But part of the upsurge may be positive: It could signal a reduction in the stigma associated with seeking help during critical times in the minds of teens and parents. It also could indicate a strong relationship between school counselors and administrators and the therapy/counseling service.
ACS has served troubled young persons in one way or another since it was founded in 1975, for many years under the leadership of Sue Barkhurst and currently under Executive Director Phillipe Rey.
Last year was "the busiest year we've ever experienced," Rey reported at an Oct. 1 meeting of the agency's Board of Advisors.
The agency's on-campus counseling program last year served 3,781 clients, of which 1,123 were therapy clients seen in 7,150 counseling sessions. About 450 young persons participated in a support group in the on-campus program, and the agency reached 2,208 individuals with education and outreach messages, Rey reported.
"What is amazing is that we had a 12 percent increase from the previous year in the therapy clients we saw," he said.
The counseling service, commonly known as ACS, serves public and private schools in Palo Alto, Menlo Park and East Palo Alto, as well as Boys & Girls Clubs in Menlo Park, East Palo Alto and Redwood City. Woodside High School was recently added to its roster, with a strong first-year referral rate.
ACS also has linked, as of last July 1, with the Outlet organization, which counsels and conducts groups and workshops for young persons with issues related to sexual preference and identity.
ACS provides on-campus counseling for middle and high schools, and operates an "after-school counseling" program that is strongly family-focused and is based at the ACS offices, 1717 Embarcadero Road, Suite 4000, Palo Alto. The name is a bit of a misnomer, as it continues into the summer — so it more accurately is a general counseling center or program.
ACS counselors see young persons with issues that range from deeply serious "suicidality" to seriously troubling anxiety or depression, as well as general life concerns.
"We're seeing kids and they're talking about what's really happening," Roni Gillenson, who directs the on-campus counseling program, reported. Despite a lingering stigma around mental health, "We see more and more kids walking in to talk, kids pulling their friends in saying, 'You should talk to this ACS counselor,'" especially in the high schools, she said.
The agency has four primary goals for its young clients: Maintenance of grades, improving a personal level of functioning, perception of being helped, and relief of symptoms of depression. The program set a high level of 80 percent for clients' perception of the counseling being helpful and received a 97 percent rating from the clients.
Maintenance or improvement of grades was set at 50 percent, and came in at 45 percent, while level of functioning targeted 70 percent but came in at 68 percent.
Lessening of mild depression, targeted at 50 percent, came up short at 36 percent.
Gillenson pointed out that going into counseling can shift the focus away from grades, and that in terms of mild depression "sometimes it gets worse before it gets better" when the person is tackling important issues in his or her life.
The high rating of helpfulness is particularly satisfying "because we are talking about some difficult things. We find that kids are talking about their depression, their anxiety, their level of stress. They're talking about their suicidal thoughts."
Connie Mayer, who directs the after-school and counseling-center programs, echoed the observations of increased use of ACS services generally, with an important addition: Young persons are dealing with deeper issues over longer counseling periods with therapists.
"They are seeing their clients in the counseling center for longer periods because their issues run deeper. What used to be a five- or six-session relationship is now much longer and deeper" and involves families for up to 10 sessions.
"We have families seen by a therapist and a child seen by a different therapist. So there's a lot of collaboration going on," she said.
"Last month we had three hospitalizations, with depression and suicidality. That's just in one month."
Mayer said she is "proud of the therapists we get, with a lot of experience under their belts." And it is noticed, she added: "Other agencies, students and parents get word that we have experienced therapists. On the first day of school we had 11 referrals in the substance-abuse program from the two high schools. We are also getting private-school referrals in substance abuse and alcohol. ... School counselors and administrators are hearing about what we're doing.
"It's really a wonderful thing to see that our outreach is reaching all these kids in need."
There are changing patterns in substance use and abuse, she said, citing the new Ecstacy-like drug called Molly "handed out like candy" at "rave" parties such as one last month in Mountain View that received media coverage. But Molly "can have up to 225 toxins in it," and the teens being given it at parties can suffer side effects and easily overdose and require treatment.
And it's not the "heavy-user" teen involved, she said. "It's the teen going to a party with their friends. It's the teen next door, with 3.5 to 4 grade-point average."
Educating parents about the nature of substance use, abuse and addiction is a key element of the family involvement, whether it is intensely personal within a family or a general awareness of issues and haunting concerns of a community.