Peggy Revell
The province must bring youth mental health “out of the shadows,” according to a recently-released report on the causes of youth violence.
“Mental health is an often-overlooked, but very significant, issue for youth,” wrote former Ontario Attorney General and chief justice Roy McMurtry and former speaker of the legislature, Alvin Curling, who headed the “Roots of Youth Violence” review for the province that was released last month.
Alongside youth mental health, the report highlighted a mosaic of “widespread, interconnected, and deep” issues, such racism, poverty, community “design,” family issues, education and justice system issues, and a lack of voice and economic opportunity as factors that contribute to youth violence.
While the majority of youths with mental health issues are not involved in violence, the report stressed the need for the province to take immediate actions since the consequences of not properly dealing with youth mental health issues has a serious effect on children, their families, and communities.
“The real popular statistic is that one out of every five children has mental health issues and challenges,” said Troy Clink, manager of children’s mental health for Family & Children’s Services here. “Be that anxiety disorders, social anxiety, depression, ADHD . . . right across the board.
“One out of five is the accepted statistic in the province of Ontario. That’s been well-studied,” he noted.
As for linking youth violence with mental health, it’s hard to make a blanket statement, Clink admitted, especially since every child and situation is unique. Yet in his line of work, there are certain patterns they see.
When faced with stresses, such as family breakdowns, some children go “inwards,” become isolated, and depressed, Clink explained, whereas others externalize the pressures and act out.
“Quite often we’ve seen people who aren’t very socially-gifted and don’t have the vocabulary to express themselves,” he noted. “Quite often those individuals act out violently. They can’t express it with their words, but they can with their fists as to what they’re feeling.
“So that’s the challenge of a mental health program, to give the kids the coping skills and the words they need in order to express that internal angst or anxiety or mental health noise, whatever you want to call it, to try to equip them so they can express that in a manner that’s healthy.”
“Right across the board, mental health issues from ‘A’ to ‘Z’ are what we deal with,” added Clink, saying the programs at FACS are available for children up to age 18 across the district.
It offers programs such as counselling services, parenting support, parenting groups, group therapy, intensive services for individuals with higher needs, and specialized programs for children up to age six.
“The counselling services that we offer address things from suicide ideation to anxiety to depression, substance abuse, just anything that kids are dealing with,” explained Clink.
To access the program, parents or children simply can phone Integrated Services Northwest (274-7787), which is located in the same building as FACS and handles all the intake into the programs.
There is a public perception that FACS is all about child protection, noted Clink, but he stressed the children’s mental health service is a separate from that department—and that privacy is highly-protected.
Despite the one-in-five statistic, the “Roots of Violence” report noted accessing the needed mental health programs is a problem for youths. During consultations, both McMurtry and Curling were advised that 80 percent of youths experiencing mental health or behavioral disorders that require intervention do not receive the services and support they need.
“This lack of treatment allows the mental health condition to worsen and its effects on the youth [and their alienation, impulsiveness, and self-esteem] to grow,” the report stated. “It adds pressure and stress to the families of these youth and can lead to the youth disrupting the lives of classmates, friends, and peer.
“Of particular concern to us is that pre-school and younger school-aged children who suffer from mental illness receive the help they need,” it added. “The earlier the mental health intervention, the higher the chance of a successful outcome.”
The increase of people trying to access children’s mental health, compared to 10 years ago, is “through the roof,” said Clink. Yet despite the increased demand for children’s mental health services, he added that hasn’t translated into a larger budget.
During that same 10-year period, Clink noted there only was one small increase in funding that didn’t even cover the cost of inflation—leading to many places across the province having to let therapists go, which, in turn, has fuelled longer waiting lists.
The report recommended children’s mental health requires urgent action by the province, independently even from the strategy outlined to prevent youth violence.
Recommendations included having one or more association with expertise in youth mental health being “retained immediately to prepare a plan for universal, community-based access to mental health services for children and youth for the earliest possible implementation.”
Echoing this report, Ontario Auditor General Jim McCarter announced in his recently-released 2008 annual report that mental health services for children in the province comprises a “patchwork system,” without the “benefits of a legislated mandate and clear service standards.”
The Ministry of Children and Youth Services lacked necessary information to make informed funding decisions, McCarter reported, and in most cases “continued to provide agencies with the same amount of base funding as in the previous year without assessing whether the funding was commensurate with the demand for, and the value of, services to be provided in the local community.”
This gap in treatment is something Nancy Daley, with the Fort Frances branch of the Canadian Mental Health Association, also sees, especially for those between early adolescence and adulthood.
It’s not just for mental health services, she explained, but other areas such as addictions counselling and even foster care, where finding homes for older kids, especially troubled ones, is difficult.
“Drug facilities, counselling facilities, are very lacking unless you want to send your kids out of town, and it’s the same for people with mental illnesses,” Daley noted. “We don’t have anything locally, in terms of a treatment facility. They would have to go to Kenora.”
Complicated input procedures and wait lists also can discourage people from seeking the help they need, Daley stressed.
“When somebody is in crisis, the last thing that they need to do is jump through a whole lot of loops,” she remarked. “They’re already stressed enough, they’re scared, they don’t know what’s happening, and that can be overwhelming in itself to turn them off.
“And then they don’t get the help the need.
“We know that the earlier a diagnosis is made and somebody starts receiving help, the better the prognosis is for anything,” she added. “It’s like a physical illness. The earlier you go in, get assessed and treated, the better it is for you.
“We know that for people who have psychosis, early psychosis intervention is the best. It can actually mean that [in] your future, you don’t have to go through multiple episodes.”
Struggling with mental health issues does not predetermine violence in adolescents, Daley said, pointing out that people with mental illnesses more often are victims of violent acts than they are the perpetrators.
“I would think that there’s a slight increase in the number of students we’ve seen with mental health issues,” said Bill Fisher, a guidance counsellor at Fort Frances High School. “Although I don’t believe many are tied to violence.”
Depression, bullying issues, and suicide are some of the things seen at the high school, added guidance counsellor Mary Jane Gushulak.
When it comes to mental health needs, guidance counsellors often will act as intermediaries between the student and outside organizations, such as FACS or the health access centre, to connect students with the counselling they need, Gushulak explained, since their own background is in education.
But in this role, she noted they also see first-hand the time it can take for students to get the help they need because of wait lists.
Depending on circumstances, they will be able to have someone at the high school immediately, said Gushulak, and that there is a FACS worker in the school regularly. But more support and programs, such as grief counselling, are things she definitely would like to see more of.
“I think we need to be educating people at a younger age,” said Daley, “so that it becomes not something to be stigmatized, and afraid of. So that people are more willing to come forward and say, ‘I need help, something is going on here.’”
While the CMHA generally deals with people aged 18 and older, depending on the circumstances and support needed, they will help out those who are younger, Daley noted. They also have been reaching out to more youths, families, and schools to educate them on mental health issues.
“One of the really great things about going into the school, the high school in particular, talking about the mental illness program that we do is it gives the students the opportunities to come up and say ‘I’ve got a friend who . . .’ and that happened a couple of times last year,” Daley said.
“I think most [youth] that we see are looking for help and recognize the need to see a professional counsellor,” remarked Fisher, with Gushulak adding many students are pretty forthright in most cases.
And yet, on the other hand, it sometimes can be the parents who are in denial about the need for extra support, warned Clink.
“We all want our kids to be healthy and happy,” he said, but added there’s a stereotype that “all kids are resilient” and can bounce back.
While some kids are like that, he noted, “there are a lot of kids who don’t have good resiliency and they need the extra support to help them.”
Clink encourages people to contact their local MPP to express concerns they have over things like wait lists for children’s mental health.
“They [politicians] need to hear that having a kid suffering from anxiety or depression sit on a wait list for a year is not right,” he said. “And the only way to get services to them faster is by having the resources so that we can hire more counsellors, more clinicians.”
The “Roots of Violence” review was first announced by Premier Dalton McGuinty in June, 2007. It came on the heels of the shooting death of 15-year-old Jordan Manners in the hallway of his Toronto school in May of that year.
More information, including the full report, can be found at www.rootsofyouthviolence.ca
