Children’s mental health system in crisis, say Canadian advocates
From funding to front-line services, programs are lacking for youth, advocates say. Youth suicide in Canada is the third highest among industrialized nations.
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Beth Nowosad started feeling anxious and suffering panic attacks in Grade 8. A counsellor at her elementary school was no help. In high school “there were absolutely no resources,” and by Grade 10 she was self-harming.
Before her 18th birthday, she tried to kill herself and ended up in hospital.
“Unfortunately, the funding isn’t there” to help kids, said Nowosad, now 24, who only started getting proper treatment when she enrolled in a college program to become a child and youth worker and learned about resources in the community.
“There are so many youth that are waiting so long — there are so many — the government needs to fill the gaps.”
For children with mental health troubles, wait lists are the norm — when problems arise, they typically can’t get help for a year and a half and end up in hospital, only to be discharged to find they have to wait yet again for services in the community.
They say the system is in crisis, and new data to be released Monday by the Canadian Institute for Health Information (CIHI), obtained by the Star, indicates the growing problem: Between 2006 and 2016, emergency department visits by children and youth seeking mental health or substance abuse help went up 63 per cent, and hospitalizations 67 per cent, while at the same time, hospital stays for all other health issues fell by almost 20 per cent.
“This data signals that our current mental health system is not working optimally and is not meeting the needs of children, youth and families in Ontario,” said Children’s Mental Health Ontario, which represents more than 100 treatment and support centres.
CEO Kim Moran said the money is needed to ensure children have access to treatment within 30 days, as well as to open more care centres, improve referral services and add staff.
“There are 12,000 kids waiting for therapy or intensive treatment,” Moran said, noting one in five kids is affected.
Moran’s own daughter suffered anxiety and suicidal thoughts starting at age 11, and she knows another mother whose 15-year-old committed suicide waiting for treatment.
The costs of not getting therapy means kids clog wait lists in schools and at college and university — when those services are really meant for those with mild issues, she said.
In the past 25 years, children’s mental health has only received two boosts in funding at a time when demand has grown, “and when you are getting zero increases, the funding erodes,” she added.
Financially, it makes sense, she added, with community treatment costing up to $800 a day, and hospital stays more than $2,300. Children who end up in emergency departments are typically re-admitted at least three more times, she added.
“The government is just not making this a priority,” she said. “It gets forgotten.”
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Michael Coteau, minister of children and youth services, said in a statement to the Star that he is “committed to transforming the way we deliver mental health supports to young people in this province. This starts, first and foremost with improving service delivery and simplifying points of access for young people” with care that is close to home.
He said the government has a “Moving on Mental Health” strategy that “will improve the experience for children and youth with mental health challenges and their families so that, regardless of where they live in Ontario, they will know what mental health services are available in their communities and how to access them.”
In total, he added “Ontario provides more than $3.7 billion in ongoing funding for mental health and addiction services. While there is still more work to be done, supporting mental health initiatives for children and youth across Ontario is a major priority of our government.”
For Nowosad, the anxiety first surfaced after her parents divorced, and she was hospitalized in York Region years later, when she was 17.
But because she was close to turning 18, staff there would not put her on a wait-list for youth services. But she wasn’t old enough for adult resources, so she waited in limbo, seeing a private social worker for $120 a session for a few months.
Those gaps need to be addressed, she said.
When Nowosad moved to attend college, it was only “through my professional life in Kingston I was able to find really great resources on my own.”
While she still suffers, she has become a youth advocate to push for more funding “and less stigma… I definitely see the stigma decreasing.”
In Canada, an estimated 70 per cent of adults who suffer mental health issues first saw signs of trouble in their childhood. Youth suicide here is the third highest among industrialized nations.
Children’s Mental Health Ontario estimates the $118 million the system needs annually could save $1 billion in the long run.
Currently, about 120,000 Ontario children and youth are being treated for mental illness.
While pleased the government announced pharmacare up to age 24, “I don’t want to take away from the fact that many kids will benefit from medications, but medication alone won’t yield the results we need,” said Moran.
Marjory Phillips, a director at the Child Development Institute in Toronto, said youth there needing intensive services can’t get it for 10 to 12 months. Right now, 37 families are on its wait list.
While the institute used to provide residential care for children under 12 with serious, disruptive behaviours, it abandoned that after seeing studies that show kids do much better if they remain at home. So now child and youth workers are dispatched out to provide service.
“It also keeps kids out of foster care, and prevents them from being pulled out of their home,” she added.
Children with less intensive needs can wait up to two years.
“It’s tough (on families),” Phillips said. “They are desperate... families go to walk-in (mental health) clinics, and it just doesn’t cut it. They need someone to really figure out what’s going on with their kid.”