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How We Can Treat Addiction on Campus

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Cornell University, like other colleges, recognizes that some students are addicted to alcohol and other drugs and is exploring the development of a collegiate recovery program. Some elements for a comprehensive program already exist on campus; others are yet to be created. A successful program, however, will embed a firm understanding of addiction and recovery into Cornell Health’s public health approach to mental health.

Addiction is characterized by the psychodynamics of denial, and collegiate recovery programs must confront those psychodynamics within the framework of a comprehensive public health approach. Anyone who has attempted to talk with a loved one about his or her addiction knows that their first reaction is to deny that there is anything wrong with their drinking. “I am not an alcoholic. I drink like everyone else.” “Alcoholic” and “addict” are highly stigmatized labels, heavily freighted with accusations of moral failing. In American culture, nobody wants to be seen as out of control, especially unable to exercise control over one’s alcohol or drug use. Denial makes helping addicted individuals difficult; nevertheless, it is possible to overcome their denial and set them on the pathway to recovery.

One in an occasional series of articles about student mental health. For more information, go to The Sophie Fund’s Student Mental Health Page

Employee Assistance Programs use the constructive confrontation strategy to break through denial and motivate employees to accept help. Supervisors, for example, focus on job performance. When they see an employee’s performance deteriorate, they use progressive discipline and offers of help to motivate the employee to seek assistance from the program. When supervisors implement this strategy, employees are most likely to accept help and recover from their addiction. The constructive confrontation strategy can be used in a variety of settings, including schools and hospitals. The crucial balance—disciple and assistance—motivates addicts to accept treatment and recover.

Collegiate recovery programs can embed the crucial balance in the comprehensive public health approach—education/prevention, intervention, and treatment—used by colleges to address student mental health. Within each approach, it is important to highlight that addiction is a real phenomenon on college campuses, that addiction is characterized by denial, and that students can be motivated to accept help by focusing on their performance (e.g. grades, personal relations, campus code) and offering them assistance in correcting the problems. It is most important to emphasize that addiction is a medical problem and not a moral one, that recovery is possible, and that many students and alumni have recovered and are living sober, rewarding lives.

Education: Colleges already educate students about alcohol, responsible drinking, and the consequences associated with excessive use, but they can do more to educate the campus—students, faculty, and staff—about addiction and recovery. Campus alcohol and drug policies should state clearly that addiction is a medical problem and that the college is committed to providing students with the support required to recover and live sober and successful lives. College presidents and other campus leaders can amplify this message across campuses.

Likewise, addiction and recovery can be included as part of education efforts such AlcoholEdu, the Alcohol Literacy Challenge, or eCHECKUP TO GO and social norming campaigns. Cornell Health, for example, is incorporating a segment on addiction and recovery into its online alcohol and drug program required of all freshmen and transfer students. It is crucial that everyone understand that students’ use of alcohol lies along a continuum: many students choose abstinence; most students consume alcohol responsibly; some students get into trouble with alcohol and can learn to moderate their drinking; some students get into trouble because they are addicted to alcohol and they can recover and live sober lives.

To reduce the stigma associated with addiction, colleges can bring successful recovering alumni back to campus to talk with students about their college experience, addiction, and recovery. At Cornell, for example, the Panhellenic Society and Interfraternity Council have sponsored alumni talks, which enable students to distinguish between normal drinking and addiction. From the talks, students learn that help is available for themselves or friends and that sobriety and success are realities for addicted students.

Intervention: Intervention means taking direct action to help someone. On campus, many individuals are well situated to identify students with a potential problem and intervene. Among those well situated to intervene are faculty, peers, student advisors, health care professionals, campus police, and judicial administrators. Unfortunately, intervention often receives short shrift in mental health programs, whether they occur in the community, workplace, or campus because clinicians are uncomfortable with the constructive confrontation strategy and prefer that clients recognize their own problems and choose to come to the program on their own. At the same time, Americans are reluctant to intervene because we prize self-control, expecting others to behave responsibly and seek help on their own. Unfortunately, individuals suffering from addiction do not seek help on their own and require external motivation to accept assistance. The good news is that programs can train individuals such as peers, faculty, and advisors to identify students with problems, to intervene constructively, and to motivate them to seek help.

Many colleges are developing bystander intervention programs, which train students to identify problematic situations and intervene. For example, the NCAA’s program, Step UP!, is an excellent bystander intervention program that trains students to take action in a variety of situations—alcohol and drugs, sexual assault, cheating. It has been adopted by many colleges. Cornell has an award-winning video and workshop, Intervene, which depicts students intervening constructively in a variety of situations. While bystander intervention training increases students’ openness to intervention, the training efforts have yet to create a norm for intervention so that it is embedded in the campus culture and that students take it for granted and feel a duty to intervene.

Comprehensive recovery programs can do more to teach intervention strategies to intervene and ensure that students who have substance use and mental health disorders receive help. This means creating a web of support for individuals to intervene so that intervention is taken-for-granted as part of their role, whether one is an advisor, professor, doctor, or police officer. It also means teaching that college students can be addicted to alcohol and other drugs, that they can motivate students to change their behavior by using the constructive confrontation strategy, and that students can recover from their addiction, live sober lives, and have successful academic and professional careers.

Creating this web of support requires commitment from the top, making it a priority so that individuals feel a duty to intervene when they see students in need of help for addiction and other serious mental health disorders. It also requires some creativity. For example, at Cornell, some fraternities and sororities are implementing peer-based health and safety committees to educate chapter members about health related issues. These committees, like successful peer-based Member Assistance Programs, could train fraternity and sorority members to intervene, refer students for help, and support them in recovery. Similar programs could be developed for faculty, advisors, and health practitioners to create a web of support and duty to intervene and make a referral to the college’s student health center.

Treatment: Treatment refers to health practitioners accurately diagnosing a student’s medical condition, providing appropriate treatment, and following up to make sure that the treatment was effective and the student has recovered. It is important that clinicians are cross-trained in mental health and substance use disorder. That capability is crucial for differentiating between students who are abusing alcohol and other drugs and those who are dependent upon substances. Like Cornell, many colleges have two programs that can help students who are abusing alcohol to control their drinking. BASICS is a harm reduction strategy, which teaches students responsible drinking by highlighting campus norms and encouraging future compliance. Research finds that most students learn their lesson and drink responsibly. Some have difficulty learning, continue to abuse alcohol, and are candidates for Moderation Management, which is typically a group program. Students agree to abstain from drinking for 30 days and are taught techniques for moderating their alcohol use. Students who are abusing alcohol will learn to control their consumption. Students who are addicted to alcohol will not be able to implement the techniques and control their drinking. These students are candidates for addiction treatment.

Sixty years ago, addiction treatment was limited to a few in-patient programs, often 30 days in length, and Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) to support one’s long term sobriety. Today, there are many treatment options. However, abstinence still remains the goal for addicted individuals and long-term support by attending self-help, mutual aid groups still works for maintaining sobriety. Some people are able to utilize out-patient programs, which teach them about addiction, abstinence, and managing their sobriety. Individuals attend individual and group sessions multiple times a week, often daily. They allow patients to maintain some involvement in their normal lives (e.g. working and attending classes) while requiring them to avoid activities that can trigger a return to drinking such as hanging out with drinking buddies and attending parties and to attend AA or NA meetings. In-patient programs remove individuals from their normal lives, put them in a congregate living situation with other addicts, and immerse them in an intensive education experience about their addiction, abstinence, and long-term sobriety.

Treatment for college students is not easy. Colleges located in urban settings may have many options, both in-patient and out-patient, where students can be referred for treatment. Colleges in rural settings may have few or no local options, especially for out-patient treatment. Indeed, local options may be limited to a single program designed for a wide range of adults and, therefore, less able to focus on the special needs of students and the demands of college life. Fortunately, there are excellent in-patient programs for college students, but they do require students to take a leave from campus life and focus on treatment and recovery. Typically, this means taking a semester off, completing the program, and finishing up at home with one’s parents and attending AA or NA meetings.

The congregate college life with its parties is not the ideal environment for students learning to abstain from alcohol and embrace a sober lifestyle. Imagine trying to adopt a sober lifestyle while living in a fraternity, apartment, or dorm with one’s drinking buddies. In this context, in-patient treatment offers a refuge where students can focus on their recovery and enjoy the support of others.

Whether one opts for out-patient or in-patient treatment, long-term recovery requires the support of others such as fellow students, faculty, and advisors. Colleges can do a great deal to support addicted students in their recovery. They can begin by telling everyone that addiction is a medical problem and that students who recover from their addictions have excellent GPAs, graduate, and have successful careers. They can provide group support through local AA and NA meetings and create campus self-help, mutual aid groups such as Sober@Cornell. Student health services can provide counseling to help students with adjustments to campus life and prevent relapse. They can also provide safe spaces such as sober dormitories and club rooms, where students can hang out and enjoy the company of other students in recovery. Colleges can connect students with alumni in recovery, who are able to share their stories of recovery.

Addiction to alcohol and other drugs is a serious problem on college campuses. Nevertheless, recovery is possible and students can live sober and rewarding lives. Cornell Health’s effort to develop a collegiate recovery program can achieve success by embedding it into its public health approach to mental health.

—By William J. Sonnenstuhl

William J. Sonnenstuhl is an emeritus professor in the School of Industrial and Labor Relations (ILR) at Cornell University. His primary research examines alcohol and drug problems in the workplace and on college campuses. He is the faculty advisor for Sober@Cornell, President of Cornell Collegiate Recovery, Inc., board member of Cayuga’s Watchers, and member of the Fraternity, Sorority, and Alumni Council.

For Mental Health, Ithaca’s MindWell Offers Evidence-Based Care

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Mental health services in Tompkins County have been stretched to the limit for years. Demand for crisis support at local mental health clinics, as well as calls to Ithaca’s crisis hotline, spiked after the Covid-19 pandemic disrupted normal life in 2020. The number of people seeking non-crisis counseling in the county has also increased steadily since then.

MindWell Center Co-Founders Sarah Markowitz and Aaron Rakow

Into this breach last October stepped a new service provider promising cutting-edge approaches to mental health care: Mindwell Center LLP, located in the South Hill Business Campus.

MindWell is the brainchild of Aaron Rakow, a clinical psychiatry professor at Georgetown University who returned to his native Ithaca with a mission to upgrade the availability of services and standard of care in rural upstate New York. In short order, Rakow and co-founder Sarah Markowitz have hired 25 therapists and are adding another one-to-two a month; they plan to open a second clinic with 10 clinicians in September in Albany. MindWell is currently supporting 350 patients and counting.

“Across our society, we have more demand for mental health services than we have providers able to support that demand,” Rakow said. “In particular, within a category of the mental health field that we refer to as evidence-based care, or psychological intervention that is based on science, to be as effective as possible in treating a host of mental health challenges amongst individuals, there are even fewer practitioners that practice in that space. My hope is that through opening MindWell Center we will be able to address some of those needs.”

The Tompkins County Chamber of Commerce honored MindWell at its 2021 Annual Meeting and Celebration on May 20 with its Distinguished Business of the Year Award. Announcing the award, the Chamber said: “In response to a specific and substantial community need—access to effective, quality mental health care, and removing stigma regarding mental health concerns—MindWell founders Aaron Rakow and Sarah Markowitz have introduced a new model of treatment to our community and expanded their staff and services considerably in a short period of time.”

MindWell strives to provide the highest quality evidence-based mental health care to children, families, and adults for a spectrum of mental health conditions, including depression, anxiety, eating disorders, sleep disorders, substance use disorders, Post-Traumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD), and Attention-Deficit/Hyperactivity Disorder (ADHD).

Besides supporting individual patients, MindWell is ramping up population-level initiatives—for example, it offers contracted services for companies where clinicians implement programs fostering healthy workplaces through leadership training, wellness seminars, stress reduction classes, support groups, and individualized care for employees. MindWell is offering similar services to schools in the region, both K-12 and colleges. Rakow believes that the Ithaca community is aware of the need to address the “mental health pandemic” many experts believe accompanied the Covid crisis.

Rakow said that another key part of MindWell’s mission is to support the training and retention of high-quality evidence-based clinicians in upstate New York. To that end, MindWell has formed partnerships with the University at Albany and Binghamton University to provide training through externships for graduate programs in clinical psychology.

WATCH: Promotional video about the MindWell Center

Evidence-Based Care (EBC) is an evolving standard of care involving a variety of treatments endorsed by leading mental health associations. According to experts, it emphasizes integrating the best available research with clinical expertise in the context of a patient’s culture, individual characteristics, and personal preferences. Nonetheless, as a 2013 New York Times article pointed out, “surprisingly few patients actually get these kinds of evidence-based treatments” despite numerous trials demonstrating their effectiveness.

MindWell clinicians are trained to provide Cognitive Behavioral Therapy (CBT) and Measurement-Based Care (MBC) to carry out its evidence-based approach. According to the American Psychological Association, CBT encourages patients to recognize distortions in their thinking that are creating problems, and learn problem-solving skills to cope with difficult situations.

Any good therapist will utilize treatment elements such as reflective listening, validation, and empathy. As Rakow describes it, evidence-based treatment adds a roadmap for the client and the therapist to most efficiently decrease the symptoms of disorders through specific strategies and techniques that have been proven through science. In treating a patient with depression, Rakow explained, the therapist will assess the factors behind the patient’s negative thinking patterns. Then the treatment will focus on teaching coping skills that can change the patient’s cognitive narrative.

“The client gets a workbook to help their guidance and help their process at home,” said Rakow. “The clinician has a workbook to help guide the sessions. That is an evidence-based intervention in practice.”

Furthermore, MBC bases clinical care on data collected from patients throughout their treatment; experts say that MBC provides insight into treatment progress, highlights ongoing treatment targets, reduces symptom deterioration, and improves client outcomes.

“We are looking at every single session for the individual on how they are improving, if they are improving,” Rakow explained. “And if they are not, what can we be doing differently on an interventional level?”

To use an example, Rakow said that a clinician treating anxiety will have patients fill out screen tests during every therapy session to measure increases or decreases in symptoms. “So they can say, ‘It looks like you’ve had a difficult week. We’re seeing your anxiety go up. Let’s see how we can calibrate the treatment effectively to bring that level back down. Because we know you have that potential.’ If we are not practicing measurement-based care, we’re not practicing evidence-based care. Those two things must always go together,” Rakow said.

Some team members at MindWell are equipped to prescribe medications. That said, Rakow points out that many of the most evidence-based strategies involve the combination of psychotherapy and medication management, as opposed to a treatment regimen that involves medication management alone. Thus, MindWell’s team of multidisciplinary providers collaborate closely on cases to ensure that the treatments are optimally calibrated to each patient’s individual needs.

Population-level initiatives provide easier access to mental health treatment, Rakow explained. “There are far too many barriers to accessing high quality mental health care in our country,” Rakow said. “We will partner with hospitals, with school systems, with institutions of higher education, with businesses big and large, to provide integrated mental health solutions for their employees, for their pupils, for their staff, for their patients, to make the process of accessing mental health care that much easier.”

Rakow said that businesses are receptive to upstream mental health support for their employees, especially amid the Covid-19 pandemic, in part because they realize that decreased wellness can impact productivity and profits. He said that MindWell services for K-12 schools can focus on administrators, teachers, and staff as well as students and their parents.

School-integrated support helps parents avoid what can be a difficult challenge in navigating mental health services for their children on their own, Rakow said. “If you are a mom or dad, and your child needs mental health care, you have to locate a provider, wait for that provider to have an opening, take time off to drive across town and take that child to that appointment, wait while the child is seen, and follow up with the clinician,” Rakow said. “That could take weeks or months to treat, in the best-case circumstances.”

MindWell’s model for higher education similarly supports faculty and staff members while seeking to relieve the increasing burden on student counseling services.

“College student mental health is right now an extremely high need for our field,” said Rakow. “The institutions of higher ed in our region are taking this issue extremely seriously and have put an incredible amount of thought and commitment and resources towards it. But our need in our society from a mental health perspective continues to grow and the demand for it continues to increase. We need to really think innovatively about how we can provide support and access points for undergraduate and graduate populations of learners in our community to be able to effectively meet that demand.”

UPDATE: MindWell is working with regional insurance carriers to become in-network as soon as possible to increase access to its care model. In the meantime, MindWell offers a generous sliding scale for clients in need. MindWell also offers what it calls courtesy billing whereby the MindWell team submits the claim on the behalf of the client so they can focus on their care rather than dealing with paperwork.

Sleepless in Ithaca

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Instead of falling asleep at 10 p.m., Daniel, a junior psychology major at Ithaca College, has just woken up. He was too tired to stay awake in the afternoon, but now he won’t be able to get back to sleep until 2 or 3 a.m. Because he won’t get enough sleep at night, tomorrow he’ll be tired again in the afternoon.

The Fountains at Ithaca College

College students are notorious for their unconventional sleep schedules. The transition to online classes during the Covid-19 pandemic has merged school and personal time, meaning even more students are having difficulty getting enough sleep at night and staying awake during the day. The Ithaca College Center for Health Promotion hosts the THRIVE @ IC Wellness Coaching program, which includes one-on-one sessions and group workshops for building resiliency to help students address these sleep difficulties and other health concerns. According to Program Director Nancy Reynolds, a Health Education Specialist and National Board-certified health and wellness coach, anyone can start taking steps today to improve their sleep cycle and overall wellness.

A good night’s sleep might be hard to get for some, experts agree, but it’s easy to define. According to the Centers for Disease Control and Prevention, adults college-aged and up need seven to nine hours of sleep every night. Sleep is generally better without frequent awakenings and when you keep a consistent routine, waking up and going to bed at similar times every day.

Reynolds points out signs of a poor sleep schedule that may sound familiar to college students.

“Do you feel well-rested in the morning?” Reynolds asks. “What’s your fatigue level during the day? Because that’s another marker of if you’re not getting enough sleep or a good quality of sleep. You’re going to notice during the day that you’re feeling groggy, maybe you’re falling asleep in class, you’re having to take naps every day because you’re so tired.”

It’s a stereotype that college students choose to stay up past midnight and sleep into the afternoon, but many students like Daniel, who requested that his full name not be published, really do have difficulty getting up and staying awake.

According to Reynolds, various aspects of student culture contribute to unhealthy sleep schedules. When students spend time on phones and laptops late into the night, she noted, blue light from these devices prevents the brain from releasing sleep chemicals. Reynolds said that many students also struggle with time management, especially when they’re juggling a lot of responsibilities. That can force students to stay up late to complete all their tasks or assignments, she said. Reynolds also points to a strange element of college culture in which students “compete” to be the busiest or the most sleep deprived—which some students dub the “Sleep Olympics.”

The switch to online learning has further complicated student sleep problems, Reynolds said. Students face even more hours of screen time, and the line between schoolwork and rest of life is blurred. It’s not unusual for students to log in to a class on Zoom and see several classmates attending from their beds. Reynolds explained that taking online classes from the same room all day may be another reason students are struggling with sleep.

“We’re not getting variety in our day in terms of social connections and moving around to different environments—walking around campus, going to the library, hanging out in different students’ rooms,” she said. “We’re not getting the same amount of stimulation that our brains need to make our bodies ready for sleep at night.”

Along with lack of stimulation, Covid-19 has introduced new stressors, such as social, financial, and health-related worries, that may keep students up at night, Reynolds said. She noted that many people are coping with feelings of grief for those they have lost to Covid-19.

Reynolds said that sleep and mental health are strongly interconnected. Bad moods, low energy, and difficulty in focusing due to lack of sleep take a toll on mental health.

Reynolds explained that sleep cycles necessary to maintaining mental wellness can be interrupted for many reasons, one of which is substance use.

“Some students are self-medicating with cannabis,” she said, explaining how students use marijuana to help them fall asleep at night. “The downside is we know scientifically that THC and cannabis prevent us from going into REM sleep, which is dream sleep. If you don’t get dream sleep on a continual basis, your mood may suffer.”

Struggling with mental health can cause poor sleep, and in turn poor sleep can make it difficult to focus on one’s mental health, Reynolds said. Anxiety specifically feeds into this cycle, as racing thoughts keep people awake, and the resulting poor sleep causes them to feel like they can’t handle challenges in their lives, she added.

Daniel agreed that the two were related, saying, “When my sleep schedule is off, I’m often anxious about class work, since I don’t have time or energy to get it done.”

It can seem like an endless cycle. At Wellness Coaching, Reynolds focuses on finding a first step that can help students move forward. This may be anything from mindfulness to a new exercise routine.

“You have to go at it from both aspects—improving the sleep and reducing anxiety,” Reynolds explained.

All aspects of health are related, which Wellness Coaching illustrates through a “Resilience Pyramid” graphic. The bottom building blocks of the pyramid are eating well, “balancing substance use,” moving your body, and getting good sleep. All of these elements are essential for building up personal health and moving up to higher goals on the pyramid such as connecting with others and adopting a growth mindset.

In a first visit with Wellness Coaching, students typically assess their own strengths and challenges on the pyramid. They can then start finding solutions. Wellness Coaching is currently available virtually at no cost for all Ithaca College students. Reynolds encourages students to reach out, even if they only need assistance for one session. (Email healthpromotion@ithaca.edu for more information.)

Reynolds said there are several first steps that a student can take today to getting their sleep cycle back on track. For example, she said, take the time to go for a walk outside, allow yourself breaks between classes, and stay connected with the important people in your life. Be mindful of activities that may be disrupting your sleep cycle, such as upsetting media, substance use, and long naps, Reynolds advised. She also recommends establishing a nightly wind-down routine, a period of 30 to 60 minutes before bed when you shut off your devices and do something quiet like stretching or listening to a podcast.

As the semester nears an end, Daniel is feeling hopeful. With three of his five classes now meeting in person, he’s having less difficulty separating work and leisure environments. He’s also monitoring his afternoon habits, trying to avoid  too-long naps. Daniel’s latest report: the sleep cycle is getting back on track.

—By Lorelei Horrell

Lorelei Horrell, an intern at The Sophie Fund, is a second year Ithaca College student with a Writing major and double minor in Sociology and English.

Support Family & Children’s Service of Ithaca

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Now more than ever, Family & Children’s Service of Ithaca needs the aid of the community to ensure that it can continue to be a place to turn when someone needs support for their mental health. Click here to donate to F&Cs’s Annual Cardboard Boat Race (Virtual Edition) fundraiser.

Scenes from the 2019 Cardboard Boat Race on Lake Cayuga

The Covid-19 pandemic prevented F&CS from hosting its fun-packed fundraiser on Cayuga Lake as usual. But boat “captains” are nonetheless flying their virtual flags high to collect funds to benefit F&CS.

This year’s goal is to raise $40,000 by September 13. Donations will support high quality mental health care that is affordable and accessible to anyone in Tompkins County.

More than 40 clinical therapists and psychiatrists at Family & Children’s Service help some 2,000 individuals and families every year by providing counseling and psychiatry services for depression, anxiety, and mental wellness.

F&CS also operates a range of social service programs, such as temporary housing for runaway and homeless youth and support for kinship foster families. F&CS’s Community Outreach Workers provide social worker support throughout downtown Ithaca.

Watch a short video to hear President and CEO Karen Schachere and board members discuss F&CS’s mission.

The Healing Power of Storytelling

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“The Path to Recovery: One Story at a Time” is the theme of this year’s Annual Depression Conference being held at the Tompkins County Public Library from 9 a.m. to 3:30 p.m. on Tuesday, November 28. Open to the public, the conference includes a keynote talk, a panel discussion on mental health recovery, workshops focused on children/adolescents, adults, and older adults, and a book discussion.

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The keynote speaker is Regi Carpenter, an advocate for “narrative medicine,” a medical approach that utilizes patients’ personal stories as part of their healing. She is the author of Snap!, the story of her own severe mental illness as a teenager and her path to recovery, and a memoir, Where There’s Smoke, There’s Dinner: Stories of a Seared Childhood.

Carpenter was 16 years old when she first experienced severe mental illness and was committed to a New York State mental institution. According to the conference organizers:

“After being released she never spoke of it for over thirty years. As a professional storyteller, author and workshop leader, Regi knows the importance of telling one’s story to overcome trauma, ease anxiety, depression and shame. It wasn’t until she told her story of teenage trauma that Regi knew the healing power of stories to restore and heal the battered psyche. In this keynote you’ll hear stories of Regi’s experience as well as how stories can be used as a therapeutic tool to help clients become more resilient and resourceful.”

From Carpenter’s website bio:

“For over 20 years Regi Carpenter has been bringing songs and stories to audiences of all ages throughout the world in school, theaters, libraries, at festivals, conferences and in people’s back yards. An award winning performer, Regi has toured her solo shows and workshops in theaters, festivals and schools, nationally and internationally.

“Regi is the youngest daughter in a family that pulsates with contradictions: religious and raucous, tender but terrible, unfortunate yet irrepressible. These tales celebrate the glorious and gut-wrenching lives of four generations of Carpenter s raised on the Saint Lawrence River in Clayton, New York. Tales of underwater tea parties, drowning lessons and drives to the dump give voice to multi-generations of family life in a small river town with an undercurrent.”

Ithaca’s 24th Annual Depression Conference is sponsored by: the Alcohol and Drug Council of Tompkins County; Cayuga Addiction Recovery Services; Family and Children’s Service of Ithaca; Finger Lakes Independence Center; Ithaca College Gerontology Institute; The Mental Health Association in Tompkins County; Multicultural Resource Center; Suicide Prevention & Crisis Service; Tompkins County Mental Health Department; Tompkins County Office for the Aging; and the Tompkins County Public Library.

Photo Caption: Regi Carpenter

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