Struggling With Substance Use Recovery — and High School — in a Pandemic
At Archway Academy in Houston, which serves 50 high school students who are in recovery from substance use disorder, counseling sessions are essentially on-demand. Students can ask for support any time they feel a panic attack coming on, or if they feel overwhelmed or angry. Coupled with a tight-knit sense of community, it’s what makes the school successful, says Executive Director Sasha Coles.
That’s why, after COVID-19 shifted academics online, Coles and her staff hit the road. When students called, counselors drove to their homes and held sessions on driveways and porches. Even with the masks and social distancing, it was a better therapy alternative for some students than Zoom.
“I don’t think we understood, at least at the beginning, how not being able to deliver services in person would change really important dynamics at our school, the magical parts of the school, the community,” she says. “I have kids calling me falling apart, and so I’m trying to coordinate with parents, ‘How do we meet the needs of your kids when it comes to their mental health?’”
Recovery high schools are specially equipped to help students remain sober. Alongside typical academic classes and extracurricular activities, they provide peer support groups, licensed counselors, drug testing and other accountability measures.
A Vanderbilt University study of recovery high schools published in 2017 found that 62 percent of students met the criteria for an alcohol abuse diagnosis and 93 percent met the criteria for a substance dependence diagnosis.
That tracks with what Andrew Warren, a recovery coach, sees when students enter Archway Academy. Marijuana and alcohol are the most common substances for which they are in recovery, though a small number have used intravenous drugs or painkillers. Depression and anxiety disorders are the most common mental health conditions they face, he says.
By and large, researchers found these schools were effective. On average, students’ reported significantly less use of drugs and alcohol when researchers checked in with them six months later, according to the study. They reported about nine days of marijuana over the previous 90 days, compared with 55 days of marijuana use prior to beginning treatment. Use of alcohol and other drugs dropped to about three days or fewer over the preceding 90 days. And students attending recovery high schools were more likely to stay sober and attend school compared with a control group of students with substance use disorders who attended other schools.
But COVID-19 has significantly upended the model—posing a unique hurdle to recovery high schools, whose students were dealing with crises even before the pandemic.
“There are occasions where we’ll have a kid with some good sustained recovery, but normally we get calls because the parents have tried everything they can think of,” Coles says, “and we become the place that is their last-ditch effort.”
Balancing service and safety
Recovery schools are currently split into about even thirds when it comes to their delivery model. Some are fully in-person, others are hybrid or remote, says Roger Oser, chair of the Association of Recovery Schools. The organization’s membership is made up of 43 schools across the country that support students in 9th through 12th grade who are in recovery from substance or alcohol use.
He is also principal of William J. Ostiguy High School, one of five recovery schools in Massachusetts, which is part of a public-private partnership affiliated with Boston Public Schools. Oser says his campus has used all three models at different stages of the pandemic. It was most recently fully remote.
“We’re all trying to balance the need to provide in-person services with safety. That equation is different depending on what part of the country you’re in,” he says. Our population is a priority population to be in-person, so that’s the challenge. What can we do in our location situation to get kids in the building safely?”
Prior to the pandemic, Oser says his campus and recovery schools nationwide were looking into remote learning as a solution for students who could not be on campus due to distance or treatment.
“We have a student population that has interrupted experiences sometimes due to relapse or other reasons, so the more ability we have to connect to students remotely increases our capacity,” he says. “Obviously we wouldn’t want it to be driven by COVID, but we were already looking at different models.”
While some students are doing fine remotely, Oser worries about those experiencing isolation.
“In the best of times, people isolate for different reasons: not wanting to deal with people, covering up their use. Being remote makes that so much easier,” he says. “You can still be showing up, but not. And it makes it harder to detect what’s going on.”
Being remote has driven his staff to make their virtual interactions with the school’s students as engaging as possible. Each day begins with a community check-in and one-on-ones between students and a case manager.
“It’s much more intentional virtually because if someone doesn’t show up for a day, we don't want that to go by [unremarked]. There has to be a place where that’s noticed and followed up on,” he says.
Reopening the support system
Coles says the transition to online schooling at her Houston campus, which partners with the Southwest Schools charter district, was smooth. But there wasn’t a way to replicate the human element of mental health services on a screen. Important parts of communication were lost. She couldn’t read students’ body language or give them a hug.
While there were no worrying dips in academic performance, students at home were experiencing more anger outbursts and relapses in depression, anxiety or bipolar disorder. More kids were running away, Coles says, and having a harder time getting medication refilled because doctors’ offices were closed.
“What we learned from March to August was that in the mental health aspect of the school, we were not seeing the normal outcomes that we would due to the isolation,” she says. “Quite frankly, too much time with their families was not good for anybody. It felt like complete chaos.”
While most public Texas schools reopened in mid-October, Archway Academy opened its doors again in September. The small school was divided into learning pods of no more than 10 students who stayed in the same socially distanced classroom, supervised by a faculty or staff member, and had their classes delivered via Zoom.
Warren, who is an alumnus of the school in addition to being a recovery coach, says getting students back near their support system was important for two significant reasons.
“Young people just crave that social life, and what you find with people who have substance use disorders is that it couples with mental health disorders,” he says, “so anyone who has depression or anxiety needs support or needs a social life.”
During a normal school year, part of building community among students would include group activities involving close proximity. That could include tug-of-war one day or a trust exercise the next.
“Activities like that aren't really doable when there’s an airborne virus,” he says. “There’s a lot to be said about a staff member and student sitting down in a hallway and letting them cry and be there for them.”
When the school closed and went remote in March, Warren says there was a portion of his students who were fine. They were motivated to stay on top of their studies, and meeting with him over Zoom was sufficient. But that wasn’t the case for everyone.
“During our daily Zoom meetings, you could tell, ‘This person isn’t feeling connected. This person isn’t getting enough.’ We had students who enrolled with us in early March and didn’t have a chance to see what our community could really do,” he says. “We ended up going to these students' houses and sitting on a driveway and just talking to them. Two or three times per week if necessary, bring them goodies and interact with the families and the kids. That was special when you had someone willing to drive out, sit in the driveway and just be there.”
David Claunch, a math and science teacher at the academy, shares a connection with students in that he’s been in recovery for 17 years. If a student has an issue that’s preventing them from focusing in class, help from a counselor is right down the hall.
“And they come back ready for academic work,” he says.
Claunch taught remotely while he quarantined for two weeks after testing positive for COVID-19 following Thanksgiving break. While he didn’t miss a day of school over Zoom, he was glad to be back in the classroom.
“It’s really easy for them to nod and say, ‘Yes I understood,’ versus looking at a screen. You pick up so much more body language in person than you do on Zoom,” he says.
Coles says that the number of staff and students who had to quarantine following Thanksgiving has her worried. If coronavirus forced the school to return to fully virtual learning, delivery of mental health services would remain a challenge.
“We are continuing to toss around creative ideas for how we could do a better job of that while still keeping an eye on health and safety,” she says.
Beyond all the changes to schooling, Coles says this year has left her to reflect on how educators can take better care of themselves as they jump from one emergency to the next. Each morning before checking her text messages, she takes a deep breath.
“We’re a school that spends a lot of our time and energy focused on the health of the kids, and surviving the last year of school has reinforced in me why the self-care of the grownups is so important,” she says. “We barrel through the school year and breathe in the summer, and that can’t happen. We will become mentally and physically ill because this is too much to carry.”