Saving the throw-away kids
Monday, October 18, 2004
Isabel Teotonio, The Ottawa Citizen
When children with mental illnesses are not dealt with, it's the police and courts who must handle them later as adults, experts warn. Isabel Teotonio examines the crisis in children's mental health services.
Susan Hess can still remember the wild look in her daughter's eyes, which she likened to the desperation of a caged animal. Shaking, crying uncontrollably, Leah had trapped her in the kitchen corner and pressed a butcher knife against her throat.
Leah was only 10.
"I saw in her eyes a child whose life was totally out of her control. There was absolute fear and desperation," recalled Ms. Hess, whose deep breaths eventually helped calm her daughter.
From an early age, Ms. Hess knew something was wrong with Leah, who she occasionally called Dr. Jekyll and Mrs. Hyde.
Leah behaved nothing like her four siblings. She didn't play well with others. She'd swear at teachers. She'd throw things in class. She'd kick, punch and scream at her mother. She'd write, and say, things such as: "I have a lot of pain inside me. I am angry all the time; I hear voices in my head telling me to kill myself and to kill my mom. I want to strike out at anyone."
When Ms. Hess solicited teachers for help in getting Leah tested for mental illness, she was met with criticisms about her parenting skills and told she wasn't properly disciplining the "manipulative" girl, who they declared a "bad kid" and "troublemaker."
"My story is not unique," Ms. Hess told a crowd gathered Thursday night at the Jim Durrell Recreation Centre for a community forum on children's mental health titled, Throw Away Kids.
"My daughter is not the exception. As I travel the province, I hear this story over and over and it angers me as a parent."
Ms. Hess, who is now the president of Parents for Children's Mental Health, made the journey from her home town of Windsor to participate on a panel of experts for whom raising public awareness is key to addressing the incidence of mental illness among youth.
According to the Canadian Mental Health Association, one in five Canadians will suffer a mental illness in their lifetime. Increasingly, children and teens are suffering from illnesses such as depression, anxiety, bipolar disorder, schizophrenia, addictions or eating disorders.
For the past 12 years, government funding for community-based children's mental health services was virtually non-existent.
This, in turn, created a crisis in the sector, explained panellist Dr. Xavier Plaus, executive director of the Roberts/Smart Centre, which specializes in treatment services for severely troubled and behaviourally challenged teens.
While new funding for children's mental health was announced in the 2004 Ontario budget -- $25 million in 2004-2005 growing to $38 million in 2007-2008 -- there are still countless young people with diagnosable mental health disorders who aren't being treated, he said.
"We use the term 'throw-away' to emphasize that the province is not funding enough services to meet the needs of children who are banging on the doors of children's mental health centres across the province," said Dr. Plaus, adding his agency can only process 17 per cent of the 1,000 calls it receives annually for its crisis programs.
There just simply aren't enough treatment centres, agencies and private psychiatrists and psychologists in Ottawa to absorb the overflow.
"Parents want services for kids but there's simply not enough resources. The whole spectrum of services are needed -- outpatient counselling, residential care, more day treatment. The system has been strangled."
Society must recognize that these children are victims, many of whom have suffered profound neglect, as well as physical and sexual abuse. They act out violently and aggressively because they're anxious, angry and depressed.
"Instead of focusing on anxiety or depression, the focus is on the kind of behaviour they exhibit, so people don't see those kids as mentally ill or severely troubled, they see them as bad kids who should be punished."
Parents need to be better advocates for their children, he said, pointing out that "politicians will listen to parents, but they don't listen to professionals."
And to those who think it simply costs too much to keep afloat children he refers to as the "five per cent at the deep end," Dr. Plaus suggests adding up the costs of not treating them.
If troubled children do not get the the support and treatment they need, the future they face is grim: life on the street, living off welfare, turning to a life of crime, turning inward and committing suicide or turning outward and injuring others.
"When we don't deal with the underlying issue (of children's mental illness), the Ottawa police become involved," said Sgt. John Medeiros of the Youth Division. But by that point, police are dealing with the consequences of their behaviour and not its root cause.
"In order to reduce the number of youth that we're dealing with, something has to be done about the underlying issues. Otherwise, we'll just keep dealing with them and their mental health issues, and their depression and anger will grow into adulthood and we'll deal with them as adults."
But before they reach adulthood, the education system has an opportunity to help them while they're still children, said Geoff Botting, principal of trades and technology for the Ottawa Carleton District School Board. But, he warned, it must "smarten up because Shakes-peare and quadratic equations are not what these kids need."
Youth are marginalized by a school system that caters to the academically inclined and ignores large numbers of students whose needs aren't being met. Frankly, he said, not all children will grow up to become doctors, lawyers or engineers. Fifty per cent of students in Grade 9 will not go to college or university.
The regular school system is a "recipe for disaster," said Mr. Botting. It has unrealistic expectations and sets up many students for failure. But students who are less likely to do well in a traditional classroom setting tend to have an interest and aptitude for trades.
"Significant solutions are at hand," he said, calling for more money for technical education programs. "These kids are worthwhile human beings, we need them, we've got to do something with them. Let's use the skills they've got, they can be trained and they can be taught. They have a useful place in society."
But the system needs much more than just an infusion of cash, said Dr. Simon Davidson, chief of psychiatry at CHEO.
"I would not want to see us pour a whole lot of money into a broken system," he said, adding a closer look at fixing the system is needed.
Before the creation of the Ministry of Children and Youth Services last year, several ministries were responsible for funding multiple agencies, which resulted in a lack of standard practices.
Furthermore, there's a lack of integrated services across the mental health continuum, he said. If a child suffers from a psychological disorder and a substance abuse disorder, it's unusual to find one facility that will treat both.
In addition to grappling with a broken system, there's also the problem of filling that system with workers. Not only is recruiting and retaining pediatric mental health professionals a problem, "our front line people are getting (inadequate) experience."
Despite these challenges, he remains optimistic, pointing to the newly created ministry and Ontario's first Centre of Excellence for Child and Youth Mental Health, which aims to streamline and standardize the delivery of mental health care.
With all these forces working together -- government officials, health professionals, educators, parents and children -- hopefully, the system can be fixed.
"While I think there are tremendous problems ... hopefully we've reached a point that will allow us some optimism."
Leah, who is today a 24-year-old high school graduate and award-winning volunteer at a seniors' centre in Windsor, also hopes that point has been finally reached.
Thanks to a mother who refused to give up on her, Leah says she was spared from becoming a throw-away child.
"If I hadn't gotten the help I needed I wouldn't be here today," she said in a telephone interview.
After being tested she finally got the help she needed at the age of 14. Leah was diagnosed as being chronically depressed and suffering from free-floating anxiety and paranoia. She spent four years receiving daily treatment.
Today she's still on medication and admits there are still times when she feels frightened and alone, but she's learned to cope with those feelings and has learned to better communicate them.
"My mom has been through a lot. She fought for my life," she said. "I was lucky. There are a lot of kids who aren't so lucky."