Mental health care for kids ‘fractured’
TheStar.com – News/healthzone.ca
July 9, 2010. Diana Zlomislic, STAFF REPORTER
The mental health care system for children is “fractured” and needs better oversight, say critics after a Toronto Star investigation found a psychiatric centre was locking up kids who didn’t belong there.
“The role of oversight is not taken as seriously as I think it should be,” Irwin Elman, Ontario’s Children and Youth Advocate, told the Star.
Elman’s comments came after the Star revealed that the provincially funded Youthdale Treatment Centre admitted children to its secure treatment unit even though they did not have a mental disorder. Within the last two years, the Child and Family Services Review Board ordered released nearly half of the children who appealed their placements in the centre’s secure unit.
Elman said unecessarily intrusive treatments are happening across the province, something he called a “fundamental systemic problem.”
“It could be physical restraints or chemical restraints or the locking or blocking of young people in rooms,” he said. “These are the kinds of things we hear about.”
The Ministry of Children and Youth Services licenses children’s mental health care agencies such as Youthdale and provides them with the bulk of their funding. Occasionally, the ministry uses its oversight powers, Elman said, but “it’s not a real, day-to-day oversight body.”
Ministry spokesperson Paris Meilleur pointed out that doctors working in clinics like Youthdale are scrutinized by their professional college. “We trust our clinicians,” she said.
A provincial committee on mental health is considering whether the Ministry of Children and Youth Services should remain responsible for the sector.
Liberal MPP Kevin Flynn, chair of the committee, said parents and children’s mental health care professionals are urging his group to recommend that the Ministry of Health oversee treatment centres like Youthdale.
“(Mental illness is) an illness like any other illness,” Flynn said. “You don’t send a child to a different hospital when they break their arm, you send him to the same hospital you send the adults to.”
Youthdale’s executive director Dan Hagler, who founded Youthdale 40 years ago, supports the move.
“(We want) to link back with the Ministry of Health to provide a more balanced approach to mental health services for children and youth,” he wrote in an email to the Star.
Hagler added that legislation governing the health ministry gives patients a stronger voice where the Child and Family Services Act, which sets out key criteria a facility must meet to legally secure a youngster, creates an “adversarial approach.”
The committee will release its recommendations in the fall.
“What’s become very apparent is that you’ve got a very fractured system,” Flynn said. “You’ve got over 440 agencies funded (by various ministries) delivering services in a not very well coordinated manner.”
The Ministry of Children and Youth Services said it’s looking forward to the discussion the report will spark.
Whether the money comes from one ministry or another is irrelevant, Elman said.
“The issue needs to be what will improve services to kids and how do we ensure that proper oversight and accountability is in place.”
He suggested ministries work together to deliver an integrated-service approach with common principles that protect the child.
New Democrat leader Andrea Horwath says the provincial children and youth services ministry has fallen down in its responsibility to ensure society’s most vulnerable are protected.
What happened at Youthdale, “it’s absolutely shocking,” she said. “This needs some attention.”
Earlier this week, Elman met with representatives of one GTA-area children’s mental health organization to talk about a new behavioural therapy approach that involves teaching young people and staff how to think before they act; to understand what triggers them. The need for restraints in facilities using this approach has gone down.
The ministry must encourage all agencies to adopt similar methods, Elman said.
“It sounds common sense, but in a way it’s cutting edge.”
< http://www.healthzone.ca/health/mindmood/mentalhealth/article/833979–mental-health-care-for-kids-fractured >