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SAMHSA’s Award-Winning Newsletter
May/June 2010, Volume 18, Number 3 

Image of infant in neonatal intensive care unit holding finger of adult

Meeting Infants’ Needs Down East

“A county at the end of the earth.” That’s how Marjorie F. Withers, LCPC, describes Washington County, Maine, a region the size of Rhode Island and Connecticut combined but with fewer than 32,000 inhabitants.

The area is beautiful, said Ms. Withers, with ocean views, many lakes, and blueberry barrens that turn a lovely crimson color in the fall. But that beauty belies some very serious problems: unemployment, poverty, and rampant misuse of prescription opiates.

These problems have hit very young children especially hard: A third of the county’s infants are born at risk because of exposure to substances, low birth weight, or other factors. The county also has the state’s highest percentage of infants in child protective custody, children in special ed, and children under age 4 kicked out of childcare for acting up.

Photo of young girl in process of learning with adult

Enter the Community Caring Collaborative, which received one of SAMHSA’s Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health) grants in 2008. The program promotes wellness in children from birth to age 8 by addressing their physical, emotional, social, and behavioral needs.

The collaborative, which Ms. Withers directs, brings together representatives of various agencies, the Passamaquoddy Tribe, and families determined to give the county’s children a healthier start in life.

One top priority is to make sure at-risk infants get the services they need after they return home from the neonatal intensive care unit (NICU) at a hospital 90 miles away. In the past, Ms. Withers explained, hospital staff often assumed that families could get the services their infants needed locally or make the trip back to the hospital. “But people don’t have money to fill the gas tank,” said Ms. Withers. “They’d be stuck in Washington County and then people would say they didn’t care about the baby.”

The solution was something called the “bridging” program, which matches each high-risk mother with a nurse or child educator even before her child is born. Together they craft an individualized plan to support the family during the infant’s hospitalization and beyond. Bridging partners take women to visit the NICU ahead of time, so it’s not as intimidating. They can help get the resources families need to travel back and forth. They can even arrange respite care for other children. Home visits and parent support groups provide additional help.

A similar effort is under way at the state level, where Ms. Withers says a child wellness council is working at “busting barriers that make it impossible for us to do what we need to do.” The council is examining the issue of appropriate case loads for case workers in isolated areas like Washington County, where workers must sometimes travel more than 3 hours one way to see a client, for example.

Ask Ms. Withers how well these efforts are working, and she points to a baby recently born at just 24 weeks. “Most babies born under 28 weeks in Washington County have multiple rehospitalizations,” she said. “This was the first baby we can track who’s never been rehospitalized.”

Learn more about Project LAUNCH.

  Cover Story & Related Articles  
Promoting Wellness in Early Childhood

Promoting Wellness in Early Childhood

Project LAUNCH focuses on children from birth to age 8.

  From the Administrator  
Your Responses to What's in a Term?

Your Responses to “What’s in a Term?”

Comments are continuing to arrive in SAMHSA’s email reader-response box. Thank you! Read the responses so far.

Your Comments, Ideas, Personal Stories . . .

Your Comments, Ideas, Personal Stories . . .

SAMHSA has received more than 150 emails in response to the Administrator’s call for comments. Read selected responses.

  Health Reform  

Affordable Care Act: Implications for Behavioral Health

The Act improves services for people who have mental health and substance use disorders.

  Suicide Prevention in American  
  Indian Communities  
Helping Youth “Live To See the Great Day That Dawns”

Helping Youth “Live To See the Great Day That Dawns”

AI/AN youth are 10 times more likely to attempt suicide.

First-Person: Commitment, Hope, Community

Collaborating across tribes helped create a needed publication for AI/AN youth.

  Teens & Substance Abuse  
Adolescents Do What Every Day?

Adolescents Do What Every Day?

A day in the life may include more than texting and homework.

Tobacco Sales to Minors Increasing?

Tobacco Sales to Minors Increasing?

Sales of tobacco to minors increased nationally in 2009.

Youth Smoking & Maternal Risk Factors

Youth Smoking & Maternal Risk Factors

If a mother smokes, does that affect her teen?

Teen Smoking: New Data

Trends in young people’s smoking habits.

TIP 49 in Your Pocket

TIP 49 in Your Pocket

Pocket “Quick Guides” for counselors and physicians.

By Metro Area: Treatment Data

By Metro Area: Treatment Data

Activities in 27 metro areas include Baltimore and San Diego — Metro Briefs.

PRISM Awards Honor Films, Television

PRISM Awards Honor Films, Television

Kudos for the realistic depiction of substance abuse and mental illness in film and TV.

  Staff in the News  
Leadership Award to Kana Enomoto

Leadership Award to Kana Enomoto

The Arthur S. Flemming Awards honors SAMHSA’s Kana Enomoto.

  Ending Seclusion & Restraint  

Organizations Making a Difference

SAMHSA honors facilities for reducing these practices.

  Drug Abuse Warning Network  

Rise in Nonmedical Use of Pain Relievers

Emergency visits double for prescription opioid pain relievers.

  Recovery Month  
Toolkits, Posters Available

Toolkits, Posters Available

For September, planning materials at


Substance Abuse & Mental Health Services Administration – 1 Choke Cherry Road – Rockville, MD 20857
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