Mind the Gap: Vancouver Island children in crisis
Nanaimo News BulletinMay 30, 2021
Content warning: This article contains mentions of suicide.
This is part one of a two-part series exploring mental health services for youth in
Sarah desperately types an email as she waits in
"I am at a loss of how to support her and keep her alive," she types.
"I know my story is just one of thousands of parents in the same situation."
Sarah – whose last name has been withheld to protect the identity of her underage daughter – has been fighting referrals and wait times that have left her feeling like her daughter has fallen into one of the gaping holes in
It is a system many experts said was cracked before the COVID-19 pandemic blew it apart.
Mental disorders in youth are ranked as the second-highest hospital care expenditure in
In B.C., there were 21 suicide deaths involving 10- to 18-year-olds between
Sarah's daughter could have been one of them.
Sarah and her daughter
After moving to
Three weeks after being released, she was back in hospital after another attempt.
Every month since, Sam has been in hospital, with three attempts in March alone. A single mother on shift work, Sarah is doing what she can to keep supports in place for her daughter, but it hasn't been enough.
Staff have been very good, but there's a disconnect between what hospital staff think is available and what is actually available, Sarah said.
"You think you have all the options but you end up on wait lists."
The biggest hurdle has been trying to find the right medication balance. With no family doctor, a
Despite plans in place for when she finds herself in crisis, or lands in the ER, Sarah said they've been on a conveyor belt that's been moving them through the system from emergency response back to the community with referrals to a provincially operated clinic.
"She's chronically suicidal … every time we see them since it's this broken record that she needs therapy."
But they've been stuck waiting. Most referrals are for one-off consultations or short-term treatment plans and Sam now sees the ER as the only place to access mental health professionals.
"It seems like every resource is meant to be there for three to six months and then you're done," Sarah said.
She found a private psychiatrist but that came with a recommendation of specialized treatment only available in
"We're all just falling into (the holes) and trying to climb out."
Navigating the gaps
While
Crisis intervention services generally can be accessed as urgently as needed, without a wait. Once a patient has been assessed and stabilized, an
There are seven children and youth mental health (CYMH) intake clinics – which are operated through the B.C. ministry of children and family development – on the south Island, including one mobile unit, as well as offices in
Access to CYMH services should take place without unnecessary delays, according to the B.C. government. In the 2018-19 fiscal year (the most recent data available for performance indicators) more than 20 per cent of clients had no wait for services. On south
But what happens after that first referral?
That gap between referral and treatment, that's where
"That's who we see the most – youth not quite at the point of emergency intervention but who are in a lot of pain and don't know where to go."
The problem, she noted, is when too much time passes between appointments. Need2, which operates the chat/text crisis line youthspace.ca, has been helping to fill that void by conducting follow-ups when requested by other services, such as counsellors, who can't see a patient for an extended period of time.
Resources
The B.C. ministry of children and family development said for years people who need mental health care have struggled to get help and COVID-19 has made those challenges worse. While more work needs to be done, since 2017 new services have helped reduce wait times for children and youth to see a psychiatrist or access other clinical services.
In its 2020-21 budget, the province has set aside almost
But is more money the simple fix?
Youthspace.ca is a text/chat crisis line available to youth from |
Dr.
"The mental health system was already very broken prior to COVID … since COVID it's been in crisis," she said.
Prior to the pandemic, there were treatment options for people in need of urgent care, but pre-pandemic those wait times were a few weeks. Now waits can range up to six months or longer.
"And that's if they're accepted at all … the urgent program isn't able to handle urgent needs," Roseman explained.
While it was an issue before, Lysak said her practice is now beyond full, and she's still receiving a few cold calls a day from across the province. These are people in urgent need but are unable to find services in their area.
Like many resources, patients age out of the child system and are forced into the adult stream. Lysak only treats patients over the age of 18 and often receives calls from child psychiatrists who are desperately looking for someone to take on their patients as they turn 18, but they have nowhere to send them.
"It's heartbreaking … now they have nothing."
Despite the dark days of the past year, Lysak says there is hope. She looks to other provinces where models of primary care networks are being utilized to re-imagine how resources are used to treat patients and improve gaps in the continuation of care.
If you or someone you know is struggling, call the provincial suicide prevention hotline at 1-800-suicide (1-800-784-2433), or visit crisislines.bc.ca to find local mental health and crisis resources. Black Press Media has also prepared a mental health resource guide filled with information specific to