How to get mental health help for your child

We reached out to several mental health experts to put together a tip sheet for parents. It can help you recognize some of the signs of mental illness in children and youth and learn more about resources in your community where you can access services and supports.

SIGNS THAT YOUR CHILD OR TEEN MIGHT BE STRUGGLING

One of the first signs that your child or teen may be struggling with mental illness? They may start to behave in a way that is unusual or out of character for them. For example, if they used to be quite social and outgoing and they suddenly become more isolated, even refusing to go to school or interact with their peers, this could be a red flag.  “You may also notice changes in a child’s appetite or sleeping patterns,” says Myra Levy, Clinical Director at East Metro Youth Services, a United Way-supported agency. “Sometimes mental health concerns, for example depression and anxiety, can also be triggered by a stressful or traumatic event including a divorce, a serious breakup or a death in the family. Your child or teen may tell you that they’re not feeling happy or that they’re having thoughts about suicide.” It’s also important to remember that you are not alone: 10 to 20 per cent of Canadian youth are affected by a mental illness or disorder and only one in five children who need mental health services receives them.

WAYS TO GET HELP:

IN AN EMERGENCY

If you suspect your child or teen is at risk of harming themselves or others, and you feel that you’re not able to keep them safe, take them to a hospital emergency department right away, advises Dr. Joanna Henderson, a psychologist and Director of the Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health at CAMH. In less urgent situations, Dr. Henderson also suggests that parents can call United Way-supported Distress Centres for support and advice on other appropriate community or professional resources to help your child. Young people can also call the Kids Help Phone to speak to a counsellor and to learn more about other mental health supports in the community.

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FAMILY DOCTOR

Many parents often turn to their family doctor or pediatrician for mental health support. The Toronto Star notes that, according to the Ontario Medical Association, family physicians deliver about half of all mental health services in Ontario. This includes supports such as assessments, therapy and prescribing medication. If your family doctor or pediatrician works as part of a multidisciplinary team, he or she can also refer children and their parents to other healthcare professionals on the team including psychologists, nurse practitioners or social workers. All of these services are typically covered by OHIP when delivered in this setting.

COMMUNITY MENTAL HEALTH CENTRES

There are also a number of accredited community-based mental health centres, including United Way-supported East Metro Youth Services, where parents and their children can access a range of mental health services. The best way to find a centre near you is to visit Connex Ontario or call United Way-supported 211 for resources in Peel, Toronto and York Region. Some community mental health centres offer walk-in clinics where parents and their children can access help with no doctor’s referral/diagnosis or appointment required. The services provided by these centres are also paid for by the government, private donors and, in some cases, supported by organizations, including United Way. Additional services range from one-on-one/group counselling sessions to more intensive options including alternative classrooms and residential treatment programs. United Way also invests in a variety of community-based mental health programs that support vulnerable and marginalized groups including LGBTQ+ and homeless youth. Counselling services at community mental health centres are typically provided by professionals with Masters-level designations in social work, psychology or counselling. “Although traditionally there have been wait lists to access psychiatry or community counselling services, walk-in clinics are supporting early access and reduced wait times,” says Alanna Burke, former Clinical Manager at East Metro, which is the lead agency for infant, child and adolescent mental health in Toronto. The agency, in partnership with the Hospital for Sick Children, piloted a telepsychiatry project and plans to scale up the initiative across the city to connect young people with psychiatrists to provide faster diagnosis.

SPECIALISTS

Many family doctors will also refer parents and their children/teens to specialists including psychiatrists, psychologists and psychotherapists. Psychiatrists are medical doctors who can assess and diagnose mental illnesses including depression, anxiety, bipolar disorder or ADHD, among others. They are also licensed to provide therapy and prescribe medication. Although services provided by psychiatrists and other specialists in the publicly-funded system (including hospitals) are covered by OHIP, wait times for doctors can be significant and variable, depending on circumstances, says Henderson. Psychologists, who do not typically require a doctor’s referral, can diagnose mental illness and provide therapy, but can’t prescribe medication. When they work in the publicly-funded system their services are covered by OHIP. While wait lists to see psychologists in private practice can be shorter, the hourly cost to see this type of specialist ranges from approximately $150- $250-per-hour. Henderson says some specialists offer a “sliding scale” of hourly fees for lower-income clients. Specialists such as psychologists and psychiatrists offer a range of therapies for children and teens including cognitive behavioural therapy, dialectical behaviour therapy and mindfulness—in both an individual and group settings. There are also a small number of school board social workers in school boards in Peel, Toronto and York Region that offer supports to students in a school setting. “As a parent of a child or teen struggling with mental illness, it’s also important to take care of yourself,” adds Henderson. “We know that when families are getting support together, that can really lead to positive outcomes.”

Want to learn more?

Who cares for the caregivers?

More attention is being paid to mental health, but what about the impact on those caring for a family member or loved one who struggles with mental illness or has attempted suicide? Research shows that caregiving takes a toll — physically, mentally and emotionally, even financially. Imagine a City looks at the impact on families and how vital community-based supports and respite can provide much-needed care for caregivers.

By age 40, about 50% of Canadians will have or have had a mental illness

Informal caregivers provide critical support and care at home. And it’s becoming increasingly commonplace: As of 2012, 8 million Canadians — that’s 28 per cent of the population aged 15 and over — provided care to family members or friends, according to Statistics Canada.

But among regular caregivers, StatsCan found that 38 per cent of those who helped their child, 34 per cent who helped their spouse and 21 per cent who helped their parents reported feeling depressed. The Centre for Addiction and Mental Health (CAMH) also found that caregivers have higher rates of emotional and anxiety disorders, and are twice as likely as non-caregivers to use mental health services for their own problems.

Caregivers are not a homogenous group; caregiving runs the gamut from navigating the healthcare system and administering medication to providing personal assistance in the home, such as housework, feeding, bathing and toileting. In some cases, caregivers have to take time off work or quit their job — for example, to supervise a family member with dementia — which adds financial stress to the situation.

“Families can really be at risk for developing their own physical health issues or mental health issues as a result of chronic stress,” says Leanne Needham, family work lead at the Canadian Mental Health Association, Peel Dufferin, a United Way supported agency. “Some families can be exposed to this chronic level of stress for years and years.” Through her work, Needham has seen caregivers develop chronic pain, illness and depression as a result of ongoing worry and fear.

Add to this the fact there may be conflict in the home that can lead to trauma — having interventions with police or having their loved one disappear for days at a time, and “the grief around that and not knowing where to turn or when things are going to change,” says Needham.

Caregivers often have multiple responsibilities; the ‘sandwich-generation’ may be taking care of children and elderly parents at the same time. StatsCan found that 60 per cent of caregivers were working at a paid job or business, and 28 per cent had children under the age of 18.

“Sometimes [caregivers] just need a break,” says Wanda Morris, chief advocacy and engagement officer for the Canadian Association for Retired Persons. CARP’s Caring for Caregivers campaign is advocating for increased financial benefits for family caregivers in Canada, many of whom are on the verge of burnout. “People are being dropped off in emergency on a Friday night, and that sounds really heinous, but sometimes families are just at their wit’s end.”

Even in cases where government-funded care is provided, Morris says informal caregivers are frustrated with lack of continuity and flexibility. There’s a “revolving door” of government-funded caregivers, which impacts continuity of care. This is stressful for the person being supported, particularly when that care is intimate, such as bathing. “Imagine having that happen with different random strangers all of the time,” says Morris.

Caregivers are often so busy looking for supports for their loved ones, they forget to take care of themselves, says Needham. Or, they don’t know supports even exist. But it’s similar to the safety warning on airplanes: Put your own oxygen mask on first before helping the person next to you. “If you wear yourself out, then you’re not going to be able to be there for your loved ones,” she says.

CAMH has come up with a list of recommendations for caregivers, including income support to cover expenses and lost income; peer support where family members can share their fears and frustrations, and learn coping skills; and respite services to give caregivers a break from their responsibilities.

While much needs to be done on the legislative front to provide better income support and job protection to caregivers, there are a broad range of other supports, from skills-building workshops to adult daycare. Local CMHAs across Ontario, for example, offer family support, from educational workshops to counselling; there are also options through hospitals.

In the GTA, a number of non-profit family support organizations provide education, counselling and peer support groups, such as the Mood Disorders Association of Ontario, Family Association for Mental Health Everywhere (FAME), and the Family Outreach and Response Program (now affiliated with CMHA Toronto). The Sashbear Foundation runs a 12-week program called Family Connections, which provides skills training and support for people in a relationship with someone who has emotion dysregulation.

“[Caregiving] can be very draining — reaching out and getting support can help you understand better how to support somebody,” says Needham. “It can reduce conflict in the home and it can keep you going longer and stronger.”

Head to LocalLove.ca to learn more about preventing caregiver burnout and watch this inspiring video to hear a personal account of how community supports can help caregivers.

We’re in this together

Peel. Toronto. York Region. No matter where you live within the region, you know that poverty remains a real and ongoing threat. But, if the past year was any indication, there’s lots of proof of how we, as a community, are fighting back.

Today, we are pleased to share United Way Greater Toronto’s 2017–18 annual report. It highlights all the change that your generous donations, on-the-ground volunteer efforts and tireless work on the front lines helped to create—in the places, populations and priorities most impacted by poverty.

Watch this video for President & CEO Daniele Zanotti’s summary of an eventful 2017:

Then, for all the ways that your support fuelled our region-wide uprising of care, read the full report here.

Putting mental health on the agenda

Photo of Steve Lurie Executive Director of the Canadian Mental Health AssociationSteve Lurie is the Executive Director of the CMHA Toronto, a post he has held since 1979. Steve is a strong voice for improved services for individuals living with mental health challenges. In 2016, he was appointed as a Member of the Order of Canada, recognizing his contributions as a leading advocate and administrator in the field of mental health care.

On May 4 the Canadian Mental Health Association joined community organizations across the GTA for the launch of Ontario for All, a new alliance convened by United Way that’s working together this provincial election campaign to highlight five priorities that we believe are critical to a fair, equitable and prosperous Ontario.

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Investing in inclusive, healthy communities with affordable and quality childcare and public education pharmacare and dental programs, transit and transportation, and community programs and services is an essential goal in our 5-point Call to Action.

Mental health is just one component of health in our communities. But as Canadian Mental Health Association branches across the country participate in Mental Health Week— an opportunity to promote awareness about mental illness, mental health and the supports we all need access to — it’s very much top of mind.

What should also be in the spotlight is the direct connection between poor health — mental and physical — and poverty.

In 2013 the CMA (Canadian Medical Association) published a report that showed that only 25% of a person’s health status is attributable to their access to health care. 50% is determined by the social determinants of health such as:  income, early child development, food security, employment, housing, race, aboriginal status and community belonging. The Hamilton Spectator/ McMaster collaboration Code Red which examined poverty in Hamilton showed a 21-year life expectancy gap between low and high income neighborhoods.

The CMA called for government action on: a poverty reduction action plan, a guaranteed annual income, affordable and supportive housing, development of a food security program, more investments in early childhood education, including parental support, collaboration between government and industry on a pharmacare program, and a comprehensive strategy for First Nations Health.

Around the world, cities are starting to work together to promote mental health and well-being. Strategies include: early intervention, closing treatment gaps, partnering with local citizens, neighborhoods, the corporate sector and fostering innovation.

Taken together, action on these fronts will result in healthier communities, reduced pressures on hospitals and improved quality of life for all of Ontario’s citizens — regardless of means. That’s the kind of province that the organizations behind Ontario for All envision, and that’s why we’re working together for a healthier Ontario.

Join us. Put healthy communities on the agenda in your own neighbourhood this election: ask candidates how they’re investing in healthy communities when you attend a local debate or they come knocking at your door.

In times of distress, make employees’ MindsMatter

headshot of Sevaun Palvetzian CEO of CivicAction

Sevaun Palvetzian is the former CEO of CivicAction and as an expert on civic engagement, she focuses on inclusive cities. An authority on urban issues, Sevaun frequently speaks to media and is a member of groups like the Premier’s Community Hubs Advisory and Waterfront Toronto. Through her work with CivicAction, and her roles at the Ontario Public Service, she has worked to advance human resources practices such as diversifying leadership positions and supporting mental health in the workplace. In this guest post for Imagine a City, Sevaun talks about why workplace mental health matters and how employers can best support their employees to be mentally well.

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It’s important to remember how employers can make an ongoing effort to support their employees’ mental health. Workplaces have a huge impact on employees’ state of mind and can play a powerful role in contributing to good mental health and supporting employees who may be struggling.

Fifty per cent of all people in the Greater Toronto and Hamilton Area (GTHA) workforce have experienced a mental health issue, and 82% of those experiencing a mental health issue say that it impacts their work. This is an issue we simply can’t afford to ignore.

But there is good news—employers want to take action. According to CMHA, 42% of senior leaders are interested in taking action to support mental health but haven’t yet due to a lack of time, resources, or knowledge.

To help that 42% turn intention into action, CivicAction launched MindsMatter—a free, first of its kind online assessment tool for organizations of any size or sector that provides three tailored actions to make that first or next step towards a mental health supportive workplace easier.

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Many employers have already started, such as Dundee 360 President and CEO Brad Henderson. Henderson decided to make mental health a priority at the real estate management firm by strengthening mental wellness supports and highlighting what resources were available, leading to an impressive 57% increase in staff awareness of mental health supports.

President of CGI’s Canadian operations, Mark Boyajian, also realized the power of raising mental-health awareness through the overwhelming success of CGI’s Mental Health Month. More than 5,000 employees participate in the month’s activities and fundraising initiatives that have helped destigmatize mental health and create a supportive environment.

Ryerson University gave their employees tools to respond to colleagues in distress through a workshop series known as Notice, Engage, Refer. After taking the workshop, 84% of participants felt they had increased their ability to respond to mental-health distress.

These are just three organizations taking action, but close to 1,200 organizations representing as many as 2.5 million employees across Canada are on their own workplace mental health journey thanks to MindsMatter.

Take time to check in with your employees, and join this growing movement towards mental wellness by taking MindsMatter at http://mindsmatter.civicaction.ca.

Do you really know how to listen?

If you’re like most people, you probably consider yourself a pretty good listener. But you might not be as good as you think you are. It’s true—in their 2013 book, The Plateau Effect, authors Bob Sullivan and Hugh Thompson point to several studies that show most of us actually “stink at listening.”

But there’s good news, says Jerilyn Dressler, Executive Director at Distress Centre Calgary: We can all become better. She should know—the Centre provides support through crisis and 211 lines, crisis chat and a professional crisis counselling program, so listening, and training people to listen, is a big part of her job.

“When we first start training new volunteers for our help lines, we see a natural tendency to jump to solutions with callers or with each other,” she says. That usually means the listener has jumped to conclusions based on personal experience or preconceived notions. There’s an unfortunate outcome to that misstep: it may inadvertently alienate the person they’re trying to help.

So, how do you really listen? Dressler says it’s important to have your friend focus on the main problem, and really allow them time to talk about its impact. You want to ask questions that will further shed light on the situation: What was the last straw? What was the thing that caused you to bring this to my attention? “You want to focus on the feelings and emotions surrounding the situation and make sure you’re demonstrating empathy,” says Dressler.

Once you think you have a grasp of the issue, you can start paraphrasing some of the problems and how they are creating issues in the person’s life—but continually check in to ensure what you’re saying is accurate. “Always offer an opportunity for the other person to correct you, because you may have gotten it wrong,” says Dressler.

Even once you understand the person’s issue, it’s best to be careful when dispensing advice. Instead, have friends come to their own conclusions. This is because suggesting change before someone is ready can be damaging. “People might not be ready to think about making changes, and by suggesting one, you are actually pushing them into an uncomfortable place,” says Dressler. “This can make them back away from you as a confidant.”

People who are in distress often feel alone and unheard, especially when dealing with sensitive topics like suicide or abuse. If that’s what your friend is going through, keep in mind that his or her family or other friends may react strongly, or even judgmentally, which makes them feel like no one is really listening. In these cases, it’s important to respond in a non-judgmental way and direct the person to a professional service like the Distress Centre’s crisis line or 211 program to get help.

And don’t think of crisis support as a last resort, says Dressler. It’s a service that’s open to anyone who needs an impartial or non-judgmental perspective, and it can make a huge impact.

4 ways Community Hubs can help a friend in need

If a friend mentions they need job hunting tips, legal advice, or even housing help, do you know where they can access resources? In many cases, the answer is the same for each of these issues: their local Community Hub.

Community Hubs provide everything from seniors’ programming to English classes for newcomers to information for parents, all within one space.

“Many people might not even realize that their neighbourhood has this wealth of resources all under one roof,” says Alex Dow, United Way’s Director of Neighbourhoods. And even if they can’t directly help, Community Hubs can connect an individual with further resources.

Here are four reasons why it’s worth checking out your local Hub:

1. Hubs address multiple needs

Often someone who needs help in one area could use a hand in other ways as well. A newcomer who needs English classes can also access employment support. Someone who is struggling with parenting can get support along with counselling services. In fact, these “wraparound” supports provided by Community Hubs are vital to overall well-being and help create a strong social safety net across our neighbourhoods. United Way’s Hub in Rexdale, for example, provides everything from health services to social programs, as well as legal help and cultural assistance.

2. The whole family can find support

All of the hubs offer a variety of programming specially tailored to local residents. Go to United Way’s Bathurst-Finch Community Hub and you’ll find seniors’ programs, breastfeeding support and childcare. AccessPoint on Danforth provides health care, LGBTQ+ programs and youth peer mentoring. “The Hubs are really designed for people of all ages,” says Dow. “You might come in looking for a program or a service for your child, but if an elderly parent lives with you, you’ll find activities for them, too.”

3. They create opportunities to volunteer

Don’t be surprised if your friend wants to continue going to the local Hub after receiving the help they needed. “After accessing services, many people like to give back,” says Dow, and there are many different types of opportunities to pitch in, including working in a community garden, running classes, helping with promotions, participating in workshops, or leading cooking classes or playgroups.

4. Hubs help people connect

The connections and friendships that can come from Community Hubs are one of their biggest advantages, says Dow. That’s because meeting neighbours and learning more about the community’s needs can lead to increased engagement with the neighbourhood and a better understanding of the issues that are affecting it—not to mention a desire to help.

Looking to access services at a Community Hub near you? Try calling 211, a helpline supported by United Way, to connect with one of these vital community resources in your neighbourhood.

Surprising ways community centres can help

When you’re searching for help—whether you need legal advice, mental health resources or financial aid—Cynthia Drebot, Executive Director of the North End Women’s Centre in Winnipeg, says you should look first in your own community. “It’s not just a matter of convenience,” she says, “it’s because the organizations often understand the needs of their community and tailor their resources to suit them.”

One of the best ways to find these resources, she says, is by asking other people in your network. In fact, community organizations get most of their clientele by word of mouth, and that can often lead to resources that you may not realize are right in your own backyard. Case in point: family resource centres, which offer a variety of services, from helping people access food and housing to programs for literacy and social activities.

And once you find an appropriate organization, you may be surprised by the extent to which they can help, says Drebot. Many of the organizations work to decrease the barriers that prevent people from being able to get help in the first place—for example, the North End Women’s Centre provides transit tokens for those who need help getting to the Centre to attend workshops, and free on-site childcare for women who are accessing its programs. Through the Centre, women can work at a thrift shop in exchange for the organization paying their damage deposit or their hydro or phone bill.

“We have women who come to our drop-in who may have originally walked in the door not knowing what we do, but we can set them up with up to a year of free counselling to work through the challenges they may be facing, such as domestic violence. They can also sign up to take a mindfulness or self-esteem workshop with a group of other women,” says Drebot. “And that idea of connecting with other women is huge—it reduces that sense of isolation.” That’s something that is valuable to everyone.

By connecting with others in your neighbourhood, you may receive far more than you expect—not just a solution to that original problem, but a circle of support that will help in all areas of your life.