The road to recovery from mental illness can be long, and it is invariably sinuous, at times torturous.
Just ask David Klein.
Severely withdrawn, he was diagnosed with depression and anxiety disorder at age 10. By 13, his anxiety and panic attacks were such that he could no longer attend school.
Mr. Klein's parents, physicians and educators tried everything. There was a panoply of drugs, each of which tended to work for a while. There was psychiatric and psychological counselling, individually and in groups, when he could garner the strength to attend sessions. There were special education programs, from small classes offered at the Children's Hospital of Eastern Ontario through to alternative schools. There were in-patient treatments of varying lengths. There were shock tactics and desperation moves like getting police to arrest the teenager and commit him to treatment in a psychiatric hospital. There was electroconvulsive treatment to alleviate depression.
Nothing worked very well.
Mr. Klein says he spent his days and nights "lying around the house doing nothing except being in a foul mood."
Then, one day, at age 17, he was awoken at 4:30 a.m. and "whisked off by transporters" to the airport. Destination: Bend, Oregon, and a treatment program called Second Nature Cascades.
Mr. Klein spent the next 10 weeks camping out in the rugged wilderness, hiking up to 20 kilometres daily and getting intensive group therapy.
"It was the hardest thing I've ever done in my life, but it was also the best thing ever," he says.
The dark cloud that had engulfed him since childhood gradually dissipated. "I finally realized I had the strength to get better, and I turned my life around."
The other treatments, the medication and the cognitive behaviour therapy, began to work a lot better.
Dr. Simon Davidson, chief psychiatrist at Children's Hospital of Eastern Ontario and the young man's long-time doctor, says Mr. Klein was, at once, one of his most challenging and rewarding patients.
"Finding what works for the patient is part of the art of the work we do," he says. "In David's case we tried a ton of different things until we found what worked.
Dr. Davidson says the lesson here is: "In mental health, there is no one-size-fits-all."
In fact, the psychiatrist is an outspoken critic of the increasingly common practice of treating children and adolescents exclusively with prescription drugs. "Medication should never be used as a singular intervention. It should always be adjuvant to other interventions."
He says it is also essential that patients and parents (in the case of children) work in concert to "come up with an appropriate game plan."
Sending Mr. Klein to Second Nature Cascades was a non-traditional treatment option but a carefully considered one. The program is not a boot camp for delinquents, but a certified mental health treatment program with both a psychologist and a nurse in the field with the young people.
Time in the wilderness proved to be a treatment breakthrough. Afterwards, Mr. Klein did his high school equivalency and then applied to university. He opted for Carleton University in Ottawa because it was close to home and offered an "enriched support program" for young people who had difficulties in high school.
Now 21, Mr. Klein is enrolled in an honours psychology program and, with straight As, planning on completing his Master's.
"Right now, I'm on top of the world," he says.
His recovery is going so well that he has not even bothered enrolling with the disabilities program.
Those programs, which offer education and peer support, are increasingly popular with young people with mental-health problems, who make up an estimated 15 per cent of the university and college population.
Enid Weiner, manager of the Mental Health Disability Support Service at York University, says that while students with psychiatric problems - past or present - get support, they still need good marks to get into university and they tend to thrive.
"I see recovery every day and it's a pretty amazing sight."