An alarming number of young people are anxious and depressed. One in five has a mental illness. One in ten considers suicide as the solution. Join CBC host Heather Hiscox and a panel from Mohawk College in Hamilton. Watch the live stream of the town hall from October 24, 2012 below.
Sarah Cannon's daughter Emily was excited to go to her friend's birthday party.
She received the invitation on a weekend. That week, Emily did an interview with the local newspaper about having bipolar disorder. The day after the article appeared, she was uninvited from the birthday party.
That story and more were among those shared at CBC Hamilton's first town hall — Mental Health 101: Youth and the Hidden Crisis in Our Community — at Mohawk College on Wednesday night.
The session started with each of the four panelists saying a word that defined youth mental health. Cannon, a St. Catharines mom and executive director of Parents for Children's Mental Health, said “stigma.”
“I think that is for families and for children and youth pretty close to enemy No. 1.”
Busting stigma was one of the goals of the town hall, which was moderated by Heather Hiscox, host of CBC News Now. About 120 attended the session, and dozens more participated online as the session was streamed live at cbc.ca/mentalhealth101.
Joining Cannon on the panel were Mariette Lee, a McMaster University student living with depression and anxiety; David Hoy, manager of social work services department at the Hamilton-Wentworth District School Board, and Dr. Sheila Harms, a child and adolescent psychiatrist at McMaster Children's Hospital.
Attendees included local youth, teachers, social workers and mental health survivors. Among them was Eric Barby, a Dundas native and nursing student in a joint McMaster/Mohawk College program. He also survived a suicide attempt at age 15.
Barby attended the session because he thinks the issue should be talked about more.
“Without mental health, there is no health,” he said. “So I'd like to get more involved in doing what Sarah Connor said — to turn up the heat and keep it a boiling issue.”
Dr. Hamidah Meghani, Hamilton's associate medical officer of health, agreed. Child and youth mental health is “really important work,” she said after the session.
“I feel that there's more work to be done and Public Health is looking forward to furthering this work in Hamilton.”
The session was held in light of statistics that one in five Canadians will experience mental illness in their lifetime, and of those, only one-third of children who need services get them.
You can watch the session again at cbc.ca/mentalhealth101. It may also be a future broadcast on CBC Radio.
In addition to a series of CBC Hamilton stories at cbc.ca/mentalhealth101, Mohawk College journalism students are scheduled to release a special edition of their news magazine on Thursday.
Cody Evans describes one of the most harrowing nights he spent without a proper roof over his head.
It was wintertime, on a night his plans to crash on friend's couch fell through. His immediate surroundings, the Ancaster Meadowlands, provided little cover from the elements.
He sought shelter in a shed outside a hardware store. “I'm sitting there and the snow is coming through the vent. And I'm freezing.”
But to Evans, the obvious alternative was simply not an option. Then a teen, he'd bounced between stints in shelters and living on his own, and vowed never to sleep in a shelter bed again.
“I'd be too paranoid to sleep in the same room with people I don't know,” said Evans, who has post-traumatic stress disorder, attention deficit hyperactivity disorder (ADHD) and a non-verbal learning disability.
Like many homeless and street-involved youth, Evans, now 23, has struggled with serious mental health problems for much of his life. He grew up in a single-parent family, and said his mother, though she tried to get Evan professional help, wasn't capable of addressing his needs. Frustrated with his home life, Evans struck out on his own at age 16.
The prevalence of mental health issues among homeless and street-involved youth is extremely high, said Loretta Hill-Finamore, director of youth services for the Good Shepherd, which manages Notre Dame House, a Hamilton youth shelter.
“Last year, we saw 701 youths come through the program. Over half were identified as having mental health issues.”
The relationship between mental health and youth homelessness is a close but complicated one, according to Sheila Harms, a child and youth psychiatrist with McMaster Children's Hospital who works with homeless and street-involved youth.
“It's a really interesting question of the chicken or the egg.”
“A lot of the young people I've been working with have pre-existing mental health issues that would have been identified in early childhood — learning disabilities, ADHD, acting-out behaviours. Over time, for whatever reason, the family system hasn't been able to contain them or provide the type of course that's needed,” she said.
Some youth, according to Hill-Finamore, suffer mental health problems as a result of neglect or abuse.
Leaving home, though, doesn't necessarily fix their problems.
“If every day you're looking for food, you're looking for a safe place to live, a lot of people struggle with their mental health,” Hill-Finamore said. “Kids are scared. Kids are forced to do all kinds of things to survive. And that contributes to mental illness.”
Even youth who seek help in shelters can endure trauma in those, supposedly safer, environs. Those who have behavioural problems sometimes get into conflicts or exhibit behaviour that forces them to leave the facility.
Evans, who first left home in 2005, says until a few years ago, downtown shelters were mostly unequipped to deal with youth with severe mental health problems.
“It became a very unhelpful service. It became, 'Well, you're not doing what you're supposed to be doing — get out,' or 'you're just causing problems.'”
Evans said the cycle didn't necessarily compound his mental health problems, but rather delayed his issues from being properly treated. It's a process he likens to “kicking the can down the road.”
Hill-Finamore said that though youth shelters have become much more proactive about addressing mental health, they do not have the resources to needs of youth in the system.
Ontario's Ministry of Children and Youth Services provides Hamilton shelters with funding for a total of 1.6 mental health clinicians for homeless and street-involved youth.
“Last year alone, they were able to help 306 of the highest-risk youth,” she said, noting the waiting list for treatment for severe cases was 67 names long.
The outcomes for youth who do not get proper treatment, she added, can sometimes be dire.
Many street-involved youth self-medicate with alcohol and drugs, behaviours that carry high risks.
“Since January, we know of three youth who overdosed from intravenous drug use,” Hill-Finamore said.
Currently, Evans is completing his high-school diploma and has a part-time job at Tim Hortons. Eventually, he hopes to work as a professional in the information-technology field.
He attributes part of his hopeful outlook to having a team of professionals who advise him on different aspects of his daily life, including his education, mental health, employment and life skills.
But to get that far, he had to vigourously — and persistently — advocate for himself, to constantly seek out services that could help him get his life on track.
“My mother was always fighting to get me help, always challenging to do more.”
“Watching that, seeing that and learning that from my mother was a big tool that I brought to the table when it came to, 'Now, it's my turn to take care of me.'"
Newcomer youth have specific challenges when it comes to mental health. And as of next month, they'll hear those challenges reflected in a new Hamilton radio show.
Starting Nov. 5, a group of five staff and volunteers from the NGen Youth Centre will broadcast Revolutionary Lives at 93.3 CFMU.
The group, many of them refugees or children of refugees, will present spoken word, interviews and other segments to address the issue with Hamilton listeners.
“It will help youth feel that someone else has had the same experiences and overcome them,” said Amr Abdel, 19, a Palestine native who moved here from Jordan. “We'll show that this is what they've done. This is how they've moved forward.”
The project was spearheaded by Don Mahleka, a 23-year-old operations manager of the youth centre who moved here as a refugee from Zimbabwe.
Working at the former The Globe youth centre, which closed due to lack of funding in late 2010, Mahleka noticed how youth expressed themselves through art projects. They needed an outlet.
Mahleka approached Gonca Aydin, 18, a volunteer youth leader and native of Turkey. The radio group met earlier this year to plan the show and apply to CFMU.
Revolutionary Lives is for everyone who wants to listen to it, Mahleka said. But newcomer youth have specific challenges.
The concept of having mental health issues carries a stigma, particularly in some cultures more than others. And many refugee youth arrive here from intense situations, such as the political and economic turmoil in Mahleka's native Zimbabwe.
In some cultures, “mental health is somebody who is crazy and doesn't have any sense of what they're doing,” he said. “Or they hear, 'You're fine. Just need to pick yourself up from your bootstraps.'”
The show will have “some broader themes with stigma, negotiating your self identity and finding your place in your community,” said volunteer Tristan Raghunan, whose parents arrived in Hamilton as refugees.
“You can universalize them to appeal to youth in general, but there is a strong element of them in refugee youth.”
Revolutionary Lives will air from 9:30 to 10 a.m. every Monday in November on 93.3 CFMU. The show will also be available on the CFMU website.
It will air through the month of November, and possibly beyond that, Aydin said.
Sharing my story never gets any easier, because in many ways, it's still going.
I attempted suicide because I felt pushed to the very extreme of negative thinking because I was unable to handle my depression and anxiety. In short, I wanted my panic attacks and feelings of worthlessness to go away — permanently.
By this point, I was entering my third year of university and I wasn't happy with my original program. I wasn't excited about my studies in the way that I had hoped. I felt socially isolated because I never felt that I fully adjusted to university life, and in retrospect, I can see why. I had a terrible living situation resulting from not getting along with my first-year roommate and that made me weary of strangers. I didn't feel I have the same academic support I received in high school.
The friends I had grown up with and loved for the past 10 years were scattered all across Ontario, and I was constantly homesick. But I pretended that none of this bothered me and carried on, which didn't work very well because I was almost always ill and failed two courses in my second year. The littlest things would send me into a crying fit, which is probably why I almost stopped talking completely to everyone I knew, including my family.
My concentration was awful and I genuinely believed that I was too stupid for school. At this age, I’m supposed to be a thriving full-time student . . . and I wasn't fulfilling this demand. I was stuck in this rut of unhappiness.
Much better in that now I can better cope with my depression and anxiety. It has taken a lot of work through the hospital, and peer support. Now, I can recognize when I’m slipping and I refuse to allow myself to fall back into suicidal thinking. That's not to say that I have fully recovered. Living with a mental illness implies that I’m always in a state of recovery. There is turbulence through the ups and downs in my life, where I experience intense emotions both good and awful. But I've also come to learn to tolerate the awfulness such that I can go about my day — one day at a time — without being overly hindered by it.
It has changed from where I used to constantly be down and refuse to participate because I didn't feel capable of doing anything. And it has changed in that first I was guided by a good friend who also lives with a mental illness to seek professional and medical help.
Everything subsequent to taking that first step fell into place when I was required to go beyond my comfort level. I didn't force myself, but I recognized my state of discomfort and slowly pushed myself to enlarge my comfort zone and regain ownership of my emotions and life. Sounds kind of abstract doesn't it?
In the past two years from when I attempted suicide and thankfully did not succeed, I have since gained overwhelming support from my family and friends, my school, my teachers and my fencing teammates.
Before, this support was shrouded from me because I was too afraid and too confused to see it. I slowly saw more of it when a bunch of my friends found out and took turns to visit me at the hospital everyday. For that, I will always be grateful.
My illness forced me to take a year off from school. I returned to find that people noticed my absence – not just my physical absence, but also my joy and love for volunteering, fencing, school and my friends and family prior to my hospitalization.
And upon my return, when I finally felt comfortable enough to share my story, my friends embraced me and apologized for not speaking up. Some of them would have never guessed because during the days where I could function, I could hide my “inabilities” quite well. Most of them were just happy I returned and that I was alive.
This was a shock to me, because I hadn't realized what I and my life meant to my community. Returning to school was difficult because my confidence from my experience with attempted suicide dropped drastically. But knowing that I didn't need to feel alone or scared in this space was enough for me to keep going. It was hard and I couldn't always keep up with my peers, but I no longer felt incompetent because I've come to learn that my recovery takes as long as it takes.
That's not to say that I haven't had people who upon finding out that I live with a mental illness, looked down on me and shunned me for it.
My personal growth through my mental health experiences – it’s a big part of why I’m so devoted to COPE: A Student Mental Health Initiative.
I’m so blessed to be able to work with such amazing people. COPE consists of not just students living with mental illness, but also those touched by it and those who are willing to learn more about it.
The work that we do: awareness campaigns, fundraising, and volunteering – we engage the student community in mental health issues and I’m so proud of how far we have all come together.
Over the years, I’ve interacted with many students, and every year, more people come up to us, thanking us and sharing their own stories. This gives me hope that COPE is doing something right.
Many people tell me that I’m “brave” for doing what I’m doing, and I’m never sure why, because I look around me, I look at my colleagues and members from COPE, and I look at the other mental health organizations on campus, and even ones at other universities.
I look at all the people who are seeking us out – they are the ones who are brave. Some of them, I’ve had the privilege of seeing become more confident over the years.
Others, simply because they actively seek us out for mental health opportunities. These are the people who are willing and actively standing up for mental health awareness. They may not know it, and I don’t very often get the chance to tell them either, but they teach me to be brave as well.
Stigma exists. And I will not apologize for saying it. COPE received a letter from someone who expressed his contempt for us using the word during our MOVE FOR MENTAL HEALTH awareness run back in September. We had made it known that we were doing it to defeat depression and to spread awareness of mental illnesses. In hosting this event, we wanted to promote compassion and understanding on campus to mitigate this stigma.
This person emailed me expressed that he doesn't believe that the word stigma should ever be used, and went as far as saying that he would never allow his son or daughter to attend a university that alleges a stigma no matter against whom, or by whom. And when I read that email, I was deeply unsettled. Just because somebody doesn't want to say there is stigma, doesn't mean that it's not there.
When I say that I've had unpleasant experiences with people looking down on me, it was painful. Upon returning to school, yes, I had more than my fair share of support, but likewise the opposite.
People I thought were good friends and respectful colleagues told me that they thought my mental illness was just an excuse to be lazy or a “bitch”. There where people who refused to associate with me because they felt I was too “mentally unfit” to work with. And those were some of the nicer terms they used.
I remember several occasions in class where, and I can't remember how this discussion came up, but students were talking about accommodations for students with disabilities were unfair. While they can sympathize with why those with a physical disability needed academic accommodations to perform on par with other students, they could not with those who identify as living with a mental illness. For someone living with a depression or anxiety, some students don't believe someone like me deserve extra help because I just need to “get their shit together”.
These interactions, both personal and listening to what my peers had to say, I say YES. STIGMA IS A SERIOUS PROBLEM. For somebody like me who enjoys school and loves everything that I’m studying, who is involved in athletics, and engaged in student and community life, be told that I am an undeserving to be a student at any academic institution is incredibly unfair and atrocious.
It's going to be hard. It is hard and there is no way of sugar-coating it.
Everybody needs to take the time to find that anchor in their life that they can always hold onto when they start feeling horrible about themselves.
There are definitely resources available for those who are struggling with mental illness. But everyone is also unique, so not all resources are appropriate for everyone. Again, it takes that time and effort to go beyond your comfort zone to find something that works for you. Resources exist, but you have to want to deal with these issues of mental health and mental illness. And from my experiences, these issues are both clinical and social.
We must learn to tolerate it and this takes a tremendous amount of inner strength. I believe everyone deserves to wake up every morning and say, “I want to be okay today. I want to be able to be the best that I can be today despite whatever circumstances.”
Not everything will always be peachy, because there are always good and bad moments. But having those good moments will be worth it. These moments when we've taken everything we've done and say “I'm okay”, are the ones we need to cherish. We cherish these moments because they remind us that there are more to come.
For me, it's waking up everyday and going to school knowing that I deserve to be alive and that I deserve to be doing all that I’m doing right now.
The first thing that I would say is that if you have a knee jerk reaction of “Oh! This can't possibly be happening!” or “What does this even mean”? I can completely understand — the fear, the confusion, the shock, the worry and whatever else that may accompany you in discovering that your friend or family member is living with a mental illness. Too often, it seems to come out of the blue.
Definitely give it time to sink in. Your loved ones are experiencing that same fear, confusion, shock, worry. You may not understand everything that they're going through, because they may not necessarily understand what they're going through.
I remember being hospitalized and I couldn't bring myself to tell my friends and family right away. They eventually found out. Unfortunately, my best friend found out through my sister and I remember him being terribly upset. He told me later on that he was really concerned and that he felt helpless. But he was willing to reach out to me in any way that he could, even when I wasn't in my unreachable state. And for me in that moment, his willingness was more than enough.
The second thing that I would say is that please be patient with people living with a mental illness because they're still trying to figure things out. It's not that they don't want to open up, it's that they're stuck in this inexplicable situation.
In my personal experience it wasn't that I didn't want to speak to people, it was that I couldn't speak to people. With my peers and with my classmates, I felt utterly stupid and incompetent.
With my family, I felt like an invalid, disconnected with all aspects of my family's lives. I couldn't talk to my family in the beginning about it because how can I possibly explain to my loving parents and sisters that I didn't want to live anymore?
I knew I loved my family and my friends, and I valued my life and everything in it, I just couldn't remember it at the time. But I can't possibly forget it now, because I’m constantly reminded of it now.
Sam Russell thinks of herself as gender fluid — neither male nor female, but somewhere outside society's usual binary. And she's fine with that. It doesn't need to be fixed.
The McMaster University student also has depression, anxiety and obsessive compulsive disorder (OCD).
Like many LGBTQ youth, the 21-year-old faces a specific set of fears when approaching the mental health system.
How do you find a therapist who doesn't consider your gender identity to be part of the problem? How can you be sure, when sharing your deepest thoughts, that the person listening isn't judging your gender or sexuality?
It's a problem Russell anticipates facing one day. While Russell's therapist at McMaster is liberal and understanding, the fear was there, and will be in the future.
"Having to go to new people triggers my anxiety," Russell said. "I had seven billion trains of thought about not fitting where I thought I should be fitting."
The communications major grew up in a "pretty normal" family full of rough-and-tumble brothers. Russell's mother was a fan of traditional gender notions such as dresses and dolls and playing house.
"It was always 'Sam can play with Barbies and the boys can go out and play in the mud,' but I always wanted to play in the mud," Russell said.
When puberty hit, Russell's self loathing increased. It continued through high school, when Russell created a character of sorts — a pretty girl who wore dresses and dated boys. A girl who fit the so-called norm.
It wasn't until Russell's third year at McMaster that the mental health issues became too great to ignore.
"I started skipping a lot of classes. I stayed in bed for four months," Russell recalled. "That's when my friends stepped in and said, 'We're going to get you to go to the doctor. We're going to figure this out.'"
Russell was diagnosed with depression and anxiety last year and OCD this year. Now there are answers and medication, and the pieces are slowly fitting into place.
Russell's anxiety about seeking help is not uncommon, or even unfounded, said Dr. Albina Veltman, a McMaster psychiatrist. Veltman sees patients in a small, dark basement office at The Well — Hamilton's LGBTQ resource centre — once a week.
Many psychiatrists and social workers in Canada are undertrained and uninformed about LGBTQ issues, particularly as they pertain to gender, Veltman said.
One of Veltman's transgender clients needed foot surgery but approached a surgeon only to be told "I don't do trans surgery," Veltman said.
Some therapists even attempt "reparative or corrective therapy" with patients.
"That is something that although pretty much every single professional association has come out and said shouldn't be happening, we do know of people who have had that experience," she said.
As a result, a population already more likely to attempt suicide has difficulty getting help. That same population is more likely to have family problems and social ostracism, Veltman said.
The closet itself can also be a stressor, said Deirdre Pike, a social planner and co-chair of the Hamilton Positive Space collaborative. And queer youth with mental health issues are living in two of them.
"The first closet is your sexual orientation, which you might not have disclosed," Pike said. "The second closet is identifying yourself as someone with mental health issues."
The Canadian Psychiatric Association does not have a policy around dealing with the LGBTQ community, Veltman said. But she and Dr. Gary Chaimowitz from McMaster just wrote one that is now being reviewed.
It needs to be implemented, she said.
"Without that policy statement in place, at this point in time, if a trans identified patient comes to a psychiatrist and says they want care for depression or bipolar, that psychiatrist can still deny care if that's what they chose to do."
Queer issues also need to be addressed at the post-secondary level when nurses, social workers and medical students are trained, she said.
"If you haven't encountered it in the curriculum, the implication is it's not important, and we know that's not true."
Right now, Russell is getting good help at Mac. But finding help may be more challenging later on. In the meantime, she is learning to feel better about herself.
"People seem to approach that your gender is a mental health issue, and that's not what it is to me," Russell said. Rather than sitting on a static point on the gender spectrum, "I'm flowing through it all."
Ten years ago, Sarah Cannon was devastated by mental illness in her family. Her husband, who had bipolar disorder, died by suicide. The same year that her five-year-old daughter was also diagnosed as bipolar.
Sarah is one of the panelists at the town hall in Hamilton. She's also the executive director of Parents for Children's Mental Health. She spoke with the CBC's Matt Galloway Wednesday morning.
Common warning signs of suicide:
It was 4 a.m. on a Saturday morning when Cathy Jerome was roused awake by her 16-year-old daughter, Katie. She couldn't find her twin sister, Emily, and she was worried.
Cathy got out of bed, and in the darkness, the two began to search their Stoney Creek home.
They looked under the bed. Emily had slept under the bed during a recent stay in the mental health unit because she hated the cameras on her. They checked the closets, where the pretty, sensitive teen could possibly hide.
Hearts thumping, they went down to the main level, checking the kitchen. The living room. The front door.
That's when Cathy knew.
"I thought, 'She's done something.'"
When they went down to the basement, Cathy knew where to look. The furnace room was the only place where the joists were exposed. She found her daughter — her smart, athletic daughter with blazing red hair — hanging from the ceiling in a case of suicide.
Reality shifted. Time blurred. Cathy, a nurse, attempted CPR, but it was too late. Emily was dead.
"I kind of went on autopilot," Cathy said. And for a while, she stayed there. "It's the only way I was able to get through the funeral."
It's a story permanently embedded in the history of the Jerome family now. The story of a girl with a mechanical knack who assembled the family treadmill. The story of a diplomatic girl who was appointed captain of the Stoney Creek Sabres midget girls BB division for her ability to make peace. She was a compassionate girl who loved animals so much that she dreamed of one day living on a farm. "She wanted pigs," Cathy said.
Emily never got a formal diagnosis, Cathy said, but her mental health struggles likely date back to elementary school. She was bullied then. As a tall, thin, freckled girl with red hair, "she was an easy target," Cathy said. "She was sensitive and kept everything in."
She didn't tell her parents about the bullying. She suffered quietly as she graduated elementary school and entered ninth grade at Saltfleet District Secondary School, where she hoped for a clean slate. But the bullying continued.
She dreaded "Kick a Ginger Day" every November because classmates would shove her or punch her arm, Cathy said. These were details revealed after her death, as Cathy went through emails where the teen spoke of the torment.
In high school, the world around Emily changed. She made new friends. Her grades slipped, forcing her to take time off from hockey until she showed her parents that they'd improved. But Cathy's first clue that Emily's troubles exceeded the usual rocky, sullen ride of teenhood was late last year when Katie showed her Emily's Tumblr account.
The Tumblr posts were dark. They depicted images of self-injury and death. The Jeromes took their daughter to the family doctor, then to therapy. In January, Emily approached Cathy around 10 p.m. on a Wednesday night and said she wanted to hurt herself.
The Jeromes drove their daughter to McMaster Children's Hospital, where they were referred to St. Joseph's. They waited six long, somber hours for an ambulance to transport her back to McMaster, where she was admitted for two weeks.
At McMaster, Emily saw three other Saltfleet students, and they became each other's informal support network. They left messages for each other on Facebook. "Are you staying safe tonight?" they'd write.
When Emily was released from the hospital after two weeks, she swallowed a bag full of stockpiled pills before coming down for dinner.
Cathy noticed, and soon, they were in the car headed back to the hospital. She stayed there four days and didn't want to be released. She still thought she'd hurt herself, Cathy said.
When Emily was discharged, Cathy called Contact Hamilton to arrange meetings with a social worker. The appointment, scheduled for a month later, came too late.
Eight months after Emily's death, the Jerome family is still trying to pick up the pieces. Rebecca Jerome, the oldest of the five Jerome children, is studying concurrent education at Brock University in hopes of becoming a high school teacher. She's trying to find appropriate grief counseling for herself, she said.
"I value my family more now," Rebecca said. "We can't imagine going through this pain again, so we're trying to prevent that. We're trying to be more protective of each other. I try to protect Katie and Sarah, and when I can, I try to hang out with Alex. We try to appreciate what we have."
Emily's death was part of a grief-stricken time for the Saltfleet high school. Earlier that semester, a student died from a longer-term illness. Four months later, on June 16, fellow Saltfleet students Irn Mace and Alex McCormick fell from the Jolley Cut in what police eventually determined to be a joint suicide.
Emily did not know the boys who died at Jolley Cut, Cathy said.
Her impact is felt in other ways too. Her hockey team dedicated a game to Emily. Numerous Stoney Creek teams wear green heart stickers on their helmets with Emily's number, 77.
Earlier this month, the Jeromes attended a quiet ceremony at the high school's Healing Garden, a space commemorating the passing of students.
The garden includes some red-orange flowers, for Emily's hair. It was one of Emily's claims to fame, but she wanted to escape it so much that sometimes she dyed it black.
"She hated her hair," Cathy said. "Oh my God, she hated it. But it was beautiful."
Cathy mulls over what happened all the time, but she knows there's nothing more she could have done. She worked hard to get her daughter the help she needed, but in the end, her mental health difficulties were too much.
"She talked about it, but I thought 'she could never do it because she loves me too much,'" Cathy said. "Now I see she was tormented more than I realized. She hid it well because she didn't want to bother anybody. That was Emily."
It's a large room with plenty of unique touches one would find in a tight-knit workplace.
Family photos hang at desks. A picture of Madonna is pinned to a board. The walls are exposed brick, and one bears a large white board covered with the names of people the staff are helping today.
You have to go through two levels of security just to get into the office. They won't tell the general public where it's located. But in this secret space somewhere in the lower city, the Crisis Outreach and Support Team (COAST) is answering calls of youth with mental health issues across the city.
The 15-year-old organization handled 2,533 cases in 2011, 550 of them were people under the age of 18. Of COAST's roughly 30 staff, four work on the child and youth team.
Many of the team's calls come from schools where a student is having some kind of mental health crisis, whether it is a break down, a violent outburst, or the looming feeling that they're going to hurt themselves. They also hear from families, or sometimes, the youth pick up the phone themselves.
"When you look at the (youth) referrals that have come in to COAST in the last 15 years, it just keeps going up," said Terry McGurk, COAST founder and executive director. "The community is quite stressed."
COAST deals with people who have serious mental health issues. Its team includes child and youth workers, nurses and social workers, as well as four plain-clothed police officers who accompany workers on potentially aggressive calls.
Each morning, the members of its child and youth team come into work and check the calls that came in overnight, when an adult team member might have taken a youth call. Then they head to the white board to see a list of cases, shuffled in order of importance, to determine who to visit that day.
Their duties vary according to call. Sometimes it's to take someone to the hospital. Sometimes it's to coax an anxious teen out of her room.
"We see depression, anxiety, OCD," said Esther Bulk, a child and youth worker. "We see school issues with attendance because of drugs or alcohol or family, and usually those have an underlying mental health issue. Bullying is a huge factor."
When they answer the crisis line, they determine the danger with a series of questions. Has the youth attempted suicide before? If so, that's a risk factor. Are there supportive family members around? Has this person made a plan for suicide?
Even gender and age are involved in assessing risk, Bulk said. Boys are more likely than girls to attempt suicide, and the most dangerous age is the "transitional years" between 16 and 18.
After a few hours on the road, the workers return to their desks to do paperwork. They do follow-ups on previous calls while taking new ones.
The child and youth team members only work weekdays. That's when the demand is highest. This is their busiest time of the year when kids go back to school.
"The stressors really come from the school, especially with young kids," McGurk said.
McGurk founded COAST after two-year-old Zachary Antidormi was stabbed to death by a neighbour with schizophrenia. Zachary's parents, both who worked in mental health, knew their neighbour was dangerous but couldn't inspire the courts or the police to take action.
Every October, on the anniversary of the founding of COAST, McGurk takes his staff to the Mandarin restaurant to celebrate "surviving another year," he said.
"We even forward the crisis line to a cell phone. Staff have to excuse themselves to take the call. But it's our time."
McGurk is happy with the work COAST has done with children and youth. And their mental health is a subject we need to be discussing, he said.
"Children and youth are really in dire straits, and we need to talk as a community about how we're going to as a community respond to that."
It's noon at Cardinal Newman Catholic Secondary School in Stoney Creek, and the foyer at the centre of campus is bustling with students.
They walk in pairs and small groups. They wear the uniform red and white.
With an estimated one in five youth dealing with a mental health issue, chances are many in the crowd do. But the iMATTER group, with their blue T-shirts and encouraging hand-made posters, are on duty.
With the iMATTER program, about 60 students act as “peer mentors,” or safe confidantes for students who suspect they're having trouble. They hold three sessions for each year's Grade 9 religion classes where they discuss mental illness and call on local guest speakers.
The provincial curriculum doesn't include any mental health discussion in mandatory courses, so the program is an anomaly. The students have found themselves speaking at conferences and training other schools anxious to develop their own programs.
“When people from across the country are coming up to us saying 'this is a great program, what do we need to get started at our school?' you can imagine how honoured and humbled we feel,” said Marisa Mariella, guidance counsellor and iMATTER teacher advisor.
“In other parts of Canada, mental health is part of the curriculum. I know in Ontario, we're moving towards that, but we're not there yet.”
IMATTER started in 2009 and includes training 14 teachers to cope with students in mental health crisis. Teachers are often uncertain how to recognize or deal with mental illness, Mariella said.
Such training would be easy to incorporate teacher's college, but right now, it's not, Mariella said.
“As a society and as school boards, we need to equip these gatekeepers with the tools they need to support students,” she said. “It's not a matter of math and English and science and checking up on homework. You have a real live body in front of you and we need to address the whole person.”
IMATTER aims to increase awareness, dispel myths, link students to resources and teach healthy ways of dealing with emotions.
The Canadian Alliance on Mental Illness and Mental Health recently awarded the group a Champion of Mental Health award. Last year, the Mental Health Commission of Canada interviewed them while compiling its 10-year mental health strategy.
The group presents at conferences that range from a Ministry of Education symposium to this week's Canadian Association for Suicide Prevention conference in Niagara Falls. Mariella has won a number of awards, including the Teacher of the Year Award from the Teachers Credit Union and a YMCA Peace Medal.
Mental health issues vary among students, said Faith Gallant, a 17-year-old peer mentor. Many stress about family, grades and getting into university, and “that starts in Grade 9.” Plus there's the age-old problem of peer pressure.
“There is pressure to look a certain way, and to act a certain way at school,” she said. “We're trying to get rid of that as best as possible and just let kids be themselves, but at the end of the day, that's still there.”
It costs about $5,000 per school year to operate the program. That includes supplies and providing honorariums for guest speakers.
Teaching others costs too. Training staff at the St. Clair Catholic School Board to start their own program had a $2,000 price tag, Mariella said.
The group cobbles together money from various community funds, including the Hamilton Community Foundation and the Ontario Centre of Excellence for Child and Youth Mental Health. The students and their advisors spend hours filling out grant applications, said teacher advisor Halina Salciccioli.
Mariella wishes the Ministry of Education provided school boards with base funding to teach youth mental health. Right now, it's only discussed in some physical education and social science classes in Grades 11 and 12.
In one Grade 9 exercise, students cite adjectives they associate with cancer patients. They use words like courageous and strong. When asked the same about people with mental illness, they use words such as stupid and crazy.
By the end of the sessions, that's changed. That makes the program worthwhile, Gallant said.
“Kids are recognizing that this is something important and something needs to be done about it,” she said. “They're stepping up and coming forward and that really shows it's working.”
The province was scheduled to release a new health and physical education curriculum two and a half years ago that addressed mental health. It was shelved when aspects of the elementary curriculum, such as teaching about homosexuality in Grade 3 and oral sex in Grade 7, drew criticism.
On Wednesday, the Ontario Physical and Health Education Association released a report, Time to Move on Child and Youth Health, urging the province to implement the new curriculum.
“This means educators are struggling to work with a curriculum that was developed before 'cyberbullying' was even a recognized term, and without updated instructional approaches for teaching about bullying, mental health, social and emotional learning,” the report says.
“The feelings of isolation and hopelessness some students face can eventually lead them to take drastic measures. And considering that 10 per cent of students report having seriously thought about committing suicide in the past year, this is another area in which the stakes are too high to tolerate any further delay.”
But there will be a little more delay. The Ministry of Education is doing "additional consultation" on the curriculum plan, but it still hasn't decided when that will happen and who it will involve, said Laurel Broten, Minister of Education, in an interview with CBC Hamilton.
"No decisions have been made about the timing and the process, but we're committed to having that consultation," she said.
Broten pointed to the government's 2011 Comprehensive Mental Health and Addictions Strategy, with its $257 million in funding over three years, as evidence it takes the issue seriously.
As for the Cardinal Newman program, "it's something I would certainly look forward to learning more about next time I'm in Stoney Creek."
Steven Cook of Hamilton knows mental illness is a tough hill to climb.
He spent his youth struggling with bipolar disorder and borderline schizophrenia. From a young age, he was bullied at school.
His teen years included drugs, suicidal thoughts and a misdiagnosis of depression. His scariest moment involved a tense stand-off with his family as he held a knife to his own throat.
At 18, he was properly diagnosed and got the help he needed. Since then, life has gotten better.
“I own my own house,” said Cook, now 26. “I have boarders paying my mortgage and I’m dating my neighbour. Life is good.”
Cook’s history is not unique. The Canadian Mental Health Association (CMHA) estimates as many as 20 per cent of Canadian youth have a mental illness or disorder. About 5 per cent of boys and 12 per cent of girls aged 12 to 19 have had a major depressive disorder.
In the 12 to 19 age group, 3.2 million are at risk for developing depression, CMHA says. Suicide is the leading cause of death in 15- to 24-year-old Canadians, second only to auto accidents.
And each year, 4,000 Canadians die by suicide.
This doesn’t surprise Jennifer McTaggart, a psychologist who works at the Child and Youth Mental Health Program at McMaster Children’s Hospital.
“Anecdotally, there are more youth presenting to the emergency room,” she said. “I don’t know if the rates are increasing, but people are getting diagnosed more.”
The most common issues McTaggart sees are depression and anxiety. September and October are the busiest months. Everyone is heading back to school.
While McTaggart describes Hamilton as “one of the better funded regions out there,” waiting lists are common in local mental health care.
The waiting list to see a social worker at the Canadian Mental Health Association in Hamilton is about five months. Youth wait about that long for residential treatment beds at Lynwood Charlton Centre, which provides mental health services for youth and their families. They wait for as long as a school year for the organization’s day treatment classrooms.
The wait times are “not ideal,” but it’s the best services can do with their limited resources, said Camille Quenneville, director of policy and communications at Children’s Mental Health Ontario.
It means from the time families ask for help to the time youth are treated, the situation has often worsened, she said.
“They go in to be served and if it’s not in a deep end situation, they may go on a wait list,” Quenneville said. “But by the time they get the service they need, they may be a lot worse.”
The issue, she said, is often money. Youth mental health has, for whatever reason, suffered long periods of political and financial neglect.
Lynwood Charlton’s base funding hasn’t increased for years, executive director Alex Thomson said.
The province unveiled a new 10-year mental health plan last year called Open Minds, Healthy Minds. That meant 10 new staff for Lynwood Charlton — five to work in schools and five in the community.
But there was no new money to administratively support those workers, Thomson said. Even gas mileage for them to travel around Hamilton equals $36,000 per year, which Lynwood Charlton takes from other areas of its strained budget.
To balance the budget, “you cut back on your training budgets. You cut back on your admin support,” Thomson said. “You try to get lean and mean.”
Jean Clinton is a McMaster psychiatrist and longtime consultant of children’s mental health programs. She also sits on the child and youth committee of the Mental Health Commission of Canada, which recently released a national “mental health blueprint.”
From a funding perspective, mental health has been “the orphan of the health care system,” Clinton said. And youth mental health is “the orphan of the orphan.”
While the province’s 10-year strategy is long awaited and much needed, “right now, we do not have enough money to support all the programs that are currently in place,” Clinton said.
But there is reason for hope. With its new strategies, governments are paying more attention to youth mental health. There isn’t enough money devoted to it, but “the intent is very good,” Clinton said.
The issue has been pushed to the forefront this year, bringing focus to a long-obscured crisis. This month, for example, British Columbia teen Amanda Todd committed suicide after posting a YouTube video with a series of handwritten signs describing her torment.
While tragic, the story’s visibility may help, Cook said.
“I’m very happy that she put it on YouTube so that others could see,” he said. “That’s such a graphic way to show people what it can cause. It’s just really sad that she had to kill herself to do it.”
Locally, Saltfleet District High School suffered a series of student deaths this year. Two boys fell from the Jolley Cut in what police have ruled a joint suicide. In February, 16-year-old Emily Jerome also died by suicide. She was awaiting an appointment with Contact Hamilton, which links youth with mental health services, when she died.
These incidents, painful as they are, may promote understanding of youth mental health, said Jill Dennison, Hamilton co-ordinator for the Talking About Mental Illness program.
This is true as long as the stories are respectful, and written “with knowledge and compassion.”
“When people realize that mental illness is just like any other illness, it truly reduces the stigma,” Dennison said. “It reduces that fear factor and increases people’s knowledge.”
If talking helps, 2012 is a year of change.
“I can’t recall a time when this has been more in the news and more top of mind with the people we need to get to,” Quenneville said.
“Having said that, it remains to be seen how knowledgeable the average parent is about mental health and their kids.”
This town hall will examine the hidden crisis of youth mental health in our community. We'll hear from young people and their parents, youth counsellors, health care professionals, educators, and the police. They will share their personal stories, discuss ways to break down the stigma of mental illness, and suggest solutions for change.
Mariette Lee is an Honours English and Anthropology student at McMaster University. As a survivor living with depression and anxiety, she is dedicated to educating, empowering and engaging other students touched by mental health issues. Mariette is president of COPE: A Student Mental Health Initiative at McMaster. In this role, she spearheads awareness campaigns, fundraises for local and national mental health projects, and connects students with volunteering opportunities related to mental health in Hamilton. Currently, she is part of a team implementing the McMaster Peer Support Line through which students can talk to trained Peer Listeners about their problems or concerns. Outside of school and mental health advocacy work, she volunteers, fences on the McMaster Varsity Fencing Team, writes and does theatre work. You can follow Mariette and the rest of the COPE team on Twitter as @COPEMcMaster.
Sarah Cannon is the Executive Director of Parents for Children’s Mental Health, the only non-profit, parent-led organization representing the voice of Ontario families raising children and youth with mental illness. Sarah’s teenaged daughter Emily was diagnosed with Bipolar Disorder at the age of five. Her husband also suffered from mental illness and took his own life a decade ago. Sarah sits on the Child and Youth Advisory Committee to the Mental Health Commission of Canada and she’s an advisory member to the Ontario Provincial Centre of Excellence for Child and Youth Mental Health. She has received a number of awards, including the For Kids’ Sake Award by Today’s Parent in 2009, the President’s Award from Kinark Child and Family Services in 2010, and the YWCA Niagara Region’s Woman of Distinction Award in 2011 for her work in children’s mental health and efforts to eradicate the stigma that surrounds children, youth and their families.
David Hoy is the Manager of the Social Work Services Department at the Hamilton-Wentworth District School Board. As part of his responsibilities at HWDSB, David sits on the Board’s Mental Health Leadership Team, which is responsible for the development and implementation of the Board’s District Mental Health Strategy. David earned his Bachelor of Psychology and Bachelor of Social Work degrees at McMaster University prior to receiving his Master of Social Work degree at Wilfred Laurier University. Before coming to HWDSB, David worked in child welfare, children’s mental health and youth justice. He is a strong advocate for school- based mental health services recognizing the important role schools can play in delivering prevention and early intervention programming as well as increasing access to mental health services for children and youth.
Dr. Sheila Harms is a Child and Adolescent Psychiatrist and Assistant Professor at McMaster Children’s Hospital in Hamilton, ON, working with children/youth and their families in the outpatient and inpatient settings. She is also the director of post-graduate training in Child and Adolescent Psychiatry at McMaster University. She completed medical school and residency training at McMaster University as an adult learner. Prior to this, she received degrees in music performance, music therapy and occupational therapy. Clinically, she has a particular interest in the mental well-being of marginalized populations and currently works with Hamilton’s homeless and street-involved youth at Good Shepherd Youth Services, as well as those incarcerated at the Peninsula Youth Centre in Southern Ontario. She also has an interest in global mental health issues and has participated in both education and research in Sub-Saharan Africa over the past 10 years, focussing on conceptions of mental health in youth orphaned by HIV AIDS.
If you are feeling hopeless, distressed or are having thoughts of suicide, there are many people and organizations that can help.
If you are in crisis and live in the Hamilton area, 24-hour assistance is available:
Suicide Prevention Community Council of Hamilton: www.spcch.org
Salvation Army Suicide Prevention Services: 905-522-5244 (Crisis Line 24 Hrs/7days 905-522-1477), www.hopesalive.ca
Youth Net Hamilton is a mental health promotion and early intervention program: www.youthnethamilton.ca
Your Life Counts is a website for youth to share thoughts and get help with their problems via online counselling to survivors & families: www.yourlifecounts.org
LGBTQ Community Wellness Centre of Hamilton: www.thewellhamilton.ca
Parents and friends of LGBTQ youth: www.pflagcanada.ca
Health Initiatives for Youth Hamilton: www.hifyhamilton.com
Bullying Resource Sheet – Hamilton area: http://www.mac-cura.ca/download%20docs/Bullying%20Resource%20Sheet%20Jan07.pdf
Children’s Mental Health Ontario: www.kidsmentalhealth.ca. Children’s Mental Health Ontario (CMHO) works to improve the mental health and well-being of children and youth and their families. It represents and supports the providers of child and youth mental health treatment services throughout Ontario.
Reasons to Go On Living Project: www.thereasons.ca
The Jack Project: www.thejackproject.org
Speaking of Kids Mental Health: www.speakingofkidsmentalhealth.ca. Communication and resource tool for youth, parents, educators and mental health professionals.
Parents for Children’s Mental Health: www.pcmh.ca. Ontario nonprofit, parent-led organization provides a voice for families who face the challenges of child and youth mental health issues.
Girls Action Foundation – Study about mental health challenges faced by girls: http://girlsactionfoundation.ca/en/the-need-for-a-gender-sensitive-approach-to-the-mental-health-of-young-canadians
Mood Disorders Society of Canada: www.mooddisorderscanada.ca
Teen Mental Health: teenmentalhealth.org
IgniteNews.ca, Articles in Mental Health: www.satelliteonline.ca/category/mental-health/