Dr. Anthony Levitt never fails to be moved by the emotionally drained and desperate families he meets as a psychiatrist in the mental-health unit of the Sunnybrook Health Sciences Centre in Toronto.
Canadian youth – and their families – are suffering, he says. With a dizzying array of children's agencies and treatment centres – and a dire lack of child psychiatrists – parents and their kids are often left floundering, not knowing where to turn. Too often, they're left to their own devices and fall through the cracks.
Levitt hopes that a new program at Sunnybrook will help counter that.
With Canada's youth suicide rate now the third-highest in the industrialized world, Levitt says the Family Navigation Project aims to "shine a flashlight" into the "black hole" that families now encounter as they struggle to find specific mental-health treatments and facilities that are targeted to each child's unique needs, whether addiction or complex mental disorders. "If someone fractures a leg, that's scary and problematic, but you know where to go and the whole family is not in crisis. Most parents I see have been trying to navigate the system for many years, at a huge emotional and financial expense. They're handed lists and big binders. We will work with them closely to determine what the pathways are."
The project, Levitt adds, "will hold these families' hands" from diagnosis, to finding outpatient and/or residential treatment facilities, ongoing psychiatric care, and follow-up to ensure the child is actually making progress. He and his team (with help from parents) have raised $1.3-million to launch the program, which will hire seven therapeutic placement specialists with years of experience in sorting through Canada's confusing and overburdened mental-health system.
The system has been broken for so long that Levitt and other mental-health professionals know it's going to be a long, bumpy road before it is fixed. The wider, systemic problem for youth mental illness revolves around many factors: a serious lack of residential treatment centres, a shortage of child psychiatrists and long waiting lists for the scarce inpatient and outpatient facilities that do exist. And the cost for Canadians to adequately support mental disorders in youth keeps creeping up, making it the second-highest hospital-care expenditure in Canada, according to the Canadian Mental Health Association.
Toronto mother Lesley Skelly welcomes the initiative, and hopes it can keep up with demand. She also can't help but wonder if, had a service like this existed four or five years ago, around the time her son Christopher (Kit) was diagnosed with schizophrenia, he might be alive today. Kit died by suicide last March by jumping off the Leaside Bridge, near their home. He was 23.
And Skelly knows, too well, how untenable and frustrating Canada's mental-health system can be. For years, she and her husband, David, tried to get Kit the help he needed. He was in and out of Sunnybrook, the Centre for Addiction and Mental Health, and youth shelters. He was prescribed medications, which he often refused. When he was paranoid, delusional and dangerously anti-social, the Skellys had no option but to call the police to forcibly take him to a hospital emergency room for treatment.
It broke Skelly's heart to see her son shackled. "If that hurt us, I can't imagine how much that hurt him," she says. "I don't think he ever forgave us."
Sunnybrook's new initiative should launch by spring, 2014, says Levitt, director of research in Sunnybrook Health Sciences Centre's department of psychiatry and co-chair of the Family Navigation Project. "We'll work on a case-by-case basis. … And if we don't find the right solution to that youth's needs the first time, we'll go back, find something else and continue on."
In the first year, Levitt expects to provide assistance to 400 to 500 families in the Greater Toronto Area – a figure to hopes will grow to 1,000 within five years. "For years, there has been no language for mental health. People did not talk about it. We want to facilitate discussion, get it on the radar for public debate, so we can work toward solutions."
That's a good thing, Skelly says. "There is just a huge gap in meaningful direction for families like ours. We didn't know where to go, or what we should be doing. We loved the doctors at Sunnybrook, but we were just not happy with the lack of family support or peer support for Kit. There are so many options out there, it was overwhelming for us."