Acadia’s Sierra Tucson Group Ramps Up Efforts to Address Trauma, Expand Specialty Programs

In the year ahead, Sierra Tucson Group plans to get personal, expanding its specialty program offerings and honing its trauma-informed care efforts, CEO Valerie Kading recently told Behavioral Health Business.

Formed in 2019, Sierra Tucson Group is owned by Acadia Healthcare (Nasdaq: ACHC) and consists of three behavioral health treatment centers: Sierra Tucson, Sierra by the Sea and Sunrise Recovery Ranch.

The centers, which are located in Arizona and California, offer a mix of residential and outpatient services for patients with substance use disorder (SUD), mood disorders and other mental health conditions. Plus, they focus on providing trauma-informed care and treating specialty populations.

Behavioral Health Business recently connected with Kading to discuss the company’s 2021 goals, which include better serving postpartum mothers and health care workers; honing trauma-informed treatment; and improving the efficacy of telebehavioral health care delivery, among others. 

You can find that conversation below, edited for length and clarity.

(BHB also recently connected with the head of Sierra by the Sea and Sunrise Recovery Ranch, which you can check out here.)

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BHB: First of all, can you tell me a little bit about how you came to be CEO of Sierra Tucson Group? Before this, you were COO of the stand-alone Sierra Tucson center, correct? 

Kading: Yes. I’ve been with Acadia Healthcare for six years.

I’m a psychiatric nurse practitioner by training, so I’ve had different roles at Sierra Tucson. I was the director of medical operations. I was the interim chief medical officer. And my last position was COO.

When we had the opportunity to take on these two facilities in California, I was promoted to CEO for those facilities. And then in June, I had the opportunity to come back to Tucson to be the CEO of the entire Sierra Tucson Group.

What kind of tasks are in your purview as CEO of the group? 

My major responsibility is to ensure Sierra Tucson and the group continue to be leaders in healthcare.

How can we continue to provide the best medical/clinical care? What sorts of new innovations can we bring to the organization? How can we keep addressing the mental health and substance use issues happening in our world, society and communities?

Then recently, with COVID leading to a lot of anxiety, depression and increases in substance use, how can we continue to capture and help as many people as possible?

Sierra Tucson Group was formed in 2019. Why structure it that way, rather than for Acadia to operate these three centers separately? 

Sierra Tucson has a Sierra Tucson model, where we really focus on individualized care and attention to trauma treatment. We acknowledge that individuals suffer from substance use issues and depressive disorders because there is a trauma component.

A lot of our treatment has been centered around how we can address the root causes of issues. That’s very, very unique to Sierra Tucson and has made us successful over the years.

So creating this group and having the additional facilities has allowed us to take that model and infuse it into these other two facilities.

Sierra Tucson Group locations offer inpatient, residential and outpatient treatment for SUD and co-occurring disorders. But I’m curious: What type of treatment is most commonly provided?

At the Sierra Tucson facility in Arizona, we’re dual licensed for mental health and substance use. 

The majority of our clients are being treated for mood disorders, anxiety and trauma. Yes, we do have a significant substance use population, but in the past year, we’ve really seen an increase in the need for mood treatment.

In California, those two facilities are licensed for primary substance use and co-occurring conditions. We’re seeing primary substance use trauma at those facilities.

What sets Sierra Tucson Group apart from competitors?

The biggest thing that differentiates us is our ability to address trauma.

Someone can come here for substance use and, yes, we’re able to use all sorts of tried-and-true substance use interventions. But, additionally, we offer very significant trauma components. People receive EMDR, somatic experiencing and body work that really addresses the trauma connection to the body.

You can’t address the behavioral problem until you address the roots. A lot of treatment centers don’t do that: Trauma is something that is seen separately and not a focus of treatment.

The Acadia backing also doesn’t hurt when it comes to setting you apart.

The good thing about Acadia is that we are given the liberty and independence to do what we want to do within our treatment model. It is definitely positive to have the resources, brains and corporate support.

When it comes to dealing with the financial strain of the coronavirus, those resources must be especially useful. A lot of smaller facilities have struggled through this period, and many people predict the SUD industry will see closures this year as a result.

I’ve been witness to small facilities in California going under in the past year because of the coronavirus. Unfortunately, it’s the mom-and-pop places.

In terms of Sierra Tucson, we’ve been strategic. Don’t get me wrong, COVID has absolutely affected every single health care entity in this country, but I think what’s really set us apart is that we didn’t conduct business as usual.

We were facing different challenges, and so we responded to all of that. You have to look at what’s different with COVID and what’s going on with the community. What do we do to continue to be the primary choice for treatment? How can we make treatment more accessible? How can we listen to patients’ needs, then meet them? 

You can’t do the same thing you were doing before if you want to be successful. 

What did those changes look like at Sierra Tucson?

We focused on the prevention of COVID, making sure that all our processes were creating a very safe environment for not just your staff, but for the patients coming in.

Anytime there’s any sort of change in CDC recommendation, we are responding quickly. We’ve been very agile and flexible.

We also looked at how COVID impacted substance use, depression and anxiety. How can we change treatment so we are addressing the things that really are significant?

What about COVID-19-related travel restrictions? Did those pose any problems? Or do most of your patients come from nearby communities?

It’s a combination. We have a significant amount from Arizona and bordering states. Then we do have a good portion coming from all parts of the country.

Depending on how significant the increase in coronavirus rates are in different parts of the country, travel has posed some problems at some points in time. But in general, it has not. I would say that most people have felt the benefit of getting treatment at Sierra Tucson really outweighs the concern they had for travel.

Did your census at all as a result of COVID-19?

No.

I know census reductions posed some problems for struggling mom-and-pops: Decreased censuses led to decreased revenue amid increased costs. As behavioral health is a collaborative industry due to the high level of need for services, what do you think those closures you mentioned mean for the SUD treatment industry in 2021 and beyond?

It’s really disheartening to see the closures of various facilities that had been helping and providing care for those in need. My hope is that the facilities that continue to provide treatment become stronger and continue to thrive.

Switching gears here a little bit: I want to talk about specialty service lines, which are a big point of emphasis for Sierra Tucson Group. Can you tell me about some of those and why you’ve made them an area of focus? 

There are unique needs for different populations.

For example, one of the specialty groups we’ve worked with are licensed professionals — nurses, physicians, pilots, attorneys — who have concerns with substance use or mental health issues. Just being in those fields puts people at a higher risk for stress or substance use.

It’s sometimes challenging when you put someone who has these unique experiences in treatment with people that don’t understand what they’ve experienced. People who have a shared common experience feel comfortable talking about these issues without being judged or ashamed. It’s very therapeutic and allows that person to really be honest about what’s happened. It becomes a more successful sort of treatment.

You see this also with our Red, White and Blue Program, which is for first responders and veterans. Most of them usually hesitate to talk about their painful trauma histories, but when you get them together, it’s like a brotherhood or a sisterhood. They know they can trust each other and be open and honest and talk about the trauma they’ve experienced.

Do you have any plans to add more specialty programs this year? What are your goals on that front?

Absolutely. I’m very excited about our plan for treating women with postpartum depression. That’s a big focus for us this year.

Up to 20% of women suffer from postpartum depression, and treatment is not available to most of them. Many healthcare care providers don’t assess for postpartum depression, perinatal depression or substance use, and women end up suffering alone.

What we’re doing is putting together a virtual IOP for postpartum depression so that women can receive treatment at home. If they have a baby there, they have greater access to care through telemedicine. Then we also continue to help women who are either pregnant or postpartum through our residential program.

What other goals or priorities do you have for 2021?

The major goals for this year are to, first of all, continue to help people who have suffered from the effects of COVID. We want to continue to help people who are suffering from depression, loss and grief.

Then, we’re also focusing on our Healthcare Heroes. It’s a program designed for nurses, like those have been on the frontlines of COVID, which is not going away anytime soon. Our health care workers are suffering, and I want to make sure that we continue to put a lot of resources into helping those individuals.

What are the biggest challenges you expect to see this year?

Telemedicine is extremely valuable in the sense that it provides access to care, but it’s also challenging. People are getting tired of not having face-to-face interaction, so that’s going to be one of our challenges this year. 

How do we continue to connect with people? How do we continue to provide the best care while we’re still trying to utilize all these other platforms to keep safe from COVID?

More so than ever before, it seems like the government is trying to help behavioral health providers grapple with some of the challenges they’re facing, thanks in part to the attention the coronavirus has given the industry. What else do you think needs to happen on the federal front to improve the industry?

Parity laws need to be enforced to ensure people are able to use their insurance to receive the care they need, just like if they had a heart attack or other serious medical issue.

That’s been a challenge. The behavioral health field is always trying to justify why we need to provide care for someone — whereas if it was a medical issue, it’d be like, “This person is post-myocardial infarction. They’re going to get this much treatment.”