The emergency department at Victoria General Hospital. Sarah and her daughter frequent the ER as they can’t find supports in the community. (Black Press Media file photo)

The emergency department at Victoria General Hospital. Sarah and her daughter frequent the ER as they can’t find supports in the community. (Black Press Media file photo)

Mind the Gap: Children in crisis

Navigating Greater Victoria’s mental health system

Content warning: This article contains mentions of suicide.

This is part one of a two-part series exploring mental health services for youth in Greater Victoria. Please see next week’s edition for more.

Sarah desperately types an email as she waits in Victoria General Hospital’s ER. This is her 15-year-old daughter’s third suicide attempt in a month and she’s certain the hospital will send them away again.

“I am at a loss of how to support her and keep her alive,” she types.

“I know my story is just one of thousands of parents in the same situation.”

Sarah – whose last name has been withheld to protect the identity of her underage daughter – has been fighting referrals and wait times that have left her feeling like her daughter has fallen into one of the gaping holes in Greater Victoria’s mental health services.

It is a system many experts said was cracked before the COVID-19 pandemic blew it apart.

Mental disorders in youth are ranked as the second-highest hospital care expenditure in Canada, according to the Canadian Mental Health Association, surpassed only by injuries.

In B.C., there were 21 suicide deaths involving 10- to 18-year-olds between April 2020 and February 2021, although the B.C. Coroners Service warned statistics could change as investigations are concluded. During that same time, 102 people between the ages of 19 and 29 died by suicide.

Sarah’s daughter could have been one of them.

Sarah and her daughter

After moving to Greater Victoria last fall, the teen – who we’ll call Sam – spent two weeks in hospital for a suicide attempt. That hospitalization led to a month-long stay at Ledger House – which is an Island Health facility – where she was diagnosed with borderline personality disorder and complex post-traumatic stress disorder.

Three weeks after being released, she was back in hospital after another attempt.

Every month since, Sam has been in hospital, with three attempts in March alone. A single mother on shift work, Sarah is doing what she can to keep supports in place for her daughter, but it hasn’t been enough.

Staff have been very good, but there’s a disconnect between what hospital staff think is available and what is actually available, Sarah said.

“You think you have all the options but you end up on wait lists.”

READ MORE: Mental Health – A look at a fractured system

The biggest hurdle has been trying to find the right medication balance. With no family doctor, a Victoria-based integrated health centre is filling that role, but it means there is no consistency in who is treating Sam.

Despite plans in place for when she finds herself in crisis, or lands in the ER, Sarah said they’ve been on a conveyor belt that’s been moving them through the system from emergency response back to the community with referrals to a provincially operated clinic.

“She’s chronically suicidal … every time we see them since it’s this broken record that she needs therapy.”

But they’ve been stuck waiting. Most referrals are for one-off consultations or short-term treatment plans and Sam now sees the ER as the only place to access mental health professionals.

“It seems like every resource is meant to be there for three to six months and then you’re done,” Sarah said.

She found a private psychiatrist but that came with a recommendation of specialized treatment only available in Vancouver – which also has a six-month wait list.

“We’re all just falling into (the holes) and trying to climb out.”

Navigating the gaps

While Island Health declined to provide an interview for this article, it did note its primary services for child and youth mental health are crisis response or hospital-based inpatient services. These are for youth experiencing a significant crisis or who have complex mental health needs that require long-term inpatient support.

Crisis intervention services generally can be accessed as urgently as needed, without a wait. Once a patient has been assessed and stabilized, an Island Health clinician connects them with a community-based service.

There are seven children and youth mental health (CYMH) intake clinics – which are operated through the B.C. ministry of children and family development – on the south Island, including one mobile unit, as well as offices in Duncan, Sooke, Esquimalt, Saanich, Victoria, and Colwood.

READ MORE: Fractured services leave community to fill gaps

Access to CYMH services should take place without unnecessary delays, according to the B.C. government. In the 2018-19 fiscal year (the most recent data available for performance indicators) more than 20 per cent of clients had no wait for services. On south Vancouver Island, a total of 1,308 clients received their first clinical service. Of them, 186 clients had to wait and the average wait was 70 days – higher than the provincial average of 56.

But what happens after that first referral?

That gap between referral and treatment, that’s where Maria Weaver, acting executive director of Need2 Suicide Prevention, Education and Support, said many youths are falling through the system.

“That’s who we see the most – youth not quite at the point of emergency intervention but who are in a lot of pain and don’t know where to go.”

The problem, she noted, is when too much time passes between appointments. Need2, which operates the chat/text crisis line youthspace.ca, has been helping to fill that void by conducting follow-ups when requested by other services, such as counsellors, who can’t see a patient for an extended period of time.

Resources

The B.C. ministry of children and family development said for years people who need mental health care have struggled to get help and COVID-19 has made those challenges worse. While more work needs to be done, since 2017 new services have helped reduce wait times for children and youth to see a psychiatrist or access other clinical services.

In its 2020-21 budget, the province has set aside almost $117 million for CYMH services, with $9.25 million designated for the south Island. That’s up from almost $99 million in 2018-19, which was the latest spending markers available on its website. Of that, $8.37 million went to the south Island, which received the most funding following South Fraser with $10.6 million and Vancouver/Richmond with $9.6 million.

But is more money the simple fix?

Youthspace.ca is a text/chat crisis line available to youth from 6 p.m. until midnight 365 days a year. (Katherine Engqvist/News Staff)

Dr. Pauline Lysak operates a psychiatry practice in downtown Victoria with her business partner and husband Mark Roseman.

“The mental health system was already very broken prior to COVID … since COVID it’s been in crisis,” she said.

Prior to the pandemic, there were treatment options for people in need of urgent care, but pre-pandemic those wait times were a few weeks. Now waits can range up to six months or longer.

“And that’s if they’re accepted at all … the urgent program isn’t able to handle urgent needs,” Roseman explained.

While it was an issue before, Lysak said her practice is now beyond full, and she’s still receiving a few cold calls a day from across the province. These are people in urgent need but are unable to find services in their area.

Like many resources, patients age out of the child system and are forced into the adult stream. Lysak only treats patients over the age of 18 and often receives calls from child psychiatrists who are desperately looking for someone to take on their patients as they turn 18, but they have nowhere to send them.

“It’s heartbreaking … now they have nothing.”

Despite the dark days of the past year, Lysak says there is hope. She looks to other provinces where models of primary care networks are being utilized to re-imagine how resources are used to treat patients and improve gaps in the continuation of care.

If you or someone you know is struggling, call the provincial suicide prevention hotline at 1-800-suicide (1-800-784-2433), or visit crisislines.bc.ca to find local mental health and crisis resources. Black Press Media has also prepared a mental health resource guide filled with information specific to Greater Victoria, you can find it under e-editions at vicnews.com.

READ MORE: Mental Health in Greater Victoria

katie.e@blackpress.ca


 

Do you have a story tip? Email: vnc.editorial@blackpress.ca.

Follow us on Twitter and Instagram, and like us on Facebook.

Greater Victoriamental healthWest Shore

Just Posted

According to Statistics Canada, the unemployment rate in Greater Victoria stood at 6.3 per cent in May 2021, nearly unchanged from April’s rate of 6.2 per cent. (Black Press Media File)
Unemployment rate in Greater Victoria stagnates at 6.3 per cent in May

Latest figures reflect conditions before lifting of public health measures

North Saanich council Monday will consider the results of a survey conducted by the North Saanich Residents Association that finds little support for increased densification. (Black Press Media File)
Survey finds little support for increased density in North Saanich

North Saanich Residents Association conducted the online survey

The District of Saanich has pinpointed funding requests to Oak Bay and Victoria to help offset the purchase price of the Kings Park greenspace and keep the property intact. (Courtesy District of Saanich)
Saanich requests funding help from neighbours to preserve Kings Road green space

District hopes Victoria and Oak Bay will join them in protecting urban green space

An example of the forest land in the Port Renfrew and Fairy Creek area of Vancouver Island is shown on May 11, 2021. THE CANADIAN PRESS/Jen Osborne
Old-growth logging opponents launch hunger strike as arrests continue at Fairy Creek

Zain Haq says the hunger strikers will gather today at Burrard Street in downtown Vancouver

The City of Victoria is hoping to ring in the summer by celebrating local art and offering some distanced, live music to surprise people in parks, plazas and other public spaces. (Photo courtesy of the City of Victoria)
Live, pop-up concerts and local art being showcased in Victoria this summer

People will see surprise serenades at 16 locations throughout the summer

Canadian Prime Minister Justin Trudeau participates in a plenary session at the G7 Summit in Carbis Bay, England on Friday June 11, 2021. THE CANADIAN PRESS/Adrian Wyld
Canada donating 13M surplus COVID-19 vaccine doses to poor countries

Trudeau says the government will pay for 87 million shots to be distributed to poor countries

Premier John Horgan speaks as provincial health officer Dr. Bonnie Henry, right, and health minister Adrian Dix look on during a press conference to update on the province’s fall pandemic preparedness plan during a press conference from the press theatre at Legislature in Victoria, Wednesday, Sept. 9, 2020. THE CANADIAN PRESS/Chad Hipolito
B.C. officials to provide details on Step 2 of COVID reopening plan Monday

Step 2 could allow for larger gatherings and a resumption of recreational travel

Indigenous Services Minister Marc Miller is seen during a news conference, Wednesday May 19, 2021 in Ottawa. THE CANADIAN PRESS/Adrian Wyld
Indigenous child-welfare battle heads to court despite calls for Ottawa to drop cases

Feds are poised to argue against two Canadian Human Rights Tribunal rulings

The Great Ogopogo Bathtub Race has been held in Summerland as a fundraising event. Do you know which Canadian city introduced this sport? (Black Press file photo)
QUIZ: A summer’s day at the water

How much do you know about boats, lakes and water?

Two-year-old Ivy McLeod laughs while playing with Lucky the puppy outside their Chilliwack home on Thursday, June 10, 2021. (Jenna Hauck/ Chilliwack Progress)
VIDEO: B.C. family finds ‘perfect’ puppy with limb difference for 2-year-old Ivy

Ivy has special bond with Lucky the puppy who was also born with limb difference

A million-dollar ticket was sold to an individual in Vernon from the Lotto Max draw Friday, June 11, 2021. (Photo courtesy of BCLC)
Lottery ticket worth $1 million sold in Vernon

One lucky individual holds one of 20 tickets worth $1 million from Friday’s Lotto Max draw

“65 years, I’ve carried the stories in my mind and live it every day,” says Jack Kruger. (Athena Bonneau)
‘Maybe this time they will listen’: Survivor shares stories from B.C. residential school

Jack Kruger, living in Syilx territory, wasn’t surprised by news of 215 children’s remains found on the grounds of the former Kamloops Indian Residential School

A logging truck carries its load down the Elaho Valley near in Squamish, B.C. in this file photo. THE CANADIAN PRESS/Chuck Stoody
Squamish Nation calls for old-growth logging moratorium in its territory

The nation says 44% of old-growth forests in its 6,900-square kilometre territory are protected while the rest remain at risk

Most Read