CAMH project says mental health can’t wait

Seventeen-year old Alexis Fletcher had to wait four months before she could see a psychiatrist. The Bedford, Nova Scotia teen was diagnosed with severe depression at her appointment and took her own life three days later.

Alexis’ mother, Beverly Fletcher, recognized something was wrong several years before. She took Alexis to a family doctor and to a private psychologist. In one instance, the teen’s mother called 911, bringing the police and a mobile mental health crisis team to their home. But Alexis was not able to access a psychiatrist, who may have helped her, early enough.

Long wait times to access mental health services are not restricted to small communities. According to the Children’s Mental Health Ontario (CMHO) 2016 report card, more than 6,500 adolescents are waiting over a year to access mental health treatment in Ontario.

YouthCan IMPACT Toronto is bringing together the Centre for Addiction and Mental Health (CAMH) and several other community agencies to address the long wait times and enhance the existing mental health services. Three mental health walk-in clinics for adolescents aged 11 to 25 will be opening in Toronto to offer peer support and system navigation, internet-based tools and interventions, and on-site access to primary health care and psychiatric services, as needed.

One in four children will struggle with a mental health issue before they turn 18. Counselling sessions will be necessary for 11 per cent of these youth, 14 per cent will need more intensive treatment from a mental health professional or psychiatrist, and only a small percentage need inpatient treatment or a hospital stay.

However, there has been a 54 per cent increase in the number of youth visits to the emergency department and a 60 per cent increase in hospitalizations over the last decade. Like Alexis, some adolescents have been turning to emergency services in the absence of accessible mental health resources that meet their needs. Emergency room visits are only necessary for a small number of youth with mental health issues and the cost of using this resource is far more than other, more suitable services that have longer wait times. Without timely, appropriate treatment, children are reaching a crisis point.

“[The three new clinics] really came out of a need identified in the community by youth, but also by community members,” says Dr. Kristin Cleverley, the CAMH Chair in Mental Health Nursing Research and co-principal investigator of the YouthCan IMPACT research trial.

Adolescents have been driving the conversations to decide which mental health services will be offered at the new walk-in clinics. Youth have also been involved in determining what researchers should be investigating in the randomized control trial that will be conducted at the walk-in clinics.

“The outcome the youth identified as their priority was that these clinics would improve their everyday functioning, which, I think, is an important outcome of any intervention. Second to that, we’re hoping to improve their symptoms-they’re obviously seeking mental health care for a reason,” Cleverley says. “We want better access, so that tends to go hand-in-hand with decreased wait times. And then we’re hoping there’s better satisfaction with services, the youth and the families are happier with the service.”

Youth who access the walk-in clinics will have immediate access to a mental health worker and be  provided with services that meet their needs at that time. Adolescents do not need to be accompanied by a parent or guardian to use this service.

“It’s not easy, [to get] different [community and hospital agencies] together at the same table. But we’re driven by a common goal and the common goal is that youth have better access to mental health care that’s in a youth-friendly environment and that is driven by the needs identified by youth, which is different than how we traditionally thought of mental health care,’ Cleverley says.

One of the three walk-in clinics is now open in the Scarborough’s East Metro Youth Services ‘What’s up’ walk-in. The other two locations will open at Delisle Youth Services (Yonge and Eglinton) and at the South East Toronto Family Health Team (Danforth and Woodbine) in July.

Unfortunately, there are no services like these walk-in clinics currently available to adults over the age of 25. Adults with mental health concerns can access drop-in centres for counselling, including Family Service Toronto and Woodgreen. But those who need more intensive psychiatric treatment have to be referred by a family doctor or a doctor at a general walk-in clinic.

The three mental health walk-in clinics have the potential to act as a model for new clinics across the country and for a wider age range of individuals if they can successfully meet the needs of youth and decrease wait times for mental health services.