Baby Left in Woods in Manchester, New Hampshire

Treatment is inadequate for co-occurring disorders

Last week, a young lady contacted emergency services near Manchester, New Hampshire and told them she had left her newborn baby in the woods.

At first, she pointed the first responders in the wrong direction. Then she led them more directly to the child who is recovering in a local hospital.

Many will ask: “How could she do this? How could a mother abandon her baby in the woods in freezing temperatures?”

As the story unfolds, we learn the woman, although only 26 years old, has a long history of mental illness and substance use, referred to as co-occurring disorders.

In a 2010 article, Nora Volkow, M.D., Director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health, noted that brain imaging studies of people with substance use disorders show physical changes in the areas of the brain that are critical to judgement, decision making, learning and memory and behavior control.

In effect, someone with a long-term substance use disorder is operating with significant brain impairment. Add a serious and persistent mental health disorder and you have a very complicated situation referred to as a co-occurring disorder. Any treatment must address the symptoms and behaviors of the two disorders simultaneously to be effective.

One of the ugly truths of our professions (psychiatry, social work, mental health counseling, etc.) is that very few of us are educated or trained to diagnose accurately. Even fewer of us know how to diagnose and treat substance use disorders. My experience as an educator has shown that most graduate programs have only one course on diagnosing and it is not emphasized throughout the rest of the program. Assessing and treating substance use disorders is also only one course in most programs and it is usually an elective, rather than a required course. This is why so many people with co-occurring disorders are undertreated, overtreated or not treated at all.

The woman, Alexandra Eckersley, has two other hurdles to face. Her name is well known to many Boston area residents as she is the adopted daughter of Baseball Hall of Fame Pitcher and former Red Sox TV Commentator Dennis Eckersley and his wife.

It is difficult enough for a family to struggle with a co-occurring disorder in private. It becomes more difficult when a member of the family is a public figure. Former First Lady Betty Ford spoke about her experience facing her addiction to alcohol when she was in the White House.

The other hurdle is the challenge of adoption, referred to as “adoption trauma”. As reported by clinicians at the Boston Post Road Adoption Resources (BPAR), adult adoptees often experience “considerable fear of loss or abandonment which impacts intimate relationships; trouble with personal boundaries; confusion around identity; and almost always, issues around control and addictive behaviors.”

Addiction and mental illness are family diseases. In addition to the treatment services that someone like Ms. Eckersley needs, there are a number of support resources for family members. The National Alliance for Mental Illness (NAMI) provides local support groups for family members of someone with a mental illness. Al-Anon provides support groups for family members of someone with an alcohol addiction.

Locally, there are two Massachusetts-based support group organizations, Learn 2 Cope and Magnolia New Beginnings, each with a different approach that supports family members of someone with a drug problem.

I hope Alexandra Eckersley can get the treatment she needs and that her family can get the support they need. This should also include a therapist trained in treating adoption trauma and co-occurring disorders.