FY20 Annual Report

acskids.org ADOLESCENT CONSULTATION SERVICES FY20 ANNUAL REPORT

What Gives The human spirit. There is a strong, mutual sense that we are all in this You Hope? together. People are saying, “I hope you are well” much more than they have in the past, and they mean it. – Colleen Clinkscale, Clinician Me. If I didn’t have hope in myself, I wouldn’t be doing this. (Referring to participating in group treatment.) – ACS Teen Client The unstinting commitment and dedication of the ACS staff to help the vulnerable youth that are referred to us for support. – Lia Poorvu, Board Member Witnessing kids and families doing the best that they can despite extraordinarily challenging circumstances. – Dr. Elizabeth Shepherd, Clinician The resiliency I see in the kids we serve. Despite the disappointments they’ve experienced, they remain hopeful that one day there will be an opportunity to regain the moments that they missed. – Michaela Johansen, Clinician The determination and grit we witness every day in the young people we serve. Kids are more resilient than adults, and in many ways, far braver. With those qualities, the sky is the limit. – Dr. Leah Kelly, Executive Director

FRAN MILLER BOARD PRESIDENT The pandemic’s impact on 2020 was challenging for everyone. The isolation caused by COVID-19 was particularly challenging and stressful for the children and families we serve, who often lack resources to cushion the impact of medical and financial trauma. ACS clinicians worked hard to build the resiliency in each and every child we served and helped them surmount the obstacles they faced during these trying times. We are proud of what our staff and the children we serve accomplished this past year, and they couldn’t have done it without you. Because of you, each child and family we work with has hope. Hope for a better future. Thank you for making this possible. Gratefully, LEAH M. KELLY Fran Miller EXECUTIVE DIRECTOR This past year has brought extraordinary challenges. While these challenges have helped some of us discover our true capacity for flexibility and resilience, for others, the effects have been devastating. The kids and families we serve at ACS are incredibly vulnerable. When COVID-19 forced us to abruptly begin working remotely, we understood how critical it was to quickly connect with and continue to support our clients. We rapidly implemented telehealth platforms, and continued to adapt in response to the simultaneous changes occurring in all of the systems serving children. Nationwide, the pandemic has brought critical attention to the profound mental health needs of children and adolescents, and how grossly inadequate the resources tend to be. The surge of racially motivated violence has further traumatized countless children and families. It is without question that access to specialized mental health care is more urgent now than ever. As we begin to emerge from this health crisis, it is my hope that a more intentional focus will be placed on addressing the mental health crisis our young people are facing. My hope is that we can help nurture the remarkable strength of the kids we serve, while also protecting their vulnerability. Your support last year helped us to adapt quickly and effectively to the COVID-19 pandemic so as to remain highly accessible to our clients and minimize disruptions in their care. Thank you! With Gratitude, Leah M. Kelly, Psy.D. 1

FY20 Highlights 273 As with most direct care organizations, the COVID-19 pandemic markedly disrupted our service delivery for kids received help the 4th quarter of FY20. from ACS in FY20 In March 2020, All Juvenile Court operations at our Lowell all ACS staff site relocated to the newly constructed Lowell Justice Center in March 2020. transitioned to behavioral telehealth ACS serves kids and families across the 54 cities and towns of Middlesex County, home to the platforms to stay largest population of youth under the age of 18 connected to in New England. We directly serve the county’s our clients. four Juvenile Courts, located in Lowell, Framingham, Cambridge, and Waltham. 2

Who You Help GENDER RACE 67% ASIAN/ 5% ASIAN-AMERICAN BOYS BLACK/AFRICAN-AMERICAN 14% 32% CAUCASIAN 39% GIRLS HISPANIC 29% 1% OTHER/ UNKNOWN 13% TRANSGENDER/ NONBINARY AGE 15 UNDER 7 0.5% 9% 80% 7-12 3% AVERAGE AGE 52.5% were struggling with at least 13-15 one psychiatric condition 16-17 35% 83% Mood Disorder 18+ 78% Anxiety and 77% of the families we served received insurance coverage Trauma-related Disorder under MassHealth, a common indicator of poverty. 77% ADHD 44% Suicidality 25% of the children we served did not speak English 37% Substance Use Disorder as their primary language. 3

Diagnostic Evaluations and Student Training Program DIAGNOSTIC EVALUATIONS ACS clinicians conduct same-day emergency mental health and substance use evaluations and extended 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 their providers and educators, and prepare a comprehensive report of their findings. The report tells the story of the child and family in a new way, considering the many facets of the child’s life and their unique circumstances. A detailed formulation is developed, which informs a list of thoughtful and individualized recommendations intended to target the specific needs of the child and their family. I M PA C T 163 comprehensive diagnostic evaluations completed 31 same-day emergency evaluations completed STUDENT TRAINING PROGRAM ACS is a ‘teaching’ clinic for behavioral health trainees. 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. Some have the opportunity to provide individual treatment and to co-facilitate our psychoeducational group for teens. By the time they have completed their clinical internship or rotation, they have developed a deep appreciation for the complex needs of these youth “Thank you for helping me understand what my child was going through. You put the puzzle pieces together to find the most effective way to help her and us. “ – Parent of an ACS client 4

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 critical services and support for families. KIDS AND THE LAW: A USER’S GUIDE TO THE COURT SYSTEM Kids and the Law: A User’s Guide to the Court System, a book co-authored by Rebecca Pries, co-chair of the Massachusetts Alliance of Juvenile Court Clinics (MAJCC), and attorney Carol Rosensweig, continues to serve as a valuable and user-friendly resource. The 4th edition, released in December 2018, is available for purchase at www.acskids.org/kids-the-law. I M PA C T 115 kids and families received Education & Advocacy services FY20 OUTCOMES 5 71% of children increased their compliance with treatment and recommendations 74% of children improved their attendance at school or an alternative educational setting 85% of families became more engaged in their child’s treatment .

Treatment and Community Education We cannot erase the T R E AT M E N T adversities a child ACS offers individual, family, and group treatment at no cost to families. Individual sessions has experienced; often focus on helping the child find positive ways to manage life stressors; family sessions however, we can may focus on improving communication within the home; and group sessions reduce a nurture resilience young person’s isolation while helping them develop important life skills. and a sense of hope, Children referred to ACS by the District Attorney’s Juvenile Diversion program are most both critical to often facing delinquency charges. In these cases, a child’s successful completion of our treatment program will usually result in dismissal of their charges. better outcomes. I M PA C T 389 hours of no-cost treatment provided 74 kids and their families received treatment services COMMUNITY EDUCATION Many of our staff are sought out to provide training, education, and consultation to a range of audiences, including public school personnel, statewide partner organizations, and other community providers. Requested topics have been both broad and specific, from an orientation to how the juvenile court system works, to a presentation on how to nurture school engagement in children struggling with anxiety and depression. 6

Isabelle’s STORY Prior to the pandemic, 14-year-old Isabelle* was earning good grades and attending school daily. While she sometimes struggled to manage her emotions at school, she was working on this issue with a counselor. But when the pandemic hit, everything changed. Like most kids, Isabelle had to suddenly shift to remote learning, and she abruptly lost her connection to her counselor and peer group. Isabelle’s grades began to decline. She was having trouble focusing and was unmotivated to attend her classes. She began to exhibit angry outbursts and aggression toward her mother, Caroline*. Caroline suspected that Isabelle may be experiencing depression and felt powerless to help her daughter. Out of concern for Isabelle’s wellbeing, she turned to the juvenile court system as a last resort. Isabelle’s probation officer believed that Isabelle needed mental health treatment and referred her to ACS. Isabelle and Caroline met with an ACS clinician right away to discuss treatment options. The ACS clinician believed that Isabelle would benefit from both individual and group treatment. In individual treatment, Isabelle would be able to talk through more personal concerns and emotional struggles. In group sessions, she would have the opportunity to learn healthy coping skills and build social connections with her peers. Both interventions would reduce her isolation, set her on a positive path, and help her to realize that she is not alone. Isabelle enrolled in ACS’s treatment program, and participated in individual and group treatment remotely. Although Isabelle expressed reservations about joining the group, she made meaningful contributions and became an active participant. Isabelle’s clinician recently met with Caroline to check in on how things were going. Caroline shared that she has noticed an improvement in Isabelle’s behavior at home and that she has become more engaged in school, as well. *To protect confidentiality, ACS does not use the names, photos, or identifying features of our clients. 7

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. PERCENTAGE OF YOUTH 53% Number of ACEs in youth 36% 26% 16% nation-wide vs population 6% 19% 11% served by ACS 11% 12% 10% National Average* Population served by ACS** 0 1 2 3 4+ NUMBER OF ACEs *Based on ACEs Study conducted by the CDC **83 total ACEs questionaires from ACS clients 11% 36% Emotional abuse Physical abuse 28% 31% Prevalence of Adverse Sexual abuse 21% Childhood Experiences Emotional neglect 10% 13% 40% PhyMssuicecanhltnaaeslg:hleecatlth issues, 273%0%sMtraalatedgaipetsi,vesuccohpains:g Mother treate••d aavinnogxleieenrttyly 19% 36%•• self-injurious behavior • depression 23% alcohol and drug use • high-risk sexual behaviors Household subswtahnicceh acbaunseresult in… increa42s%ing the risk of... Household mental illness 5% 52% Parental separation/divorce 15% 75% Incarcerated household member 10% 18% 88

MAJCC: sustaining critical services The research is clear that keeping kids ACS is proud to be a founding member of the Massachusetts Alliance of Juvenile Court out of the juvenile Clinics (MAJCC). Below are some of the many highlights from the past year. justice system is MAINTAINED FUNDING IN FY21 STATE BUDGET critical to ensuring a MAJCC lobbied and advocated to maintain the gain of $1.5 million achieved in the better trajectory for FY19 State Budget in the FY21 State Budget. These efforts were successful and funding for the juvenile court clinics maintained the unprecedented increase! their future. SUPPORT FOR JUVENILE COURT CLINICS DURING THE COVID-19 PANDEMIC MAJCC continues to support the juvenile court clinics as they navigate these challenging times. In collaboration with the Office of the Child Advocate, MAJCC has identified the immediate and long-term concerns facing our clients, along with the opportunities that the juvenile court clinics have to address these concerns. 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. ADVERSE CHILDHOOD EXPERIENCES (ACES) LDoAngT-AterCmOoLuLtcEoCmTeIsO, N sInucChaales:ndar Year 2019, juvenile court clinics across the Commonwealth collected AC• Essuidciadtea aotnte6m2p5tschildren. The median number of ACEs in the CDC study was 1 •o ucht roofni1c0h,ewalhtihlecothneditmioendsian for the juvenile court clinic sample was 5 of 10. Th•i spirnefmoramtuarteiodnesattrehngthens MAJCC’s advocacy platform and provides conclusive evidence of the extraordinary needs of this population. 9

Financials FY2020 From the most recent audited fiscal year: July 1, 2019 – June 30, 2020 OPERATING REVENUE Government Grants and Contracts $1,360,923 Corporate and Foundation Grant $337,800 Individual Contributions $121,362 Investment Income $98,115 In-kind $95,000 Other income $31,683 TOTAL $2,044,883 OPERATING EXPENSES Program Services $1,477,648 Management and General $272,469 Fundraising $85,955 TOTAL $1,836,072 10

FY20 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 FY20 (7/1/2019-6/30/2020). LEADERS Blue Cross Blue Shield Cosette Charitable Fund of Massachusetts Foundation Susan Culman GIFTS OF $10,000+ Cambridge Community Foundation Robert and Evelyn Doran Bushrod H. Campbell and Thomas and Andrea Dupree John W. Alden Trust Adah F. Hall Charity Fund Ron and Debbie Eastwood Bank of America Lois and Jim Champy Robyn Eastwood and Taylor Snook Charitable Foundation Anne Covert Terrie Graham Marion B. Boynton Trust, Mary W.B. Curtis Trust Jonathan Hecht and Lora Sabin Bank of America, N.A., Trustee East Cambridge Savings Bank Joseph E. & Frances E. Heney Cogan Family Foundation Forest Foundation Charitable Trust Cummings Foundation Barbara and Amos Hostetter Daniel Jacobs and Susan Quinn Nancy L. Donahue Swanee Hunt Family Foundation Margo Kelly Eastern Bank Charitable Foundation Roy A. Hunt Foundation Fran and Hugh Miller Fish Family Foundation Elizabeth Keating Shirley and David Parish Orville W. Forte Barbara Leggat Tony and Kitty Pell Charitable Foundation John Petrowsky Deborah Porter and The Janey Fund Beth Pfeiffer Nicholas Negroponte The Klarman Family Foundation Karen F. Richards Laura Prager and William and Margaret Paine Wendy Shattuck and Sam Plimpton Frederick Millham The William and Lia G. Poorvu Gardiner Howland Helen and Peter Randolph Family Foundation Shaw Foundation Frank and Carolyn Reynolds Trustees of the Ayer Home Mary and David Shahian Public Sector Frederick E. Weber Eric Shank Department of Mental Health Charities Corporation Jane and Ben Siegel Massachusetts Juvenile Court The Stevenson Family A D V O C AT E S Charitable Trust CHAMPIONS Susan Stoddart and Chris Snook GIFTS OF $1,000-$2,499 Charles K. Storey GIFTS OF $2,500-$9,999 Avidia Bank Charitable Foundation Frederick A. Bailey Trust; BNY Stewart and Patricia Chapin Mellon, N.A., Corporate Trustee Bennett Family Foundation 11

FY20 Donor List Rich Wenger Tim and Joanne Oyer Emile and Sandra Caron David Wilcox and Charlotte Pierce Gary and Mary Pforzheimer Esther Chen Jonathan and Amy Poorvu Colleen Clinkscale and ALLIES Ellen Poss Timothy Lynch William and Helen Pounds Ellen Cohen and Daniel Haber GIFTS OF $250-$999 Robert and Elizabeth Pozen Eleanor Edelstein Adele Pressman Mary K. Eliot Judith Aronstein Rebecca and Weldon Pries Judy Ellenzweig Hon. Jay D. Blitzman and Abby Rockefeller and Lee Halprin Hon. Margaret Fearey Sandra Jaffe David and Deirdre Rosenberg Peter and Kathleen Forbes Hon. Ann W. Brown Lynda A. Schubert Nancy and Richard Fryberger Katie and Paul Buttenwieser Edward A. Shapiro and Hon. Gail Garinger Pete and Sara Caron Debbie Benik Monique Garrity Lael and Charles Chester Robert Silberman and Jacques and Margaret Gelin Barbara Clark Nancy Netzer Dori Gerber Grace Conway Karen Tucker and Jerry Avorn Bal-lan and Jonathan Gingerich Laura Dziorny Robert Wilstein Owen and Miriam Gingerich Sylvia Hammer Ann Starnbach Wise Robert Gittens Hon. Julian Houston and Lynne and Mark Wolf Fred Goldstein and Judith Hyatt Susan Levine Houston Bill and Grace Gregor Hughes and Company SUPPORTERS Bethany and Scott Hadley Alison Poorvu Jaffe and Penny Haney Daniel Jaffe GIFTS UP TO $250 Martin and Susan Heyman Stephen Kay Howard Hiatt Leah M. Kelly Cecle Adler William Hudgins Tom Kreider Stephen Allsopp Katherine and Ralph Hughes Sam Leadholm AmazonSmile Foundation David and Emily Hutcheson Martha Leggat and Steve Barr Anonymous (6) Theodore and Bernadine Jacobs Franklyn MacLean Susan Ayers and Nancy Salonpuro Wendy Kaplan and Tim Armour John and Kristin Macomber Richard and Bonnie Barnum Rudolph Kass Joe and Rachel Martin Cindy Barrows and Ron Berkowitz Jacquie Kay Susan and Pieter Mimno Leslie Boden and Judith Yanof Neil Motenko and Mindy Margulies Lori Anne Bonsignore Linda Myers Cambridge Art & Frame 12

Laura Khoshbin Catherine Riffin and Patrick Smith IN-KIND Kilkelly Law Offices Pam Riffin Consultierge Professional Services Patrick King and Sandra Moody Hon. Daniel Roache Massachusetts Trial Court Hon. Kenneth King and Todd Rogato Sandra Simpson Carol Rosensweig Thank you! Robert Kinscherff Eleanor and David Rubin Judith Klau Dan Sanford A generous grant from The Fish Rona Knight Gema Schaff Family Foundation enabled ACS Cheryl Kyle Greg Schwartz Leslie LaGasse Jonathan Shapiro to upgrade our technology. Missy Lipsett Robert N. Shapiro These critical improvements were Teresa Lopes and Denise Lotufo Francine Sherman and Scott Tucker Margaret Maisel Margaret Quinn Simons and instrumental in enabling us to Massachusetts Institute Thomas Simons transition to working remotely. of Technology Elizabeth and Claude Smith Joyce Maxwell Anthony Smith THANK YOU TO Joseph and Julia McOsker Linda Stewart and Joseph Figueiredo Ross Mitchell Stop & Shop The Fish Family Foundation! Paul Nwokeji John and Judith Styer Hon. Susan Oker Elias Tamene Katherine Page Peter and Charlotte Temin Mathilde Pelaprat and Lora Heims Tessman Kristen Van Damm Katharine Thomas Sylvie and Jean-Michel Pelaprat Jane Thorbeck Ava Bry Penman and Lewis Lockwood Felicity and Jeff Turgeon Lauren and Ilan Persing Nancy Tye Kathy Pilarski Soledad Valenciano Jane Prager Sophie Wadsworth Regina Pyle Jonathan and Stephanie Warburg Laurie Raymond Margaret Witecki David and Ann Reisen 1133

mission BOARD OF DIRECTORS STATEMENT Fran Miller, President William H. Paine, Chair Adolescent Consultation Services supports and empowers court-involved children and families Jacquie L. Kay, Treasurer Jane R. Siegel, Clerk by providing mental health prevention and Terrie Graham intervention services to help them Daniel H. Jacobs Elizabeth Keating envision and work toward a better future. Leah M. Kelly Michael A. Lafleur ADOLESCENT CONSULTATION SERVICES, INC. Lia G. Poorvu 189 Cambridge Street Laura M. Prager Cambridge, MA 02141 Mary M. Shahian T 617.494.0135 F 617.494.0136 Charles K. “Chip” Storey www.acskids.org David K. Wilcox /acsinckids @acsinckids FY20 Annual Report @acs_kids