Pay Now or Pay Later: Child and Youth Mental Health

BY TARA HOGUE HARRIS WITH THANKS TO ANN REILLY AND THE ACSW CHILD & YOUTH INTEREST GROUP

Trevor* is a ten year old boy who flew under the mental health radar for a long time. A social worker assigned to his school was in the classroom and noted very dark themes in Trevor’s art. Upon speaking with the teacher, she met with Trevor for a risk assessment. Trevor was assessed as a high risk for suicide, complete with intent and a plan. The art was his desperate cry for help. The social worker was able to connect the family seamlessly to counselling, consult with the family physician and make internal referrals as needed for the family and child. Without school-based mental health, Trevor may not be with us today.

*Trevor is a composite of real clients.

SOCIAL WORKERS KNOW that investments into publicly-funded mental health supports are essential and that intervention at an early age could prevent more serious long-term effects. The Regional Collaborative Service Delivery (RCSD) grant program helped coordinate and deliver in-school services to children and youth with a broad array of complex needs — students like Trevor. Those services included speech, physical and occupational therapy; supports for children who are hearing or vision impaired; and mental health supports. The loss of mental health supports, announced pre-pandemic in February of this year, is of great concern to social workers, including those who provide these crucial frontline services. Clinical social worker Ann Reilly, MSW, RCSW is a member of the Alberta College of Social Work’s (ACSW) Child and Youth Interest Group, which is working to raise awareness of these cuts.

“These are the most vulnerable children and families being affected. Even people with strong resources are having trouble coping during the COVID crisis,” says Reilly. “We need to give a voice to these children.”

Studies show that half of those who develop mental health disorders show symptoms in their early teens. A 2017 study by Alberta Health Services (Valuing Mental Health: Next Steps *1) prioritized a focus on prevention and early intervention for children and youth, saying “This will not only benefit them, but their families, the community and the province.” Paying for care at later stages of mental disorders is more expensive, as it can include hospital stays and social services.

Unfortunately, mental health issues in children are on the rise, even in early childhood. The Centre for Disease Control reports that 1 in 6 U.S. children aged 2 to 8 years had a diagnosed mental, behavioural or developmental disorder(*2). While specific statistics for that age group aren’t available in Canada, the Mental Health Commission of Canada reports that 70 percent of persons living with a mental illness see their symptoms begin before age 18. Approximately 1.2 million children and youth in Canada are affected by mental illness (*3). The upheaval caused by the COVID-19 pandemic has deepened this crisis (*4).

Research into Adverse Childhood Experiences (ACEs) confirms the connection between negative early experiences and adult health outcomes.5 People who faced childhood stressors like abuse, neglect or serious household disruptions were more likely to have poor health as adults. The good news is that strong mental health supports can play an important role in preventing the conversion of trauma into poor health– again emphasizing the societal and economic value of collaborating to support at-risk children.

Community mental health is much more economical than paying for emergency services

The RCSD program was designed to reach families where it benefitted them most. As a partnership between Alberta Health Services, Alberta Human Services (including Child and Family Services) and community stakeholders like school authorities, it allowed RCSD partners to share resources in 17 RCSD regions across the province to provide coordinated access to supports and services. This was especially valuable for families who didn’t have the resources to seek help on their own, and according to Ann, includes 4500 children in Edmonton alone.

The mental health therapists who were funded by RCSD are extensively trained and included registered clinical social workers. In addition to working directly with students, therapists in the program trained school staff to identify and work with children and youth in need of these services. This kind of streamlined and coordinated early intervention can’t be easily replaced.

While the provincial government has stated that the $75 million that previously funded the RCSD will remain in the education system6 , the money will be split between school districts who will now be responsible for offering the services. However, with Alberta schools hit by significant budget cuts even before the COVID-19 pandemic, and now attempting to manage a safe return to school without additional provincial funding, school boards are low on funds. Many will not be able to offer wrap-around services like the mental health supports offered by RCSD, especially in smaller rural districts.

The ramifications of losing this funding are far-reaching. Clinical school-based therapists see the most acute and most traumatized children and youth. These families are often resource-poor and can slip through the cracks of the normal community based mental health care system. The loss of these services leads to the risk that more children will suffer suicide, self-harm and family violence. Alberta’s health care system will face these costs at some point. Community mental health is much more economical than paying for emergency services. By funding public community-based mental health care for young Albertans, we can make a choice to invest in the future. Members of the ACSW Child and Youth Group are very concerned about the health and well-being of children and families in Alberta, particularly during a pandemic. Access to specialized clinical intervention and therapy is often not accessible to the children who need it most. We continue to seek opportunities to collaborate with governments, school boards and other invested parties to support vulnerable children, youth, and families.

SUPPORTING PRACTICE

THE ACSW CHILD AND YOUTH GROUP

is a meeting space to support social work practice for those in this field. We invite all who may be interested to join our monthly meetings. For more information, contact Membership Activities –Social Worker Andre Tinio at MemberActivitiesNorth@acsw.ab.ca.

References available by emailing MemberActivitiesLead@acsw.ab.ca.

TARA HOGUE HARRIS is a writer and editor with Bird Communications in Edmonton.