhibited suicidal thoughts or behaviors. These statistics can be discouraging, but our dedicated clinicians respond with, “How can I help?”, “What services will have the biggest impact?”, and “What more can we do?”. We are constantly looking at ways to enhance and strengthen our programming. This year, we launched a pilot drop-in group for teens and published the 4th edition of Kids and the Law. Our clinicians educated the community and other professionals by presenting at professional conferences and leading specialized workshops. These efforts give voice to the hundreds of children and families we serve each year and the complexity of their needs, as well as their resilience and capacity to thrive. With Gratitude, Leah M. Kelly, Psy.D. 1

Who You Help and FY19 Outcomes 412 RACE kids received help 76% from ACS UNKNOWN 6% 15% in FY19 AFRICAN AMERICAN of the families we served CAUCASIAN 45% received insurance coverage HISPANIC 15 27% through MassHealth, ASIAN 7% a common indicator of poverty. AVERAGE AGE GENDER 37% 1% 72% 62% GIRLS TRANSGENDER/ were struggling with at least GENDER NON-CONFIRMING one psychiatric condition BOYS 79% Mood Disorder AGE 1% 11% 71% Anxiety and 4% UNDER 7 54% Trauma-related Disorder 7-12 30% 70% ADHD 13-15 42% Suicidality 16-17 33% Substance Use Disorder 17% Self-injurious behavior 18+ 2

ACS serves kids and families across the 54 cities and towns of Middlesex County, home to the largest population of youth under the age of 18 and the most populous county in New England. We directly serve the county’s four Juvenile Courts, located in Lowell, Framingham, Cambridge, and Waltham. FY19 Outcomes Our highly skilled clinicians follow-up with the children and families we serve to track the following outcomes to measure program effectiveness. 77% of children increased their compliance with treatment and recommendations 78% of children improved their attendance at school or an alternative educational setting 88% of families became more engaged in treatment 3

Alexis’s S T O R Y Alexis* is a bright and personable 14-year-old girl who has had ongoing behavioral difficulties both at home and school. After some particularly challenging episodes, Alexis’s mother, Nicole*, had come to realize that her behavior was beyond her control and filed a Child Requiring Assistance (CRA) application with the Juvenile Court. The presiding judge referred Alexis to ACS for a comprehensive diagnostic evaluation. An ACS clinician met with Alexis, interviewed her family members and teachers, and carefully reviewed her extensive medical and school records. Alexis had received a range of mental health diagnoses over the years and had worked with multiple providers, yet things had not improved. The clinician knew that without the right interventions, Alexis was at high risk for dropping out of school, putting her at greater risk for further involvement in the juvenile justice system. Nicole found it difficult to communicate her daughter’s complex challenges to her school. To support Nicole, the clinician attended a meeting at the school to help clarify and advocate for Alexis’s needs. The clinician recommended that Alexis be permitted to return to public school, but noted that her success depended strongly on the school’s willingness to provide special accommodations to support her transition back into the classroom. A few months after Alexis’s re-enrollment, Nicole wrote to ACS, “Thank you again for your help in getting her back into school! Thank you for all of your advice and assistance over the last year. Hopefully we will be in a stretch of smooth sailing, and I appreciate your offer of assistance if needed.” *To protect confidentiality, ACS does not use the names, photos, or identifying features of our clients. 4

Diagnostic Evaluations and Student Training Program DIAGNOSTIC EVALUATIONS ACS clinicians conduct same-day emergency mental health and substance use evaluations and extended comprehensive evaluations of youth involved in the Juvenile Court. Our clinicians conduct in-depth interviews with the child and family, gather school and medical records, consult with providers and educators, and prepare a detailed report of their findings. The report tells the story of the child and family in a new way, taking into account the many facets of the child’s life and their unique circumstances. A careful and detailed formulation is developed, informing a list of thoughtful and individualized recommendations intended to target the unique needs of the child and their family. I M PA C T 428 comprehensive diagnostic evaluations completed 85 same-day emergency evaluations completed STUDENT TRAINING PROGRAM ACS is a ‘teaching’ clinic for behavioral health professionals. We maintain a robust and longstanding training program for graduate students, medical residents, and post-doctoral fellows from prominent academic institutions in social work, psychology, and psychiatry. Under close supervision, trainees learn to conduct comprehensive evaluations for youth involved in the court system. By the time they have completed their clinical internship or rotation, they have developed a deep appreciation for the complex needs of these youth. ACS staff includes a diverse, interdisciplinary team of social workers, mental health counselors, and psychologists. 5

Treatment ACS offers individual, family, and group treatment at no cost to families. Individual sessions often focus on helping the child find positive ways to manage life stressors; family sessions may focus on improving communication within the home; and group sessions reduce a young person’s isolation while helping them build critical life skills. The depth of their need and the level of their involvement with the juvenile justice and child welfare systems vary greatly. Children referred to ACS by the District Attorney’s Juvenile Diversion program are most often facing delinquency charges. In these cases, a child’s successful completion of our treatment program will usually result in a dismissal of their charges. I M PA C T 310 hours of no-cost treatment provided 80 kids and their families received treatment services Our goal is to disrupt the school-to-prison pipeline by providing the professional mental health services children need to improve their long-term health and well-being. 6

Group Treatment In FY19, we launched “Get Out of the Court System and on with Your Life.” This psychoeducational group helps kids learn the skills needed to understand and cope with the challenges they face. Sessions are tailored to the needs of the group and areas of focus often include: ◆ Effective communication skills ◆ Stress management ◆ Dealing with anger and conflict resolution ◆ Dealing with peer pressure ◆ Understanding healthy relationship boundaries ◆ Safe and responsible use of social media ◆ Coping with emotions ◆ Alcohol and drug education What is something “How to control my anger, different ways to talk to people and how to be more confident. I think you learned in that group helped me a lot. Thank you for the Group Treatment support and showing me the right path.” at ACS? “How to manage my stress.” “How to cope with my emotions respectfully and how to talk about my feelings without being rude … there were things I needed to work on and everything I learned definitely helped me.” “To control my anger in school and out.” 7

Education and Advocacy EDUCATION & ADVOCACY FOR CHILDREN AND FAMILIES ◆ Education of children and families about mental health concerns and the juvenile justice and child welfare systems. ◆ Advocacy for clients and assistance linking them with appropriate community services, such as medical care, mental health treatment, and in-home support for the family. ◆ Follow-up, with clients and providers, to help ensure that the recommended services are in place. EDUCATION & ADVOCACY FOR THE COURT AND COMMUNITY ACS has close ties with court personnel, schools, and community providers, who often turn to us with questions to help them better understand a variety of topics ranging from basic court procedures to how to access mental health services. We educate providers about the needs of high-risk, court-involved children and advocate for enhanced services and support for families. KIDS AND THE LAW: A USER’S GUIDE TO THE COURT SYSTEM As a part of our effort to educate the community about the juvenile courts, ACS published Kids and the Law: A User’s Guide to the Court System in 1996. The book is co-authored by Rebecca Pries, co-chair of the Massachusetts Alliance of Juvenile Court Clinics (MAJCC), and attorney Carol Rosensweig. Kids and the Law serves as a valuable and user- friendly resource for adolescents, families, and professionals. This resource continues to be revised to reflect periodic changes in juvenile law. The 4th edition was released in December 2018. I M PA C T 212 kids and families received Education & Advocacy services The research is clear that keeping kids out of the juvenile justice system is critical to ensuring a better trajectory for their future. 8

Vincent’s S T O R Y Silvia* and Carlos* immigrated to the United States with their two young children after surviving a series of traumatic events in their home country. The transition to their new life in Massachusetts was difficult and brought many challenges. Silvia and Carlos’ 13-year-old son, Vincent*, had attended only five days of school during the first four months of the school year. Due to excessive truancy, Vincent’s school filed a Child Requiring Assistance (CRA) application with the Juvenile Court. The presiding judge referred Vincent to ACS for a comprehensive diagnostic evaluation. An ACS clinician interviewed Vincent. She immediately observed his emotional distress and behavioral difficulties, including refusing to talk with her. She understood that his struggles were likely linked to his exposure to serious and prolonged stress, including traumatic events in his home country, a frightening immigration experience, chronic housing instability, and severe bullying by his peers. After interviewing Vincent’s family members, teachers, and healthcare providers and carefully reviewing his medical and school records, Vincent’s clinician presented her recommendations to the Court. She recommended that Vincent be placed in a specialized residential facility where he would receive trauma-informed care and the stability he desperately needed to begin to heal and make meaningful progress. Our clinician’s work didn’t stop there. She followed-up with the family, attorneys, and providers to ensure that Vincent received the recommended services. The tireless education and advocacy efforts she made on Vincent’s behalf enabled him to secure a spot in a long-term therapeutic residential program. The clinician also helped Silvia and Carlos enroll in a parenting support group and the whole family is now engaged in family therapy. *To protect confidentiality, ACS does not use the names, photos, or identifying features of our clients. 9

ACEs: Adverse Childhood Experiences The Centers for Disease Control and Prevention (CDC) examines the connection between childhood exposure to ten types of stress and trauma that can lead to significant and potentially deadly health risks. Number of ACEs in youth PERCENTAGE OF YOUTH 48 % nation-wide vs population 12% served by ACS 36% 26% 16% 17% 9% 14% 12% 10% National Average* 0 1 2 3 4+ Population served by ACS** NUMBER OF ACEs *Based on ACEs Study conducted by the CDC **127 total ACEs questionaires from ACS clients What is the link between these ACEs and adverse health and social outcomes? ACEs, such as: Mental health issues, Maladaptive coping • emotional abuse such as: strategies, such as: • physical abuse • sexual abuse • anxiety • self-injurious behavior • family dysfunction • anger • alcohol and drug use • depression • high-risk sexual behaviors If untreated, can lead to… which can result in… increasing the risk of... We cannot erase the adversities a child has experienced; however, we can nurture resilience and a sense of hope, both critical to better outcomes. 10

11% 36% Emotional abuse Physical abuse 28% Sexual abuse 31% Prevalence of Adverse Emotional neglect 21% Childhood Experiences 12% 13% 43% Physical neglect 27% 30% Mother treated violently 19% 49% Household substance abuse 23% 45% Household mental illness 5% 52% Parental separation/divorce 15% 78% Incarcerated household member 10% 22% Long-term outcomes, 48% such as: of children served by ACS • suicide attempts had experienced four or more • chronic health conditions Adverse Childhood Experiences (ACE) • premature death 11

MAJCC: sustaining critical services ACS is proud to be a founding member of the Massachusetts Alliance of Juvenile Court Clinics (MAJCC). Below are some of the many highlights from the past year. MAINTAINED FUNDING IN FY20 STATE BUDGET MAJCC lobbied and advocated to maintain the gain of $1.5 million achieved in the FY19 State Budget in the FY20 State Budget. These efforts were successful and funding for the juvenile court clinics maintained the unprecedented increase! PASSAGE OF CRIMINAL JUSTICE REFORM LEGISLATION The passage of the Criminal Justice Reform act in April 2018 changed the lower age of the Juvenile Court’s jurisdiction on delinquency matters and provided for increased diversion initiatives and expungement of juvenile records. It instituted a Juvenile Justice Policy and Data Board (JJPAD) and a Task Force on Emerging Adult Issues to further explore the issue of raising the age of juvenile jurisdiction and report back to the Legislature. The bills in the House and Senate to increase the age of Juvenile Court jurisdiction up to age 21 remain under discussion. MAJCC staff continue to stay up to date on these initiatives. EDUCATE NEW STATE REPRESENTATIVES AND SENATORS MAJCC representatives and our lobbyist met with the legislators to educate them on the needs of court-involved children and families and the critical importance of juvenile court clinic funding. INCREASED ADVERSE CHILDHOOD EXPERIENCES (ACES) DATA COLLECTION Last year, juvenile court clinics across the Commonwealth collected ACEs data on 631 children. The median number of ACEs in the CDC study was 1 out of 10, while the median for the juvenile court clinic sample was 5 of 10. This information Nationally, 70% strengthens MAJCC’s advocacy platform and provides conclusive evidence of the extraordinary needs of this population. of children in the juvenile justice system have at least one mental health condition and at least 20% are diagnosed with a severe mental illness. 12

Fall Event OCTOBER 2019 H E A L , G R O W, & T H R I V E an evening devoted to kids and families in need of Help and Hope ACS friends, donors, and supporters gathered to honor THE HONORABLE JAY D. BLITZMAN, the First Justice of the Middlesex County Juvenile Court, with the Rebecca Pries Indispensable Friend Award and welcomed JORDAN BURNHAM, Mental Health Advocate, as our keynote speaker. 13

FY19 Donor List Thank you for believing in our mission and empowering high-risk kids and their families. ACS is extremely grateful for all of our generous supporters. This list highlights donors whose financial contributions were received during FY19 (7/1/2018-6/30/2019). LEADERS Jim and Lois Champy Debbie and Ron Eastwood Mary W.B. Curtis Trust Robert I. Glimcher Family Foundation GIFTS OF $10,000+ Fish Family Foundation Terrie Graham Forest Foundation Joseph E. and Frances E. Heney Bank of America Charitable Gift Fund Orville W. Forte Foundation Charitable Trust Marion B. Boynton Trust, Roy A. Hunt Foundation Daniel Jacobs and Susan Quinn Bank of America, N.A., Trustee Swanee Hunt Family Foundation Alison and Dan Jaffe Cabot Family Charitable Trust Elizabeth Keating Barbara Lee Cogan Family Foundation Margo Kelly Fran and Hugh Miller Cummings Foundation Barbara Leggat Tony and Kitty Pell The Janey Fund Charitable Trust Edward H. Mank Deborah Porter and The Klarman Family Foundation John Petrowsky Nicholas Negroponte Jonathan Kutchins Beth Pfeiffer Frank and Carolyn Reynolds William and Margaret Paine Gardiner Howland Shaw Foundation Eric Shank The Philanthropy Connection Trustees of the Ayer Home Jane and Ben Siegel The William and Lia G. Poorvu Frederick E. Weber Taylor Snook and Robyn Eastwood Family Foundation Charities Corporation Chris Snook and Susan Stoddart Karen F. Richards Charles K. Storey A D V O C AT E S The Stevenson Family Charitable Trust Public Sector Rich Wenger Department of Mental Health GIFTS OF $1,000-$2,499 David Wilcox and Charlotte Pierce Massachusetts Juvenile Court Wolf Greenfield Anonymous CHAMPIONS Judith Aronstein ALLIES Rhoda Baruch GIFTS OF $2,500-$9,999 Hon. Ann W. Brown GIFTS OF $250-$999 Citizens for Juvenile Justice Grace K. & Wesley S. Alpert Cosette Charitable Fund Anonymous (8) Charitable Foundation Anne Covert The Aquidneck Foundation Anonymous (2) Peter B. Culman Memorial Fund Sandy Bakalar Ronald Ansin Nancy Donahue Richard and Bonnie Barnum Frederick A. Bailey Trust; Robert Doran Molly Beard BNY Mellon, N.A., Corporate Trustee Thomas and Andrea Dupree Paul and Katie Buttenwieser Bennett Family Foundation East Cambridge Savings Bank Pete and Sara Caron Cambridge Community Foundation Eastern Bank Charitable Foundation Lael and Charles Chester Bushrod H. Campbell and Adah F. Hall Charity Fund 14

Barbara Clark Edward A. Shapiro and Elaine Dunn Anne Ellsworth Deborah Benik Laura Dziorny Holly and Chris Ferguson Robert Silberman and Nancy Netzer Eleanor Edelstein Jonathan Gingerich and John and Judy Styer Judy Ellenzweig Bal-lan Yen Gingerich Mark and Lynne Wolf Melissa Dawn Farley Jonathan Hecht and Lora Sabin Marilyn and Irvin Yalom Hon. Margaret S. Fearey Hon. Julian Houston and Fiduciary Trust Company Susan Levine Houston SUPPORTERS Joseph Figueiredo and Linda Stewart Hughes and Company Susan Flood Jack’s Abby GIFTS UP TO $250 Peter and Kathleen Forbes Leslie Joseph Nancy and Richard Fryberger Leah M. Kelly Anonymous (8) Hon. Gail Garinger Sam and Emily Leadholm AmazonSmile Foundation Monique Garrity Franklyn MacLean Dorothy Anderson Dori Gerber Kristin and John Macomber Susan Ayers and Nancy Salonpuro Owen and Miriam Gingerich Joe and Rachel Martin Benevity Community Impact Fund Robin Gottardi Susan and Pieter Mimno Judith and Stephen Bernstein Laura Gray Robert and Dale Mnookin Hon. Jay D. Blitzman and Bill and Grace Gregor Neil Motenko and Mindy Margulies Sandra Jaffe Bethany and Scott Hadley Muse Paintbar Caren Bobroff Nancy Haslett Linda Myers Leslie Boden and Judy Yanof Lora Heims Tessman Mary and Sherif Nada Elizabeth Broderick Dan Hennessey Martha Ondras and Martin Pearlman Edward J. Brennan, Jr. Martin and Susan Heyman Timothy and Joanne Oyer Josh Buckley Howard Hiatt Shirley and David Parish Cappetta Law Offices Gerald and Nina Holton Mary and Gary Pforzheimer Emile and Sandie Caron Leslie Homans Jonathan and Amy Poorvu Esther Chen Janice Hrabovszky William and Helen Pounds Colleen Clinkscale and Timothy Lynch Katherine and Ralph Hughes Laura Prager and Frederick Millham Ellen Cohen and Daniel Haber Jan Hurwitz Adele Pressman Michael Collins Emily and David Hutcheson Rebecca and Weldon Pries Hon. Rosemary Connolly Judy Hyatt and Fred Goldstein Helen and Peter Randolph Priscilla Damon Melissa Hyer Max Riffin Dawn Darnell Theodore and Bernadine Jacobs Abby Rockefeller and Lee Halprin Rosemary Davis Michaela Johansen David and Deirdre Rosenberg Elaine Denniston Cheryl Jones Mimi Ross and Howard Goldstein Karen Dobson Rudolph Kass Hon. Leslie Donahue Kimberly Dunham 15

FY19 Donor List Jacquie Kay Katherine Page and Alan Hein Soledad Valenciano Lee Ketelsen Shirley Partoll Sophie Wadsworth Laura Khoshbin Gladys Paul Natalie Waggaman Michael and Susan Kilkelly Mathilde Pelaprat and Stephanie Walsh Kilkelly Law Offices Kristen Van Damm Jonathan and Stephanie Warburg Patrick King and Sandra Moody Kathy Pilarski Howard Wishnie and Catherine Mitkus Judith Klau Amy Pitter Margaret Witecki Rona and Michael Knight Jane Prager Anna Wolff Jane Kokernak Regina Pyle Norma and Arnold Zack Tom Kreider Eggert Ragnarsson Hilary Ziven Thomas and Vera Kreilkamp Emily Restivo Montserrat Zuckerman Cheryl Kyle Deborah Reyes Michael Lafleur and Johanna Benotti Pam Reznick IN-KIND Leslie LaGasse Catherine Riffin and Patrick Smith Boda Borg Marcia Leavitt and Andrew Cohn Natalie Riffin Pete Caron Missy and Christopher Lipsett Pam Riffin Susan Flood Rosemarie Lipton Hon. Daniel Roache Daniel Jacobs Christine Lovoie Martha Rodriguez Massachusetts Trial Court Alaina Lyon Tracey Rooney The Smoke Shop BBQ Elizabeth and Stephen Maglio Carol Rosensweig Gina Mantica Eleanor Rubin Thank you! Karen Martinez Dan Sanford Deborah Mccarriston Gema Schaff Joseph McOsker Robert N. Shapiro Brandy Mehlhouse Kathy Simon Mary and Ross Mitchell Thomas Simons and Carolyn Moore Margaret Quinn Simons Alexandra Moretti Claude and Elizabeth Smith Gale Munson and John Lewis Robert Straus Judi Neu Charlotte and Peter Temin Bridget Nichols Katharine Thomas Ariane Nick Jane Thorbeck Matthew Nikkel-Dumyahn Alexander True Scott O’Gorman Felicity and Jeff Turgeon Hon. Susan Oker Nancy Tye 16

Financials FY2019 From the most recent audited fiscal year: July 1, 2018 – June 30, 2019 OPERATING REVENUE Public Sector $1,243,238 Corporate and Foundation Grants $370,427 Individual Contributions $153,391 Investment Income $123,421 In-kind $94,709 Other income $33,632 TOTAL $2,018,818 OPERATING EXPENSES Program Services $1,387,296 Management and General $207,676 Fundraising $80,178 TOTAL $1,675,150 17

BOARD OF DIRECTORS ADVISORY COUNCIL Frances H. Miller, President Gerald Chertavian William H. Paine, Chair Roxann C. Cooke Jacquie L. Kay, Treasurer Nancy L. Donahue Jane R. Siegel, Clerk Robert Gittens Terrie Graham Joel Goldstein Daniel H. Jacobs Silvia M. Gosnell Elizabeth Keating Fatinha R. Kerr Leah M. Kelly Barbara Leggat Michael A. Lafleur Charles J. Ogletree, Jr. Lia G. Poorvu Kathy Pilarski Laura M. Prager Jorge Quiroga Mary M. Shahian Eggert Ragnarsson Charles K. “Chip” Storey Katharine E. Thomas David K. Wilcox Kathan Tracy FY2019 Annual Report ADOLESCENT CONSULTATION SERVICES, INC. 189 Cambridge Street, Cambridge, MA 02141 T 617.494.0135 F 617.494.0136 www.acskids.org /acsinckids @acsinckids @acs_kids