AUSTIN (KXAN) — Denise Ramirez was caught in her childhood bedroom injecting heroin at age 17 when she was sent to the Selena Center for Youth Potential, a residential rehabilitation center for adolescent girls.

“When I look back at a lot of people that I grew up with [who] are not around anymore, a lot of them have passed away because of their substance use issues or their addictions,” Ramirez said. “I just feel really grateful that I was introduced to treatment at such a young age.”

Years later, Ramirez returned to the Selena Center. This time as a licensed drug counselor with years of sobriety behind her.

For over 25 years, the Association for the Advancement of Mexican Americans operated The Selena Center, which welcomed young females with addiction problems from all over the state to its residential treatment program in San Antonio. The center served girls from all over the state but closed in August 2020 after missing a deadline to renew state funding, according to Patrick Rocha, director of prevention and counseling services at AMMA.

After the closure of the Selena Center and other juvenile rehabilitation programs during the pandemic, girls like Ramirez have had limited options for state-funded, all-female treatment she credits for much of her current sobriety.

“The need is there, and it’s heartbreaking to know that there are girls out there that aren’t receiving those services,” Ramirez said. “I kind of feel like they’re not really being taken seriously.”

‘Where do these kids go now?’

Before 2021, female teens struggling with addiction in Austin could access treatment less than two hours away from their families.

After the closure of multiple programs in 2020, only nine residential treatment centers admitting juvenile girls remained in the state — the closest located 160 miles from Austin.

“Where do they go? Where do these kids go now?” asked Rocha.

Residential treatment centers are drug counseling programs with typical stays of 60 to 90 days. The number of RTCs available to females under the age of 18 in Texas was already small, but less than a year into the pandemic, at least five programs serving young girls were cut.

All adolescent RTCs — all-female, all-male and co-ed — took a hit in 2020 due to a lack of referrals of teens into their programs. However, over 400 beds for males remain in the state versus an estimated 160 female beds.

These numbers are based on data obtained by KXAN through the Texas Public Information Act from the commission of Texas Health and Human Services. It is the most up-to-date listing of licensed RTCs kept by the agency; KXAN found inconsistencies in the bed counts after speaking with staff at various RTCs.

“There’s just no way around it. More facilities that support young teens in their addiction need to be opened — residential facilities where we can give these kids a fighting chance outside of their dysfunctional environments,” Rocha said.

Illicit drug use among minors has steadily increased in the past two years, according to the National Institute on Drug Abuse.

Losing the ‘Safety Net’

State-funded RTCs rely on the occupancy of beds to receive enough reimbursement from the state to pay staff. When school transitioned online and juvenile courts slowed due to COVID-19, identifying teens in need of treatment became difficult, according to Dr. Hani Talebi, a licensed psychologist working with the Meadows Policy Institute.

“It’s not that the problem went away, it’s that the reporting structure went away,” said Talebi.

“Suddenly these people that were getting captured in the safety net program — through being truant from school or failing drug tests with our parole officers — they were no longer being referred to us, and so we saw our referral patterns nearly come to a complete stop,” said Loewen, CEO of Phoenix House, which operates two adolescent RTCs.

Even before the pandemic, female adolescent RTCs, like the one formerly run by Nexus Recovery, did not frequently operate at full capacity. The lack of female referrals to RTCs before and since COVID-19 may have more to do with a referral system designed to assist males with drug addiction versus females, according to Talebi.

“We know that mental health issues, in particular, took a major hit across the board,” Talebi said. “If we all started at baseline, it would be one thing, but when you already have communities and cultures that are starting so far behind, all you’re doing is exacerbating … the difference in what they have available to them.”

Nexus Recovery has an adolescent female program until August of 2020.

“We got to a point that a program of 24 beds got down to four adolescent girls in the whole program,” said Stacey Burns the Chief Clinical Officer at Nexus. “It just wasn’t cost effective at all to staff a program and have an entire building with four clients in it.”

What was originally a temporary closure of the program turned permanent, after adolescent referrals stayed infrequent and Nexus saw more consistent demand from their adult clients.

“We were able to keep the dorm full with a combination of detached clients and adult clients and that indicated to us there was a need in the adult population still,” Burns said. “We were able to meet that need that best served our community.”

Unlimited Visions Aftercare near Houston and Texas Health Recovery and Wellness Center near Dallas were coed RTCs that brought back only their male adolescent residential treatment after temporary closures during the pandemic.

Phoenix House has an all-male RTC in Austin and a coed RTC in Dallas. Loewen saw a decrease in referrals in both male and female clients. However, after the pandemic, he has seen more female referrals to the coed RTC than ever before.

For the first time Loewen can remember, the beds at Phoenix House are half male and half female.

‘Always Struggled’

“When you’re that age, you look at 90 days, which is how long the program was, like it’s a lifetime, but little did I know that that would really be the changing point in my life,” Ramirez said.

Stories like Ramirez’s are the reason Rocha feels the Selena Center needs to be reopened.

“[Losing the program] is still tough to think about,” Rocha said. “It’s sad, but we still continue to keep looking. We continue to turn over every rock we possibly can, so we can get back and open up the Selena Center again.”

After the closures of the Selena Center and Nexus’s adolescent program, only two female-only RTCs exist.

Esperanza House operated by Serving Children and Adults in Need Inc. Even as one of the only all-female facilities left in the state, the Laredo eight-bed facility still does not get consistent referrals.

“We have always struggled with girls’ referrals, even though we’re a small eight-bed facility and there aren’t many other girls’ residential facilities in the area,” said Luis Flores, executive vice president of SCAN. “It’s a tough program to maintain.”

Despite the significant loss of available drug and alcohol treatment for young, females in the state since 2020, 16 new beds have recently become available to the demographic.

Selena Center residents paint a mural in San Antonio. One Selena Center resident admitted that before treatment she had spray painted the same wall she was painting a mural on with her peers.
Selena Center residents paint a mural in San Antonio. One Selena Center resident admitted that before treatment she had spray painted graffiti on the same wall she was repainting with her peers. (Courtesy Selena Center)

Roots Adolescent Renewal Ranch opened in November in Argyle, north of Fort Worth. The facility is now one of two all-female adolescent RTCs. Roots Adolescent Renewal Ranch currently serves seven clients and is expected to reach capacity by the end of the month, said Rebecca Marks Hermes, co-founder of Roots Adolescent Renewal Ranch.

Hermes co-founded the facility with her sister in honor of their brother who battled addiction for 20 years.

“We originally were going to [treat] boys, and everybody within the industry was like, ‘You’re going to do girls, right?’ and we realized that the need was girls,” Hermes said.

Roots Adolescent Renewal Ranch in North Texas is a seven-hour drive away from the Esperanza House in Laredo. Despite the empty beds, Flores doesn’t question whether the Esperanza House should remain open.

“If there’s only one small program, an eight-bed facility, that covers such a large area of female adolescents who have these problems … Why do programs such as ours struggle for referrals?” Flores asked.

Whether or not the referrals stay infrequent, Flores has no plan to shut Esperanza House’s doors. If the program does close down, young females in the state will be left with just 16 available beds in an all-female RTC facility.

“We have kept the facility open even when we were in the red because we believe that these services are needed, and we did not want to leave the area without any services,” Flores said.