When Kaya Perkins’ mother persuaded her to join an adolescent substance abuse program run by Denver Health, the 15-year-old Thunder Ridge High School student wasn’t sold on the idea that she had any reason to stop using marijuana daily.

But the teenager, who had depression and anxiety and had engaged in self-harm, did see value in therapy — and the program was offering it. So at the urging of her mom, who knew about the program because she worked at Denver Health, Kaya attended. Four years later, she still sees her therapist in the program regularly.

And said she no longer feels a need to smoke marijuana.

“It (marijuana) was just helping me avoid the source of my problems, you know?” said Perkins, now 19. “Like, I thought it was helping, but I think I was just avoiding (them). … It also made me a lot more anxious than I already was. It wasn’t actually helping me in the way I thought it was.”

Denver Health’s Substance Abuse Treatment, Education and Prevention program — called STEP for short — has focused in tandem on patients’ mental health and substance use since the public hospital system started it more than 18 years ago. For four years, funding from The Denver Post Community Foundation’s Season to Share program, channeled through the Denver Health Foundation, has helped support the STEP program.

“Our clients have often been faced with so much shame and guilt around substance use, so we really provide a safe and empathetic space to process their experiences,” said Allison Coleman, Perkins’ therapist and the STEP team lead. “We really understand that youths often use substances to manage painful emotions and traumatic experiences.”

Perkins’ experience illustrates the program’s approach: Get adolescents and teens talking about their problems, concerns and challenges, and over time they’ll recognize the connections to the substances they’re using — and often abusing. They take regular drug screening tests but don’t face penalties for positive results.

“It’s our job as providers to motivate them for positive change,” said Dr. Christian Thurstone, the program’s founder and medical director. “We work with adolescents initially on what they do want help with, which typically will be depression, anger and other issues.”

Last year, the program’s therapists counseled 607 young people referred to by their parents, teachers, clinics at their schools and through the juvenile justice system. In recent years, the program expanded to eight school-based clinics in Denver Public Schools, in addition to Denver Health’s main campus.

Participants can stick with the program until they’re 21.

Thurstone said she sees plenty of need for expansion, citing research that just one in 10 young people in Colorado with a substance use problem is receiving care for it. The program’s participants, accepted regardless of insurance coverage or ability to pay, are disproportionately male as well as Hispanic, Latino and Black. But STEP leaders say they come from families of all income levels and backgrounds.

The teens typically use marijuana, alcohol, tobacco, methamphetamines or opioids — which Coleman says have become more common. Some teens aren’t aware the pills they’re swallowing are fentanyl, a powerful synthetic opioid, she said.

Of the less powerful substances, Thurstone said: “There’s no known safe amount of alcohol, marijuana or tobacco use for the adolescent brain. Adolescents are much more vulnerable to develop an addiction than adults because their brains are not yet mature.”

A 2019 study by Thurstone and other researchers found that participants who received substance use treatment through the school clinics were less likely to be involved in behavioral incidents and attended class more often.

Perkins, who now lives in Aurora, credits the STEP program with giving her “more tools in my toolbelt” for navigating stress and mental-health challenges. She began painting more, taking walks with her dog and confiding in her mother, and she started skateboarding again.

She has begun taking classes through the Community College of Denver.

“I don’t know what I would do, honestly, if I hadn’t been involved in the STEP program when I was,” Perkins said, adding later in an interview: “I’ve recommended friends into the program — I’ve told friends that this is a really good opportunity and they’re awesome there.”