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Mental Health System Failing Youths at Risk on Many Levels

The stories are heart-breaking and they are legion. ActonUP conducted hours of interviews with numerous parents and caregivers of adolescents and young adults trying to access the mental health services in Halton. Understandably, the sources wished to remain anonymous and the names have been changed—those interviewed did not wish to compromise someone in the process of seeking or receiving treatment.

The Centre for Addiction and Mental Health makes it sound like it should be easy to get help. According to the CAMH website, “If you are experiencing a mental health crisis, please contact 911 immediately or present to your nearest emergency department.” But it's what happens next, as parents and their kids try to navigate the mental health system, that is of concern here.

Alice, the mother of a teenager, talked about her daughter's most recent experience with Oakville-Trafalgar Memorial Hospital. “Our daughter has very severe Post-Traumatic Stress Disorder as well as anxiety and depression and has attempted suicide numerous times. Recently, she tried to get hit by a train. We had to call police and they were able to rescue her off the tracks.”

Two officers took the young woman to the hospital in Oakville and waited until she was admitted--but at the time there was no psychiatrist on duty. According to Alice, one of the hospital staff told her, outside of business hours a patient has less than a 5% chance of seeing a psychiatrist at OTMH. “And this is the only hospital in our region that has a psychiatric ward,” added Alice.

Later that night, a nurse called Alice to say her daughter was being discharged. That's when Alice declined to pick her up. “The real problem there is no psychiatrist on staff, and doctors have been advised if someone is calm just discharge them. They [staff] only made space for her after we refused to come and get her.”

The next morning her daughter saw a psychiatrist at OTMH but he wouldn't admit her either, suggesting that she would be better served at McMaster Youth Assessment Centre in Hamilton. “I asked that they facilitate the transfer and a nurse called back saying it had been arranged,” said Alice. “After an hour drive to McMaster staff there told us they didn't know anything about this. So we sat in emergency for another 9 hours until they decided to discharge her as well with no follow up plan or anything.”

Alice believes that if the patient's demeanour appears calm, the hospital will release them no matter how serious the previous event was. “We had to take her home. We've been trying to keep her safe, but we have had to make a few more police calls since then. For the last two years we've averaged eight 911 calls per month and we've been struggling to get any kind of help or follow up. Her psychiatrist isn't seeing her anymore and referred her back to her family doctor. My family doctor is not comfortable managing psychiatric medicine, so we're back to having no doctor while her suicidal thoughts are getting worse.”

Patricia has a 20 year old daughter diagnosed with borderline personality disorder who was recently admitted to hospital after jumping off a second storey balcony, suffering cuts and bruises. “I begged them not to release her, but within two hours [of her returning home] I'm wrestling knives out of her hand, while my husband was calling 911. When the cops came she was holding onto my leg crying, begging not to go back, yelling at the cops to shoot her. It was really bad. They took her away in cuffs; every parent's nightmare to watch their kids being cuffed.”

Patricia suggests that the system doesn't really want to help anyone. Rather, the objective is to assess and release patients quickly so they are not burdened with another file. “They really gave us the brush off, and sent her home without enough medication,” she said.

“Another time they released her from OTMH with only a bus ticket and a dead phone. Luckily, my husband and I had time and we found her at one of the bus terminals in Oakville. The problem is there is no outreach program for anyone over 18. You either have to wait six months on a list or you have to wait hours in the emergency department and hope someone will offer some help. Part of the problem is lack of funding, but another problem is that there is no oversight. No one is checking to see if these people are doing their job.”

Long assessment and wait times are typical for a person of any age in crisis seeking help. “Once you discover there is something wrong with your child, you'll wait 6 months to a year to see a paediatrician, and another six months to year to see psychiatrist, and you'll wait a good year to year and a half to see an occupational therapist,” added Alice.

Myrna is the mother of an adopted teenage son who was at one time running away almost daily; she felt her only option was to call the police “We've been in crisis many, many times. Imagine how you would feel when you show up at a hospital and realize I have to take my kid back home and I have nothing to give them.”

Despite the lack of funding in the system, Myrna thinks there are resources available, but a parent has to work very hard to get them. “You have to really, really advocate for your child to the point where you're ready to say I can't do this anymore. You have to decline to pick them up from the hospital if they're hospitalized. When you refuse to pick up your child they have to scramble to find some resources. Most parents wouldn't know to do this. We told the hospital, 'We are not abandoning our child, the system has abandoned our child'.”

Myrna suggests that the 24 hours crisis hotlines, like the Halton Distress Centre (905-877-1211) are good places to start if you might be approaching a crisis. “If you have to call them every day, call them every day. That's what they are for. This will help you determine the level of crisis as the system is already over-burdened. If your child is a runner, have him put on a vulnerable person's list. This will help first responders as they already know what his typical behaviours are. When we decide our child has to go to the hospital, we have the paramedics come and take him. We kind of know the system.”

Parents should not be afraid to ask for help, according to Myrna . “There is a facade that we have to be super moms and dads, and that asking for help is a reflection on our parenting abilities. Well, we aren't psychiatrists.”

Similarly, some parents are reluctant to have their children diagnosed with learning disability, fearing they will be stuck with that label. However, a medical diagnosis of a learning disability will help the child access an Individualized Education Program and open up resources otherwise unavailable.

Myrna also suggests getting on line to talk and connect with other parents going through similar situations is a good strategy. “There are several parenting groups on Facebook where you can talk to those that have walked the walk. It will also help you to not feel alone. My husband and I have become open books on advocating for our child.”

Lastly, Myrna suggests self-care should be a priority. “Just like when you're in a plane and they tell you to put the oxygen mask on yourself first before your kids, the same thing applies. You're no good to your kids unless you're looking after yourself. In my case, that meant getting my own help. I had to get my own personal therapist.”

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