Vol. 77, No. 2Cover stories

"Some common sense and some humanity"

Project to transform mental health care for youth

The ACCESS program works to complement the work the RCMP in New Brunswick already does with youth. Credit: RCMP

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Nearly 75 per cent of Canadians experiencing mental health issues are under the age of 25 — yet only 30 per cent of them ever seek treatment.

Mental health awareness has come a long way in recent years, but the people who need access to intervention and treatment most, for whatever reason, are still largely not getting help.

That's where ACCESS, a five-year research project involving clinicians, youth, families, community service providers and the RCMP, comes in.

Building an approach

Two years ago, the Graham Boeckh Foundation and the Canadian Institute for Health Research launched a national competition to find the best idea for transforming youth mental health services. ACCESS was chosen as the winner.

Dr. Ashok Malla, a professor with McGill University and the Douglas Institute for Mental Health, is the lead applicant for the project.

Of 55 groups that submitted proposals, 17 were invited to Montreal, Que., to discuss their ideas. Malla attended, and that's where he met Insp. Rick Shaw, from the RCMP in New Brunswick.

Shaw helped develop and ran the province's youth intervention diversion model, which redirects youth aged 12 to 17 into community programs and services and away from the criminal justice system.

"If you look at that model, what we were actually doing was using evidence-based screening tools to help those kids," says Shaw. "We were screening them for risk factors related to their criminal activity, and some of the underlying causes were mental health issues."

Shaw had been seeking opportunities to increase access to services for young people experiencing mental health issues, which led to an important partnership with the New Brunswick Office of the Child and Youth Advocate.

"We knew from our experience that by working with police, in an integrated approach with educators, social and health services, we could connect more youth with care and not courts," says Christian Whalen, from the Office of the Child and Youth Advocate.

And so Shaw and Whelan teamed up with Malla and several other proposals to form ACCESS.

Increasing access to care

ACCESS has four goals. It strives to increase the number of identified youth with mental health problems and provide them with quick and easy access to care within 72 hours. It also aims to provide continued access to services beyond the usual cut-off of 18 years old and ensure youth connect with the right kind of specialist or primary care service for their individual needs.

"It's kind of bringing some common sense and some humanity into the way we provide care," says Malla. "We're basically saying, 'Come through any door and you're welcome, we'll make sure any door is good for you.' "

Shaw says an important aspect of ensuring the project's success has been working with all the stakeholders, from partner agencies to youth and their parents. In New Brunswick, ACCESS is planning to open nine clinics that will be safe spaces for youth to seek quick and easy treatment when they need it.

And by making it a safe environment for youth, they hope to address that reluctance many young people have when it comes to seeking help.

"Making these safe spaces available also builds awareness around this issue," says Shaw. "Once that awareness is built, I think we'll start seeing police officers doing more referrals, family members doing referrals, friends helping get people in the door. We're talking about a cultural change."

Malla adds that the impact of intervening early and treating mental health issues as soon as symptoms arise can actually prevent the early stages of many mental illnesses from becoming more serious.

And not treating youth early has both direct and indirect impacts on society. After accidents, suicide is the second-leading cause of death in young people. Malla says each suicide of a 22- or 23-year-old is a loss to society as a whole.

"I think all of us got together because we feel it's important and we like to have a bigger vision," says Malla. "It's not a dream, it's really a vision. And if we don't try, we're not going to be able to change anything."

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