I am concerned about the impending closure of Thunder Road Adolescent Treatment Center.

I was a consulting psychiatrist and Medical Director of the Thunder Road program for 11 years, from 1995 to 2006. I evaluated and treated more than 2,000 youth during that time, and worked with the brilliant and passionate collection of clinical staff and executive personnel.

Thunder Road must remain open. The agency provides a vital and absolutely mandatory service to at-risk youth, ultimately saving lives and costs of incarceration and medical expense incurred by the county and the community.

Through the years of service to the agency, I became acutely aware that the best way to intervene in this enormous population of at-risk youth is to provide a real life experience, fundamentally different than the experience of the incarceration, violence, injury, damaged family, gang culture, and truancy of the adolescent clients prior to admission. Proper treatment can be fundamentally defined as providing that experience, with carefully focused and guided attention, in the residential setting. There is no other way to retain and repair this population. It works.

At a recent Conference of the American Society of Addiction Medicine, the keynote speaker stated, "Addiction is a pediatric disease." And he was referring to adults. What he meant was the likelihood of having a persistent addiction into adulthood is increased more than 10 times if there is no intervention between ages of 13-25. The place to intervene is during those years, and there is an even greater likelihood of persistence in direct correlation to the earlier ages of use. Thunder Road aims itself squarely at the peak ages of risk in its 1-3 to 19-year-old population.

So what is this treatment experience I'm talking about? Treatment is not didactic, instructional or punitive. It is a shared life experience, guided by staff with tough minds and soft hearts, where thoughts and feelings emerge in a way they can be tolerated and managed. It is the alternative to acting out with substance use, violence and disregard for self and other. Treatment is a relationship. The relationship causes change.

The tiny building in which Thunder Road resides packs a huge therapeutic punch. Violence becomes language. Emotion becomes poetry. Disenfranchised adolescents become connected and realize they care. Relationships form. The effects of relationship extend beyond the individual clients, into their friends, families and, ultimately, back into the community. Treating an individual client treats an entire network in the community. This treatment is testament to the dedicated staff of clinicians and administrators who keep the program at an elite level, with this outcome always in mind.

If the program closes, it will have to be reinvented in another form, as the problems it treats will persist and surge in its absence. There will be unnecessary expenses in reestablishing the program, loss of the wisdom passed down through its 28-year evolution, and extreme disruption for the providers within the program and also within the community, where the ability to refer to Thunder Road remains essential.

Please consider the costs of closing the program -- they are likely greater than those of keeping it open.

Michael Wachter, MD, is a psychiatrist in private practice, the consulting psychiatrist to Muir Wood Adolescent and Family Services in Petaluma, on the medical staff at UCSF, and a clinical instructor for the Child and Adolescent program's substance abuse training. He lives in Oakland.

Original post: http://www.contracostatimes.com/opinion/ci_28045902/guest-commentary-good-reasons-keep-thunder-road-open