'A chasm of clinical wasteland': What happens after you ‘age out’ of youth-focused support services?

 

Youth-focused mental health and addiction support services can be a lifeline, but what happens when you grow too old for them? Tara Schultz has experienced the devastation of ‘ageing out’ firsthand.

Content warning: this story contains mentions of drug addiction, sexual abuse, suicide and self-harm. 

In my late teens I went to the YSAS Fitzroy Residential Withdrawal Unit, or 'Fitzroy Resi', a place that was a sanctuary.

It was listed as a 'withdrawal unit' for alcohol and drug use, but when placed side by side with adult withdrawal units it was so much more than that.

The majority of my treatment has been in withdrawal units, usually a ten-day stay as you come off a substance. Withdrawal units are easier to get into without the same several-months-to-a-year wait time as rehabs. You use them, you withdraw, and you try to rebuild your life.

In youth withdrawal units I felt like I was home. They were a place to feel a sense of peace in which you could address the demons of your life and face them down, strengthened by the support of the workers who stood by you.

Art on the walls of YSAS Fitzroy Residential Withdrawal
Art on the walls of YSAS Fitzroy Residential Withdrawal.
YSAS Fitzroy Residential Withdrawal

Fitzroy Resi was the first taste of stability for me - of inclusion. Coming from intermittent homelessness and exploitation, in which I was beaten and sexually abused almost daily, I was so isolated. Fitzroy Resi was paradise. It was adequate health care. I felt seen.

If I couldn't sleep, a support worker named Jill, who would bake the house down, was always up, ready to chat with me about everything and anything. We would talk into the night. Eventually I would go back to bed, sleepy, with a load off my chest.

As I opened up to workers, we started to identify the issues in my life and the needs I had. This was where I first disclosed the abuse I was suffering and its impact on me.

I aged out of this youth service at 21.

When I last accessed a withdrawal unit, now in the adult sector, I was treated like a naughty child who didn't understand her own health.

Ironic, considering I was treated with more dignity in youth services.

I was spoken over, cut off repeatedly, and spoken to with condescension, as if I didn't understand my own medication, health or history, as if I was lying or being irresponsible. I was offered ultimatums: take this medication or no service.

I felt afraid. I couldn't disclose many health issues for fear of reprimand or denial of service, and was forced to keep some things secret.

Further, adult public withdrawal units can traumatic.

My belongings were rummaged through, and staff threatened to take away a wheat teddy I used for comfort and warmth (my only relief from chronic pain). "You might burn yourself or someone else on it", they said. Clutching it, exhausted from the GP interrogation, I pleaded with them. I was allowed to keep him, so long as I didn't microwave without supervision.

I was then strip-searched and left, alone and shivering in the cold, lino-covered room, a chasm of clinical wasteland with a hospital bed in one corner. Outside my window there was a scenic view of a barbed wire fence and a camera.

I dressed and went to find someone to reassure me, hoping to find workers on the floor, searching out remnants of the support I had found as a youth.

The common areas were littered with dusty board games and deserted couches. There was barely a soul to be found. An elderly man watched a repeat of Deal or No Deal. The nurses had barricaded themselves behind an assault-proof door.

I knocked, and a nurse opened the door an inch to ask what I wanted, as though I was a late night caller at her house come to steal her jewelry.

She came to watch me microwave my only source of comfort, then left.

I held my wheat teddy tight to my chest and walked back to my room, the pressure against my chest helping to soothe the anxiety gnawing at my ribs.

There were no workers here to greet you with a smile and ask if you wanted a cuppa, to engage you, to pass the time, to help unravel the knots in your mind that tangled like cables at the back of a TV. It was quite literally just a part of a hospital you were locked in as substances left your body.

I checked myself out of that adult unit a few days later. To calm my suicidal thoughts, I self-harmed, and to calm the self-harm, I self-medicated.

It took a few more weeks after that to treat myself at home, using what counselling services I could in the community. I had to leave the withdrawal unit to get better.

Ageing out of youth services is devastating.

It's being thrown into the adult sector: a wasteland of fragmented services devoid of the therapeutic value that many youth services offer.

'Risk management' in units is increasingly becoming bulletproof glass and assault-proof doors, when it really should be therapeutic relationships and adequate workers on the floor.

The current risk management approach entrenches feelings of deviancy, as though we are bad people - deceitful, violent and untrustworthy. We feel a clear separation between us and medical practitioners. Us versus them.

Only looking back now do I remember the youth unit did indeed have a workers station with a locked door, but you didn't even notice it. Nurses and support workers would float in and out, and I wasn't even aware it was there for safety.

At Fitzroy Resi, staff showed me around cozy carpeted rooms, walls decorated by residents, messages of support and art everywhere. The lounge-room was lively -- two boys around my age played pool, another girl was on the PC listening to music which floated through the common area. The place was alive, it had a sense of ownership to it. A lived-in feeling, and a sense of belonging. I met other people my own age, people at life stages that I could relate to.

A bedroom at YSAS Fitzroy Residential Withdrawal
A bedroom at YSAS Fitzroy Residential Withdrawal
YSAS Fitzroy Residential Withdrawal

"You're here for you," they told me at the youth unit. "You are voluntary. We won't empty your bags. It's up to you to want to address these issues. You can walk out that door any time you like to use, but you will have to go back on the waitlist. Use your time wisely."

It was said kindly, and it fostered a sense of collaborative teamwork in your recovery. It was respectful, you felt human.

Without youth services I wouldn't have graduated university -- I wouldn't even be alive.

I loved it there. I would go back even when I wasn't using, when I was worried I was at risk of using.

You can't do that as an adult. "Withdrawal units are for withdrawing," one nurse barked at me when I inquired.

Support systems targeted at young people are vital. But we also must not abandon those who grow up and haven't 'recovered' yet.

A life of trauma and associated illnesses isn't going to go away once you hit 21. And just as we know young people have youth-specific issues, people in their twenties and thirties have specific issues quite different to over-55s.

Some youth services have responded to the void in services by increasing their age limit to 25. It's a worthy pursuit, but one that ignores the elephant in the room: the desolation of adult services. Right now, services go from "youth" to nonspecific adult clinics -- the jack of all trades, and master of none.

The term 'recovery' is often defined by 'periods of abstinence' or 'clean time'. But 'recovery' doesn't work that way. The issue has never been the presence of drugs for most of us. The issues are adversity, repeated sexual abuse, PTSD, poverty and so on. I am now abstinent from drugs, but have I recovered? No.

I still become frozen in bed with sleep paralysis, I still experience pain throughout my body, I still battle depression and panic attacks. My OCD sees me in never-ending loops of 'perfecting' projects or rooms. Back and forth over and over until I fall into bed exhausted, then find myself gripped around my chest by the cold hand of paralysis, locked in a waking nightmare.

People like me, we are labeled as drug addicts, junkies. Our symptoms include self medication, so we are diverted away from mental health help and into punitive wards or groups focused on 'not taking that drug' rather than addressing the underlying issues. Unlike youth services, where a sense of community was built around you, and your ability to address the social and mental issues that plagued you was assisted.

Young people age out of care and into prison beds or, into yet another suicide statistic.

You don't 'recover' from a life of adversity -- you gain the right supports to deal with the damage and you become reintegrated with community. Just as a soldier doesn't 'recover' from the horrors of war. They find support. Well, that's what should happen, anyway.

As I said to the Judge in my Victim Impact Statement, read after the man who abused me for several years was sentenced, I am often referred to as a survivor. But surviving doesn't mean it's over. Surviving is feeling alone in carrying that burden every day. Like Sisyphus forever pushing the boulder up the hill.

It was shocking to me, going from youth support services to adult ones. I feel for any young person reading this. I hope we can do better for you, and that you won't face this in adulthood.

It is no wonder so many young people fear ageing out, because you are ageing out of a community -- of compassion.

You are ageing out of sight, and out of mind.

Tara Schultz is an adversity writer and commentator, combining academia, sector knowledge and on-the-ground insights into poverty and disadvantage. Follow Tara @_taraschultz, or on Patreon.

Photos of Tara by Ethan Robson Photography,

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