ALEXANDRIA BAY — Many intermingling issues affecting teenagers can be identified more easily when all involved agencies are working together.

That theme was addressed throughout Samaritan Medical Center's fifth annual Behavioral Health Conference on Tuesday at the Edgewood Resort.

Michael Gordon, chief clinical psychologist and director of child and adolescent psychiatric services at SUNY Upstate Medical University, Syracuse, said gathering all agencies or providers involved in a child's care is not an easy task, but a necessary one.

"When people that should talk to each other don't, it could mean tragic consequences," he said.

Parties involved in collaboration need to plow through barriers that often may make the process difficult, such as the different goals of child welfare and mental health professionals, Mr. Gordon said. For example, he said, the child welfare side puts the child's safety first, versus the psychiatry side's mental health priority.

Mr. Gordon also is the director of the attention-deficit hyperactivity disorders program at Upstate Medical, a program he talked about in his second presentation Tuesday afternoon.

The conference, titled "Teens: Mental Health and Substance Abuse Issues," featured four other speakers, including Samuel A. Rubenzahl, chief psychologist and children's services coordinator at Lewis County Community Mental Health Center, Lowville.

In his presentation, "PTSD in Adolescents," Mr. Rubenzahl said that because adolescents often feel misunderstood, they tend not to open up about instances of trauma or any difficulties they're experiencing.

"Teenagers have difficulty regulating their emotions," he said. "They believe no one else understands what they're going through. With work and with treatment, healing can happen."

Forming trusting relationships with adolescents and other health professionals is key, he said.

After a traumatic event or an emotional, physical or mental struggle, drug abuse is one method a teen may turn to in an effort to take back control of his life, state Trooper Jack L. Keller said.

As the state police's Troop D school and community outreach coordinator, Mr. Keller said law enforcement officials are seeing increased cases of substance abuse among middle and high school students.

"Middle school is our worst problem," he said. "The drug of choice other than marijuana seems to be prescription drugs. They're easy to obtain."

Mr. Keller said until parents realize there's a problem with their children, it's difficult to get the information out. The parents are an integral part of the collaborative process, he said.

Not only are prescription drugs becoming the drug of choice among 12- and 13-year-olds, Mr. Keller said, but teenagers are raiding their family's medicine cabinets for over-the-counter drugs.

OxyContin, Vicodin and any cough and cold remedies containing the cough suppressant dextromethorphan are a few of the more common medications adolescents are getting their hands on.

A surprising addiction among teenage girls, Mr. Keller said, is diet pills. The girls take multiple pills to stay up all night, so they don't sleep or eat, they sweat a lot and they attempt to lose weight in an unhealthy way.

"It's more of an image thing," he said. "Stress has been the leading factor."

The image issue also tied into John H. Wohler's presentation: "Substance Abuse and Eating Disorders."

Mr. Wohler, clinical director for Centre Syracuse, a partial hospital program for the treatment of eating disorders, said although eating disorders and substance abuse issues are often linked, it's hard to determine which occurred first.

The conference concluded with Dr. Brian Johnson, associate professor of psychiatry at Upstate Medical University, presenting "Drug Dealers Would Like to Take Over Your Child's Brain."

Approximately 20 agencies, including Fort Drum Behavioral Health, North Country Transitional Living Services, and Lewis County Mental Health, also were on hand during breaks in presentations to share information on their programs and services related to mental health and substance abuse issues.