Social Policy in Ontario

Developmental disabilities like autism and Down syndrome are commonly thought of as childhood conditions.

Too often, however, the mental health-care system has not grown to meet the different and complex challenges that such ailments impose in adolescence and adulthood, says Yona Lunsky, a psychologist and senior scientist at Toronto’s Centre for Addiction and Mental Health.

“We kind of think of a small, sweet little kid with Down syndrome starting school, or a child with autism,” says Lunsky. “But these are lifelong disorders and mental health issues change throughout the lifespan.”

Views are about to start changing as she begins her role as the inaugural head of CAMH’s new Azrieli Centre for Adult Neurodevelopmental Disabilities and Mental Health.

Announced Monday morning, the centre is being backed by a $10.4-million donation from the Azrieli Foundation, which has poured almost $22 million into the ongoing redevelopment of CAMH’s Queen St. W. site.

Catherine Zahn, president and chief executive officer of CAMH, says many of the services offered to kids with developmental disabilities tend to be cut off as they reach adulthood.

“In days gone by, many of (the adults with these conditions) would have been institutionalized,” Zahn says. “Now we believe all people with brain dysfunction can have better lives and actually can function better if they are supported in society.”

One of the people who says he will benefit from the new adult centre is Daniel Share-Strom, a motivational speaker who was diagnosed with autism as a child.

“There’s a common misconception that things get better when you’re 18 and that you don’t need services anymore,” says Share-Strom, now 28. “But nothing can be further from the truth.”

Share-Strom, who is helping Lunsky create an online meditation service for people with autism, says there is no “off switch” for the social anxieties his condition can foster — anxieties that can lead many to depression or other neurological ailments.

Indeed, some 45 per cent of adults with developmental disorders — which also include such things as Asperger’s and Fragile X syndromes — suffer from concurrent mental health problems like anxiety, depression and addiction, Lunsky says.

Yet there’s been sparse research and even less training into how these associated conditions can best be diagnosed and treated in developmentally disabled adults, she says.

A Toronto native who did postgraduate training at Ohio State University, Lunsky has been working at CAMH since 2002 — most recently as head of the centre’s Health Care Access Research and Developmental Disabilities Program. She says mental health treatments for adults with developmental disabilities would differ markedly from those used in children or in the general population.

Part of the new centre’s mandate, then, will be to research which treatments would be optimal for those adults and train medical and social work professionals how to best use them.

“There are two critical gaps,” says Lunsky, who is also a professor in the University of Toronto’s psychiatry department. “One is that there is very little research being done . . . on the mental health of adults with neurodevelopmental disabilities.”

The other, Lunsky says, is that mental health-care workers have not been trained to deal with differences in the psychiatric issues faced by these populations.

“We need to really almost reimagine how we can do that better,” Lunsky says.

For example, she says, developmentally disabled adults are often excluded from trials of promising treatments for depression, even though they suffer from the condition at far higher rates than the general population.

“Sometimes it’s just a question of saying we are not going to exclude this population,” Lunsky says.

“But sometimes we have to think, ‘well, if we are going to include them does this protocol that we have work or do we need to make a couple of modifications?’ ”

Lunsky also says the developmentally disabled are prescribed antipsychotic drugs at far higher rates than others. But, she says, there have been few studies done to determine if such medications are effective.

“If we don’t study the drugs we’re giving everybody . . . how do we know they work?”

https://www.thestar.com/news/gta/2018/02/05/new-camh-centre-focuses-on-treating-adults-with-childhood-conditions.html