Youth with mental illnesses should have access to long-term in-patient care, report on teen's death says

A 16-year-old who died by suicide, despite many contacts with community supports and therapists, should have had access to long-term in-patient care, says a new report from Manitoba’s advocate for children and youth. 

Manitoba advocate for children and youth details struggle of 16-year-old who died by suicide

A new report from Manitoba's advocate for children and youth details the life and death of Matthew, who died by suicide at age 16. (Submitted by the office of the Manitoba advocate for children and youth )

A 16-year-old who died by suicide, despite many contacts with community supports and therapists, should have had access to long-term in-patient care, says a new report from Manitoba's advocate for children and youth.

The report released Thursday details the struggles the teen, named Matthew, and his family went through to get help for his depression and generalized anxiety disorder.

Despite having numerous contacts with community services and the health-care system, Matthew did not get the long-term help he needed, advocate Daphne Penrose said during a press conference about her office's report Thursday. 

"It was clear to us and to Matthew's family that the patchwork of mental health interventions he was offered were not well co-ordinated and did not help him recover," she said. 

"In fact, the more people Matthew saw, the more despondent he became. He eventually believed that he was not fixable."

In her report on his story, Penrose recommends the establishment of a long-term residential facility for youth mental health treatment.

She is also calling on improved access to treatment for youth experiencing mental health crises, promoting mental health in classrooms and assigning case managers to help youth and their families navigate mental health and addictions services.

Though his early years were happy, Matthew (the report uses just his first name) experienced "profound" levels of bullying that triggered, then exacerbated, his mental illnesses, the report says.

His condition worsened after the sudden death of his father, who died of heart failure in the family's home in front of Matthew, it says. 

Family watched him 'disappear slowly' 

In the months before his death, Matthew's ability to function deteriorated to the point that he was mostly housebound, the report says.

He repeatedly told adults he wanted to die and attempted suicide at least twice before his death in November 2017 — nine days before his 17th birthday. 

"Over time, the family watched Matthew disappear slowly, consumed by an overwhelming hopelessness and persistent suicidal thoughts," it says.

It was clear to the family that the patchwork of mental health services offered in Manitoba were not well-co-ordinated and were not actually helping Matthew recover, the report says.

Matthew began showing signs of mental illness in Grade 7 and was prescribed an antidepressant, the report says. Over the next five years, his family tried many services to help him. 

Daphne Penrose, the Manitoba advocate for children and youth, says the investigation reveals Matthew faced many barriers in getting the help he needed for his mental illness. (Jeff Stapleton/CBC)

He saw private therapists and an Addictions Foundation of Manitoba counsellor, had multiple sessions with a therapist at the Manitoba Adolescent Treatment Centre, was admitted to child and adolescent psychiatric in-patient services, and had 80 sessions with a Child and Family Services family support worker. 

The problem was not with the individual services but the lack of co-ordination between the services and the lack of access to long-term care.

"It was a repeated cycle of utilizing the same services, in the same way, with the same recommendations, the same outcomes, and no sustained improvement for Matthew," the report says.

"Despite the good intentions of individuals inside the systems, and his mother's unrelenting advocacy for services that would help Matthew manage his spiralling mental health, Matthew did not receive the kind of long-term, intensive help to which he had a right."

Penrose likened this pattern of being given the same treatment plan over and over again to being prescribed the same medication for a physical ailment that wasn't getting better. She said it left Matthew frustrated and feeling like there were no options for him. 

"What happened was he became the problem. He was seen as having a problem, but really needed something different from the system," she said.

"He wasn't unwilling. He wasn't resistant. He was ill and nothing that they were doing was working for him on an outpatient basis."

The report illustrates how Matthew and his family repeatedly sought help within the health system, but were met with ineffective solutions and a lack of available long-term help. (Submitted by the office of the Manitoba Advocate for Children and Youth)

Matthew's mother echoes this point in a letter included in the report, saying what her son truly needed was in-patient, around-the-clock care to ensure he was taking care of himself, taking his medication, and wouldn't harm himself.

"We did everything we were supposed to do. So what do we do when everything else fails?" the letter says.

"What if this disease of the brain is so severe that the person suffering with a mental health problem runs out of hope and refuses all treatment? The answer should be simple, he needed in-patient care."

In her fight to help her son, no one could tell her what to do with Matthew long term, she wrote. 

"There was nothing … just nothing." 

Suicide leading cause of death in youth 

Matthew's manner of death is "horrifically common" among Manitoba youth, the report says. 

Over the past five years, the Manitoba advocate for children and youth found that suicide was the leading cause of death of Manitoba youth age 10 to 17.

Manitoba Opposition NDP Leader Wab Kinew said it's a remarkable finding "that all of us, regardless of party affiliation, should take seriously."

"I think this is really a cry for help and a warning signal that we should have a specific suicide prevention strategy in this province," he said. 

Liberal MLA Jon Gerrard said he found Matthew's story "tragic and heartbreaking."

"It exposes the current system as a patchwork, fragmented, poorly integrated, poorly co-ordinated system which is failing children and failing youth — and I should add, from my experience, failing adults as well."

Both said they felt the Progressive Conservative government should work on implementing Penrose's recommendations now. 

In response to the report, Health Minister Cameron Friesen said his government has made recent investments of more than $25 million on initiatives aimed at improving mental health services for youth, including $4.4 million to improve school-based mental health and addictions supports and $4.2 million for assessments and treatment. 

"We offer our sympathies to Matthew's friends and family and to other families dealing with the loss of a child. We know there is more to do to help support children and youth dealing with mental health issues," Friesen said in a statement. 

However, he did not say whether his government would commit to establishing a long-term, residential care facility for youth in Manitoba. 

Manitoba advocate details struggle of 16-year-old who died by suicide

3 years ago
Duration 1:22
A 16-year-old who died by suicide, despite many contacts with community supports and therapists, should have had access to long-term in-patient care, says a new report from Manitoba's advocate for children and youth.

In addition to her other recommendations, Penrose said she wants the provincial government to publicly release its strategy to redesign how mental health services are provided to children and youth.

"The department has not informed Manitobans how recent and anticipated funding announcements and health system transformations are located within a systemic tiered framework," the report says. 

"This lack of transparency serves to reinforce the siloed and disjointed nature of the health care system for Manitoba families who are left to navigate a perpetually confusing public system."

If you're experiencing suicidal thoughts or having a mental health crisis, there is help out there. Contact the Manitoba Suicide Prevention and Support Line toll-free at 1-877-435-7170 (1-877-HELP170) or the Kids Help Phone at 1-800-668-6868. You can also text CONNECT to 686868 and get immediate support from a crisis responder through the Crisis Text Line, powered by Kids Help Phone.