GILLETTE — Austin Rosenau was supposed to meet his mother at Mount Pisgah Cemetery earlier this month.
It wasn’t a special occasion, per se. And it certainly wasn’t an issue that he missed their afternoon meeting, because there will be plenty more.
Rather, it served as a reminder of how close they now are, as well as just how much their family has changed over the past few years.
That’s because just about every day, his mother, Lana Dicus, visits the hand-picked headstone of her daughter, Tristan, who died by suicide more than a year ago. Now that Austin, his wife Autumn and daughter Aspyn have returned to Gillette from Rock Springs, he can be there beside his mother, remembering their loss together.
He and Autumn are both 29 years old and in the middle of three generations of a family that calls Gillette home. After their own past struggles with mental health and substance abuse, their focus is on living a clean life and raising their daughter to avoid similar missteps.
Aspyn is a happy and healthy 7-year-old, unaware of the lives her parents lived before she was born and the family history she has inherited.
But as parents who have navigated the community mental health resources themselves, they hold the challenge of helping their own child traverse that landscape, or help prevent the need from ever arising.
“Now I’m also trying to break that cycle of these other things that may have stigmas attached, mental health being one of them with my child,” Austin said.
The increased demand for mental health services for adults in Gillette has trended similarly for children and adolescents as well. A similar question of whether there are more problems developing or more people aware of treatment options also looms over the recent uptick.
The mental health problems facing some children this past year haven’t necessarily been new problems, said Lexie Honey, a social worker at the Kid Clinic. Yet the volume of patient visits and referrals is noticeably higher.
Depression, anxiety, ADHD and other behavioral problems have continued to affect children and adolescents, but more have sought help in Gillette this past year. Meanwhile, the number of counselors, therapists and available resources have stayed relatively stable, leading to long wait lists at the Kid Clinic and other providers.
“We’ve seen still the same thing, just more,” Honey said. “If we could have more therapists that would be great.”
Akin to the question surrounding the increase in adults seeking mental health treatments, when it comes to children and adolescents, it’s unclear whether there are more of them needing treatment or more awareness to help them find treatment.
It’s also unclear to what extent the myriad of pandemic-related factors may have contributed to the rise in demand for services. That’s a trend noted nationally.
“It’s hard to say necessarily that it’s the pandemic or if it’s the push that we’ve put on mental health during this pandemic time to be more aware and pay attention to those aspects, to get that help and that it’s OK to ask for help,” Honey said.
In order to accommodate the growing wait list of patients, the Kid Clinic expanded its hours and added a fourth clinician to its staff and hopes to add another.
“We’ve definitely have had people who had to wait, because I can only see so many kids in a week,” Honey said.
Its counselors tried offering 7 a.m. sessions, noon sessions and 5 p.m. sessions to fit in extra kids, Honey said. The early morning ones weren’t very successful and the extra workload took a toll on the well-being of the providers themselves at times.
“We’re doing what we can to try and get them all in,” she said.
Natalie Tucker, chief nursing officer at Campbell County Health, talked about the growing number of behavioral health patients of all ages entering the hospital and emergency room for all different kinds and levels of care. Through that wave, an obvious need for more inpatient and long-term availability for children emerged, she said.
It hasn’t happened only in Campbell County, but throughout the region. Finding long-term placements for children has been a national trend, Tucker said, with a shortage of beds a widespread issue.
“I think we need to have even more availability in the region for kids for long-term placement,” Tucker said. “I think that’s where the shortage really is, that we can tell.”
For kids and teenagers, the path toward treatment often begins with recognition. Although they may not always see it in themselves, changes in mood and behavior, or uncharacteristic comments, are often the warning signs when help is needed.
Part of the increase in referrals has come from an awareness by parents, teachers, friends and peers who recognize and report that kind of change in demeanor. Part of increasing awareness comes from reducing the stigma around mental health.
“At times we’re doing really well, but at times we’re still stuck in that stigma of, ‘We don’t talk about that,’” Honey said. “We have seen that push for being more open and more assessments, talking through things to see what the need is.”
In some cases, comments that may have once seemed harmless are held under higher scrutiny these days, which results in some of the new referrals to the Kid Clinic, she said.
At Gillette College, the increased awareness among students and staff has also led to more referrals at the college, which ties into a broader trend of more need for mental health services in higher education.
‘I think our stigma is reducing, which is a beautiful thing,” said Susan Serge, a counselor and director of student affairs at Gillette College.
The college has an Active Minds chapter, a national nonprofit organization that promotes conversation about mental health, with the goal of reducing stigma and raising awareness.
That recognition is becoming more needed because the long-haul effects of the pandemic may be impacting more students at the college level.
“I do think resiliency is wavering,” Serge said. “I think there have been so many hard hits for our students that it’s just been one thing after another and they’re tired.”
The post-high school time in life, including college years, is still when mental health struggles often manifest in young people. But that has been further complicated for students who graduated from high school and entered college amid the pandemic.
“I would say our sophomores have never had a true college experience and that everything has changed so much that it’s just not the typical, you know, get to know your friends and spend time — that social aspect has really been compromised,” Serge said.
As the college’s counselor, Serge has seen the rise in students entering her doors firsthand, but said that uptick has also shown in the number of referrals for medication management, long-term therapy and even occasional inpatient stays.
“It’s not a new trend, it’s been happening for years, that we’ve seen a huge increase in anxiety and depression specific to college students but just across the board, really, even in our communities,” Serge said. “The pandemic just escalated that.”
The trend in higher education pre-dates the pandemic, but was accentuated by some of the added stressors that students dealt with over the past two years.
Distance learning, financial burdens, less connectivity and in-person social interaction are some of the factors that may have added to the burden students carry around Gillette College. Employees and professors are trained to recognize and report warning signs in students, which helps them find the resources that are available through the college.
Not only have more services been needed, but in some cases, the severity of the depression, anxiety or other problems has been greater than in the past, Serge said. What was once relationship problems or homesickness — typical college trials and tribulations — has morphed in some cases into greater levels of depression and even higher levels of suicidal thinking.
“I think it’s been a really exhausting couple of years but I do have hope that our students are building their resiliency, and they’re doing that by reaching out and getting help when they need it,” Serge said. “That’s what we want for our entire community. We want them to understand that they’re not alone.”
Back in Gillette, Austin mines coal for Black Thunder and Autumn works as a forensic peer specialist and case worker for Personal Frontiers, helping people living through the struggles she and Austin once felt themselves.
Now raising a daughter in the same community where they developed mental health and substance abuse problems of their own, Austin and Autumn feel they have learned the tools to keep their daughter from those same pitfalls.
But the community, in their eyes, may still have some catching up to do.
“I would want more access and funding to these places,” Autumn said. “Less stigma about what is happening around mental health and substance abuse.”
Gillette has mental health services for people who need them, but that doesn’t make those options affordable for everyone. The sheer volume of demand has already tested the timeliness of those services, but cost can also serve as a barrier for many.
Parents often do the best they can with what they know, but that “tough love” parenting model of the past is not one Austin adheres to when it comes to his own daughter. Using the communication skills he learned from his own recovery and treatment processes, he said that open and honest communication is something he wants his daughter to grow up knowing.
“I try to always encourage her to talk about everything, talk about her feelings, talk about what she’s got going on,” he said.
That can mean talking about the fun parts of growing up and going to school, or the more difficult conversations that may await them down the road.
“I just have conversations with her,” Austin added. “(I’m) being honest and open with my child.”
Kids inherit traits and grow up in environments often dictated by their parents, then become adults who pass on traits of their own to the next generation, which does what they can with the circumstances they’re given.
And so the cycle continues.
Both children and adults have contributed to the rise in demand for mental health services in Campbell County. Regardless of their age, patient problems may be as unique as the individuals themselves, but in each community, they share the same pool of resources to lean on when in need.
“We care about our daughter so much that we’re going to seek whatever resources we can,” Autumn said. “And I think that might be the pattern we’re seeing. Maybe it’s not more kids who are aware of it, but it’s more parents.”