Ask the Expert: What should I say when my child comes out?

How parents react when their children come out makes a huge difference to kids’ feelings of self-worth, says Afi Browne, provincial LGBTQ+ youth outreach worker for Skylark Children, Youth & Families in Toronto. There are plenty of positive things you can say to your kid, but there are definitely things you shouldn’t say, including “Are you crazy?” or “Don’t worry, it’s just a phase”—two common responses on the less-supportive side of the parental-reaction spectrum.

Instead, validate your child’s experiences and express your support. “The best thing to say is, ‘Thank you for telling me. Thank you for trusting me. I love you unconditionally,’” says Browne.

Many parents aren’t sure how to respond simply because they don’t really understand what their children are going through. “They may need to start by untangling ideas around gender and sexuality,” says Browne. “Gender is a social construct—it lives in our heads, not in our bodies—while sexuality is about who you’re attracted to and has nothing to do with gender. It helps to understand all these concepts and to confront any preconceived ideas of what ‘normal’ means.”

It’s also OK to admit that you need some time to breathe. “A lot of parents go through a range of emotions, and there’s often some disavowed grief because they aren’t able to get support from their own communities,” says Browne.

Browne suggests that parents read blog posts by LGBTQ+ youth to gain some insight into what their own children might be going through. Another great resource is Central Toronto Youth Services, which offers a variety of programs to support families with LGBTQ+ children. It offers an online resource booklet called Families in Transition that Browne says is a must-read for families of youth who are transitioning.

Supporting your child may also mean standing up for them in the community. “People will talk, and often parents don’t do a good enough job of defending their kids,” says Browne. The best approach is to take the time to educate yourself so you can help educate others.

LGBTQ+ youth often experience depression and other mental health issues, which are a result of the trauma they often face. That’s why it’s especially important to make certain your child doesn’t feel isolated or alone. Ensure that they still feel engaged and accepted within the family and provide them with counselling resources if they need them. For example, Skylark offers walk-in and ongoing counselling options. You can also encourage your child to join an LGTBQ+ support group with their peers, such as those offered by The 519 and YouthLink. Skylark offers two great options: First Fridays for LGBTQ+ youth at The Studio and a newly opened group for LGBTQ+ tweens. “Just let kids determine what they want to be doing and support them in doing it,” says Browne.

For more information on supporting your child when they come out—and to find places where you can access LGBTQ+ youth resources—visit Supporting Our Youth, a community development program at Sherbourne Health Centre for queer and trans youth. Or visit Central Toronto Youth Services for their Pride & Prejudice and Families in TRANSition programs.

How to get mental health help for your child

It’s CMHA‘s Mental Health Week! We recently 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.  A recent Toronto Star article 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, 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 behavior 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.”