From having suicidal thoughts to becoming a peer mentor

Most mental disorders begin to develop during adolescence or young adulthood. Now a project is being developed to test the theory that giving youth quick access to mental health services is the key to preventing suicides and self-harm, as well as long-term mental health issues.

New Toronto drop-in centres offer aid to 'neglected' youth

Devon Serket, 24, had difficulty getting treatment for mental-health problems, But now he is a confident peer mentor. (Evan Mitsui/CBC)

For Devon Serket, trying to find treatment for mental illness was like travelling to hell and back. The toll was very nearly his life.

Serket, 24, a Toronto graphic design student who suffers from bipolar disorder, started dealing with mood swings and depression when he hit puberty. 

"It was oftentimes really, really debilitating. I couldn't do my assignments. I couldn't get through school. I had a lot of interpersonal problems, major mood swings," he says. 

Even when he went to a hospital emergency ward because he was thinking of "throwing myself in front of a streetcar," he was told he'd have to wait for therapy. 

"It wears you down. It makes you feel like nobody is really looking out for you, that those services aren't for you," he says.

"A lot of times if you want quick service, if you want to be admitted into programs right away, then you need to be in a crisis state. You need to be actively suicidal. You need to be actively a danger to yourself or others."

He says he started trying to get help for his symptoms when he was in high school. But instead of the sympathetic care he was looking for, Serket says he was shunted between counsellors, misdiagnosed, placed on long waiting lists and refused care because he wasn't considered sick enough.

As he reached his 20s, he became addicted to stimulants and struggled to shake his addiction.

Now a peer mentor

Serket, now a confident peer mentor at Loft Community Services in Toronto, eventually found help when a university counsellor referred him to one of Loft's youth programs.

He says he was placed in a therapy group within two weeks and quickly learned new skills to help him "address the emotional issues behind the behavioural problems. I think that was more important than addressing the behaviour itself," he said.

Serket is one of the many Canadian youth who have trouble getting timely care for mental health issues.

This age group has essentially been neglected.— Ashok Malla, McGill University professor

Most mental disorders begin to develop during adolescence or young adulthood, according to a 2012 report on mental health services by the Mental Health Commission of Canada. It found that nearly one in four Canadians aged nine to 19 experienced mental illness in 2011. That number rose to about 28 per cent among people in their 20s.

But studies show only one in four youths who need help get it, said Ashok Malla, a professor of psychiatry at McGill University who specializes in treating and preventing psychoses in youths.

"This age group has essentially been neglected," he said. 

Many communities have been devastated by the lack of accessible mental health services for young people. Earlier this year, the Ontario First Nations community of Attawapiskat declared a state of emergency after 11 teens tried to kill themselves in one day. In June of this year, high school students in Woodstock, Ont., walked out of class to demand better services after five teens took their own lives.

New walk-in program

Now Toronto's Centre for Addiction and Mental Health is testing a new program researchers hope will encourage youth to get clinical help before mental health problems spiral out of control. It's setting up three walk-in mental health clinics in malls and shopping areas for people aged 14 to 29. 

Psychologist David O'Brien runs the What's Up walk-in clinic in a mall in the Toronto suburb of Scarborough. He says services are designed to be youth-friendly and hassle-free. The key is to get young people and their families help as soon as they ask for it. 

It's rapid access to everything.— Psychologist David O'Brien of  the What's Up walk-in clinic

"It really meets their mindset of who they are as youth and children and also the culture that we've become," he says. "It's rapid access to everything and if we're not able to hone in on that and serve them right away those issues will escalate for them and a minor depression will become a major depression." 

The service is free and no referrals are needed. Potential clients simply walk in the door to get help. O'Brien says the average wait time to see a counsellor at the clinic is 25 minutes. Those who need a psychiatrist can see one, often over Skype, within 48 hours.

Fewer than 1 in 10 need psychiatric help

O'Brien says fewer than one in 10 youths with mental health problems need psychiatric help. For the others, treatments focus on finding quick solutions to current problems and might last only a few sessions.

The clinic will also work with other community-based services that offer peer mentoring programs with young people who have also faced mental health problems. 

The CAMH project is being developed alongside a larger Canada-wide initiative to test the theory that giving youth quick and easy access to mental health services is the key to preventing suicides and self-harm as well as long-term mental health issues.

The $25 million ACCESS Open Mind project also plans to open 12 walk-in clinics across Canada, including five in indigenous communities. 

The clinics are based on an Australian initiative. In an attempt to encourage youth to get help for mental health concerns, the Australian government has set up nearly 100 Headspace walk-in clinics in shopping malls and storefronts.

Every year they attract thousands of youths, who can get services online or take short courses of cognitive behavioural therapy in one of the clinics. 

But a newly released independent study of the program shows those youth aren't improving much more than they would have if they hadn't gone for treatment at all.

Are treatments too quick?

Anthony Jorm, senior principal research fellow at the University of Melbourne, says the problems may be that treatments at the clinic are too quick.

But Canadian researchers say that doesn't necessarily mean mental health walk-in clinics don't work. They plan to test the idea. 

Researchers at CAMH are setting up a randomized controlled trial with clients at their three Toronto clinics to compare results to hospital treatment. 

Researchers at six of the ACCESS Open Mind sites also plan to do controlled trials to see if youth who come to the centres find it easier to deal with work, school and relationships after they've been treated.

Malla, the lead investigator and professor of psychiatry at McGill University, says that if the research shows positive results he plans to push governments to start funding similar clinics in every province.


Anita Elash

Reporter and producer

Anita Elash is a producer with CBC's national investigative unit. Story tips are always welcome.