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Wyoming native advocates for juvenile support program to help kids before they face hurdles

Jonathan Updike grew up in Wyoming and says it was hard to overcome the stigma of mental health issues in small towns, something the Allcove program could help address.
Jonathan Updike grew up in Wyoming and says it was hard to overcome the stigma of mental health issues in small towns, something the Allcove program could help address.

Wyoming has some of the highest juvenile incarceration rates in the country and some of the highest teen suicide rates as well. Such data has a lot of Wyomingites looking for outside-the-box solutions for helping kids before they face these hurdles. Jonathan Updike grew up in Wyoming and ended up at Stanford, working on an innovative program called Allcove, which gets kids designing their own intervention strategies. Wyoming Public Radio's Melodie Edwards asked Updike about his own story of growing up in the state.

This interview was inspired by Tennessee Watson's Cowboy Up series for The Modern West about juvenile justice issues in Wyoming.

JONATHAN UPDIKE: I was born in southwest Wyoming, grew up in Green River for nine, ten years. And my father had trouble with alcohol, requiring rehab hundreds of miles away. And it's not just an individual disorder - it affects the family. And so, my parents divorced and separated, and I lived with my grandparents in Casper for three years before settling in Sheridan and Johnson counties. And I graduated from high school there and bounced between my mother and my father's place every couple of weeks. And so this cycle of separated parents, substance use disorder, and then really challenging teen years informed me that it's a hard time for folks, and I wanted to give back in whatever way I could.

I went to the University of Wyoming, not knowing what I wanted to do. And then was fortunate enough to have some clarity, make it to New York for med school, and then really enjoyed psychiatry because of the narrative and the relationship aspects. I ultimately decided I wanted to hone my abilities in psychiatry, and I had the opportunity to do my residence here in Stanford.

MELODIE EDWARDS: I wonder if, looking back on what you went through, what are some of the things that you think would have helped? That you kind of wish had been in place for you, as you grew up?

JU: So something that I've really appreciated about the model that I've been working on under Dr. Steve Adelsheim here in California, is the centering of the youth voice. A lot of young people don't feel heard, don't feel seen, feel like they're prescribed interventions, rather than listened to and dealt with individual problems. And they're common, but they're still individual problems. And so, mental health care, not only having it being accessible, less stigmatized but also informed by the youth in the area is really important because youth know themselves better than we know them.

ME: You had mentioned Allcove, and that's the model that is being used here in the United States. But this is really quite a global sort of philosophy towards how to help youth in mental health issues.

JU: Yeah, so Allcove is based off of a model that was piloted in Australia, developed in Australia, called Headspace (not the meditation app). But in response to the reality that young people everywhere, their greatest health burden is in mental health. Fifty percent of mental illnesses start by age 14, and then 75 percent by age 24. This model is expanded to Ireland as Jigsaw and British Columbia as Foundry. But yeah, it's been endorsed by the World Economic Forum, to have a youth-centered integrated care. A one-stop-shop for physical health, mental health, substance use treatment, peer support, family support, and supported education and employment.

ME: So once it did arrive in the United States, it sounds like you really got kids involved in that design element. Can you talk a little bit about how kids got involved?

JU: Young people wanted to be able to go someplace they felt comfortable and get the help they needed, not necessarily knowing exactly what they were looking for, but to have someone walk them through the process and not be given a pamphlet and told to go across town to a different agency and be put on a waitlist or have an appointment scheduled weeks months later. They wanted help when they walked in and to have it be low cost or free. And to really provide a listening ear in the moment. A key component of this model is peer support. You've got peers leading the young person through the Allcove facility as soon as they walk in with warm handoffs to the appropriate services.

That's how I grew up! There was a general place in town where you went for health care needs. But [in rural communities], there is a lot of stigma and I've been fortunate to grow up with a lot of mental health care around me. My mother and stepfather both were mental health care practitioners in the state, and then my dad having gone through rehab, I needed to navigate that growth within myself. And so over time, because of exposure, I needed to destigmatize that within myself. I think that reduced stigma can really help folks.

ME: Can you talk about how this approach could help rural kids?

JU: Yeah, so this integrated youth mental health care approach addresses mild to moderate mental health issues, depression, anxiety, early psychosis, before they progress to maybe something that requires that residential or inpatient treatment that is often at the more severe end. So it depends on what you want to be spending your money on. Do you want to be spending your money on prevention and early intervention? Or do you want to spend what little resources are available on the most severe cases? And I think we have a great opportunity with ARPA [American Rescue Plan Funds] funds with $50 million allocated toward innovative telehealth and mental health models. It's not just going to be solved by implementing a new model. We need increased pipelines of workers, which requires a degree of investment in the education system in the state, as well as the infrastructure of the ability of the state to provide those resources in rural places.

ME: As a former Wyoming kid, is there anything else that you would want to add about just where we're at and what our future holds as we go forward in the state?

JU: I think young people want to be where they're valued, where they have opportunities so that this out-migration of young people within the first ten years of graduating high school might be reduced. We should make Wyoming a place that young people want to live, as a place they don't want to leave or in some cases can't bear being in because of the way they're treated or what they think or who they love or how they are.

Melodie Edwards is the host and producer of WPM's award-winning podcast The Modern West. Her Ghost Town(ing) series looks at rural despair and resilience through the lens of her hometown of Walden, Colorado. She has been a radio reporter at WPM since 2013, covering topics from wildlife to Native American issues to agriculture.
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