Anytime I meet a young person and their family struggling with mental health and addiction issues, I hear the same words over and over. “It’s been really hard to find help.”
In fact, less than a third of B.C.’s children and youth with mental illness finds that help. They suffer, they struggle, they rage, they cry. And some of them die. Hopefully, we can all agree that change is urgently needed.
This week, the Select Standing Committee on Child and Youth Mental Health released its interim report on improving care for this vulnerable group. We at the BC Psychiatric Association were so pleased for the opportunity to provide input to their deliberations. We applaud the leadership role the committee has taken in recommending that responsibility for youth mental health services be moved from the Ministry of Children and Family Development (MCFD) and returned to the Ministry of Health, and urge the committee to go one step further in its final report to ensure mental health services for both children and youth go back to the Health Ministry.
To better understand our current system, you must recall that in 1996, Judge Thomas Gove released his devastating report on the beating death of five-year-old Matthew Vaudreuil while in government care. This prompted the creation of a new ministry (MCFD) with a bold vision: To bring all services for children and youth under one umbrella, so that what happened to Matthew would not happen to any other child.
Parts of this plan have been realized over the years, and many people have worked diligently to provide the best care possible. Regrettably, this system has fatal flaws that have led to unintended consequences.
Services for children and youth mental health are now split between two different ministries, Health, and Children and Family Development. Who provides that care and for how long depends on whether a child is first seen at the hospital or in the community.
For kids in crisis, it means meeting many different doctors, nurses and counsellors, telling and re-telling your “story”, travelling to different buildings and waiting… and waiting… and waiting. If drug and alcohol use is part of the problem, a whole other set of counsellors will be involved, none of who are seamlessly working together toward a common goal.
Why? Because different ministries means different leaders, different plans, different priorities. It means my computer doesn’t talk to your computer. My criteria are different than your criteria. It means waiting… and waiting… and waiting.
And of course, there is the added stress of a child turning 19 and overnight becoming an “adult.” That means figuring out a whole other mental health system, with different leaders and different priorities.
Then there’s the issue of money. Children and youth don’t vote. Their voices are still small and quiet and can’t be heard over the other voices asking for money for acute care and chronic illness.
We know that 75% of all mental illness starts in childhood and adolescence. We also know that, untreated, youth with mental illness become adults with chronic mental illness, chronic physical illness and addiction issues. It’s time to invest in our children, and equally important, to protect that investment. That means ensuring that funds can’t be eroded or diverted to meet the demands of louder voices.
The lifetime cost of untreated mental disorders starting in young people is staggering – an astounding $26 billion in B.C., extrapolating from U.S. figures. By not giving care to children who need it, we put them on a path to lifelong poor health, problems finding work, and early death. The mortality rate for Canadians under age 24 with untreated mental health issues is 30 times higher than that of their healthy peers.
We would never tolerate this kind of treatment for physical illnesses and injuries. As the FORCE Society for Kids’ Mental Health eloquently notes, “If four kids end up with broken arms, all four will get treated. If four kids have mental health challenges, only one and a half will receive treatment.”
We call on the government of B.C. to return children and youth mental health services to the Health Ministry and to make a substantial and protected investment in our young people. Our province needs a unified plan for “cradle to grave” and “hospital to home” mental health care. We urge British Columbians to write to their MLAs to demand a united and well-funded continuum of services.
For the sake of tens of thousands of children and youth struggling with untreated mental health issues, we must do better.
Carol-Ann Saari BSc, eMBA, MD, FRCPC
President, BC Psychiatric Association