New Brunswick's child and youth advocate has presented his final report from a task force looking at services for children with complex behavioural and emotional problems.
The report was born partly out of the death of former Moncton teen Ashley Smith in an Ontario prison.
The 19-year-old mentally ill youth choked herself to death with a strip of cloth at a jail in Kitchener in 2007.
As a teen she was initially given a 90-day sentence for throwing crabapples at a postal worker, but in-custody incidents kept her behind bars. Before her death, Smith endured months of forced medication, isolation and 17 transfers from one prison to another.
An inquest into her death is to begin April 4 in Toronto.
"I've said already that Ashley's death was preventable," said the report's author Bernard Richard. "She became worse because of her interaction with the system."
"We're already spending millions of dollars on these services now but not very effectively, so what we're recommending is really a different approach, a more holistic, networked approach from early detection to high-level treatment and transition back into families and communities," Richard said.
One of the recommendations in Richard's document "Staying Connected" is a so-called 'centre of excellence' for Moncton.
Richard believes it would not cost much more than what the province is already spending on children and youth with complex problems, in what he described as far-flung and ineffective ways.
He said he is pushing for Moncton as the centre's location because the city already has the only psychiatric unit in the province for young people, and because other maritime provinces might buy in to the service, which could offset costs.
"I think Moncton is a hub, there is no question, for the maritime provinces, and there is a possibility that other provinces might be interested in buying these kinds of services and allowing us to really develop a centre of expertise that would be more difficult to do if other provinces aren't part of the picture," said Richard.
Richard said the centre's primary role would be to offer support to a network of local teams.
Programs must be family focused
Shirley Smallwood, a nurse and parent of an autistic son, co-authored the report.
She said while the treatment programs must be child-centred, she echoed Richard's call for more focus on family interaction.
"We truly believe that unless we bring the families in from the moment of diagnosis and make them part of the care plan, no matter what recommendations we table, they won't be as effective as they could be," she said.
Her son was born into a francophone family and was slow to develop the ability to speak. She said a lack of services in New Brunswick meant the family had to travel to find help.
"We found ourselves in areas such as Mississauga, British Columbia and Wisconsin, for example, and obviously the services that they provided were in English," she said.
Her son is now speaking, but with English as his first language.
Meanwhile, Maureen Bilerman, the organizer of a march on the provincial legislature in December that called for better services for mentally ill youth, said she's pleased after reading the report.
"I was surprised because I choked up and started to cry, and for me, I think what resonated in the report was the focus on family," Bilerman said from her home in Fredericton.
"It was so bittersweet and so easy to imagine how things could have turned out for us as a family had those supports been in place."
Her daughter has been diagnosed as bipolar and has overdosed on numerous occasions. The family was unable to get her into a facility for help because all the beds were full. The teen has since left home and is living with various friends.
Bilerman said she hopes other families don't have to live through the same thing and is confident the report's recommendations can be implemented.
"I think that if we all work together, whether it's the non-profit groups, the community, the services that are here, and the government, I think we can make some headway," she said.
But the Conservative government isn't making any commitments. Social Development Minister Sue Stultz said Thursday that she had just received the report and needs time to review it.
"We just received the report this week and we'll immediately begin to analyze the findings and recommendations but we will need the time to carefully review the report," Stultz said.
Currently about 350 youths in New Brunswick are on a waiting list to receive mental health services.