Youth with mental illness ‘fall through the cracks’: Richard
Maureen Bilerman was in her kitchen cooking when she heard Bernard Richard speak on the radio about a centre of excellence that would provide mental health services for youth with complex disorders.
She knew she had to take action. She turned off the radio, sat down and wrote Richard, who is the province’s child and youth advocate, an email.
Three years ago, Bilerman’s 16-year-old daughter Sarah was diagnosed with bipolar disorder, an illness characterized by highs and lows. The high points for youth with bipolar include extreme irritability, lack of judgment, risky behaviour and poor self-control. The low points are really low and there’s often suicidal thinking, Bilerman said.
Since Sarah’s diagnosis, Bilerman has struggled to find proper mental health services to meet her daughter’s needs. Before hearing Richard speak about a centre of excellence, the Bilermans were on the verge of splitting their family up so Sarah could leave the province for treatment.
Bilerman gave herself an ultimatum on that day.
“I just thought, ‘Okay, I’m either going to fight to get Sarah out of the province to get the treatment she needs or I could put my energy into fighting to get the services she needs here,’ ” she said.
Bilerman chose the latter option and started a movement called DOTS (Development of Treatment Services) with the aim of lobbying the government to fund a centre of excellence.
The mother isn’t standing alone in pressuring government to fund a centre of excellence. On Dec. 8, more than 1,000 people gathered in downtown Fredericton to make a bold statement to the government. Each person at the rally wore a black dot on their chest and touched fingertips with the person on either side of them, physically connecting the dots in a show of support for a centre of excellence.
On that bitterly cold day, more than 1,000 people stood up for something most people sit down and stay silent about – mental illness.
Bernard Richard is determined to see the province commit to funding a centre of excellence before he retires at the end of March.
Richard has served as the province’s child and youth advocate since 2006. He has spent two years of his term doing research that would lead to the 2008 release of “Connecting the Dots: A report on the condition of youth-at-risk and youth with very complex needs in New Brunswick.”
The report made 48 recommendations to the then-Liberal government, including “the establishment of community-based residential capacity for children with very complex needs.”
The report also called on the government to decriminalize youth with mental health disorders.
Richard, who is co-chairing a task force, knows the government is grappling with a sizeable debt. He realizes it could take some time before the bricks and mortar are in place.
“Our eyes are not closed to those kinds of challenges faced by the province. We’ll be making recommendations that the province can work with,” Richard said.
Richard has spent the last few months co-chairing a task force that has gathered public input on what kinds of services the centre would offer and where it would be located. Richard and his team will make a recommendation with more details to the government in January, he said.
“People are saying it should be accessible to people from both official languages [and] it should be near academic capacities so that there’s the potential with association with university research.
“It would have to be fairly close to psychiatric services.”
The New Brunswick Health Council was formed in 2008 to report on the performance of the province’s health services and engage New Brunswickers to improve health services.
The council released their first general health population snapshot last year. The snapshots are supposed to paint a picture of the province’s health at a given time.
“While researching, it got our attention that there was a good proportion of info that had to do with youth but it wasn’t publically available or reported,” council CEO Stéphane Robichaud said.
On Dec. 9, the council released a snapshot of the health of young New Brunswickers. It revealed that 72 per cent of New Brunswick youth between 12 and 18 perceive their mental health as being very good or excellent, below the national average of 77 per cent.
That leaves 28 per cent of the province’s youth who perceive themselves to have a lower than very good level of mental health.
“[The report] enabled us to be able to highlight that when it comes to mental health, there is something we should pay attention [to],” Robichaud said.
“Tools like this should help us flag those areas we should prioritize.”
The numbers don’t surprise Richard.
“We deal with youth everyday in our office. We know that 350 youth, more or less, are on the waiting list for mental health services.”
The veteran civil servant says without early intervention and treatment, youth with mild mental health issues will develop more complex issues, pushing them further away from help.
“There are kids at risk.”
Julie Gallant Daigle isn’t surprised to hear that only 72 per cent of New Brunswick youth believe they have very good or excellent mental health.
Daigle is the executive director of Chrysalis House, a Fredericton shelter for young women between 16 and 19.
The women Chrysalis House helps have been left behind – they’re often too old for child protection services and too young to live alone — and a large portion of them suffer from mental illness.
The staff at Chrysalis House can often deal with the women who have moderate cases of mental illness, but they aren’t equipped to help women with more complex disorders.
“When they’re in a crisis mode is when they need some place safe to be. The psychiatric unit is not the right place. They’re not equipped to be dealing with teenagers,” she said.
“With the proper support, these young people and their families can do well.”
Daigle is behind Richard, the Bilerman family and anyone else in New Brunswick who donned a black dot on Dec. 8 to demand a centre for excellence. She also advocates having a screening process to identify youth with mental illness from the onset of mental illness, which often happens at 12 or 13 years old.
“The hope for me is that everyone will have access [to the centre of excellence] and we’ll start intervening early.
“Right now what’s happening is some of these kids are falling through the cracks because it’s not being detected early enough.”
Richard has long advocated a system of integrated service delivery, another recommendation from “Connecting the dots.”
Mark Barbour, a spokesman for the Department of Social Development, confirmed the department would adopt the integrated service delivery model.
The system “will improve our ability to assess problems, to provide treatment and intervention, and to conduct follow-ups,” Barbour said.
In June, the department said school district 9, in the Acadian Peninsula, and school district 10, in Charlotte County, would serve as demonstration sites for the integrated service delivery model.
“Those two school districts will be establishing at school level a combination of prevention and detection services so that youth that can be identified as being at-risk, lower level,” Richard said.
Richard acknowledges the New Brunswick Health Council statistics help his case for demanding a centre of excellence.
“It’s nice to have this kind of sound research behind some of the things that we’re doing,” he said.
But in a previous interview, Richard said grassroots movements like the one started by the Bilermans is what will really make a difference in influencing government.
“You can write reports and publish reports, there are many that accumulate dust.
But when you have people who dealing with the issues directly in their families (who) get together and organize this kind of movement it really matters.”
Although Richard has done a lot of work in trying to bring awareness to youth mental health in the province, he acknowledges mental health is still an issue “we haven’t talked a lot about in New Brunswick.”
Daigle agrees there’s still a stigma around youth mental health in the province.
“Someone said to me that if your child has cancer, everyone rallies around you to help out. If your child suffers from schizophrenia, it’s not something that people generally talk about,” she said.
The Bilermans buck that trend, and it’s all because of 16-year-old Sarah.
After Sarah’s release from a psychiatric hospital at 13, she faced the prospect of returning to Grade 8 and explaining to her classmates why she missed a month of school. The students had speculated on why she had missed so much time while she was gone.
Sarah knew how to approach the speculation after seeing Margaret Trudeau speak once she got out of the hospital.
“Everybody there was kind of owning their illness and Sarah came home and said, ‘You know what? I’m going to just be who I am.’ She went back to school, people asked her where she was and she said, ‘I was at a psychiatric hospital being diagnosed with bipolar’ and she’s never looked back and neither have we.”
Without openness, Bilerman doesn’t think the DOTS movement would have started.
“You have to stand up and speak out and the community will rally. But you have to have the courage to ask for help and when you do, it’s there.”