N.B. mental health system continues to fall short for many troubled youth, say counsellors

The recommendations from last week's coroner's inquest into the death of 16-year-old Lexi Daken are a step in the right direction, but the system continues to fall short for many, say some mental health professionals who work with young people. 

While better education and awareness are important, New Brunswick still needs to deliver on a long-talked-about residential treatment centre for young people struggling with mental health issues, said John Sharpe, executive director of Partners for Youth, based in Fredericton.

"That's never come to realization. We have an empty piece of land on the Salisbury Road [in Moncton] where it's to be built sometime next year." 

Sharpe said reports from as far back as the mid-2000s have called for a residential treatment centre. 

"We're talking 16, 17 years ago and we're still waiting." 

Last week, a coroner's inquest looked into the circumstances surrounding Lexi's death by suicide, in February 2021, within days of being turned away from the Dr. Everett Chalmer's Hospital's emergency department without having received any mental health interventions. 

After listening to 16 witnesses over three days, the jury made 10 recommendations and endorsed 12 more that came from an internal review by the Horizon Health Network. 

Much of the focus was on better education for emergency department staff about mental health and providing the public with more information about mental health resources, including using brochures to help with communication.

"That's a lot of communication pieces that we've talked about for a very, very long time," said Sharpe, adding that it's also proved to be "very difficult to implement." 

The bottom line, he said, is that it isn't easy to find help when it's needed. 

"Part of the challenge is some of those services don't exist," said Sharpe. 

He said the "perfect example" of that is the lack of a residential mental health treatment centre for youth.

The Department of Health was asked on Thursday for an update on the project, but none was provided by publication time.

Child and youth advocate weighs in

Kelly Lamrock, the province's child and youth advocate, said the jury's "fairly limited recommendations are not going to fix the system." Nor, he said, was that their mandate. 

More than a year ago, Lamrock looked at changes that were made in the wake of Lexi's death and said there was no clear indication the same thing could not happen again to another child.

Although more changes have been made, Lamrock said his office continues "to get a number of calls" from families. Most, he said, describe "an unavailability or a lack of where to go."

He quotes a teenager who said, "It feels like there's really nothing between crying on your couch, surfing the web looking for help, and going to the emergency room in crisis."

Lamrock said there are three outstanding areas of concern. 

The first, he said, is that "we still don't have a proper way of departments communicating." In Lexi's case, the failure was between the Education Department and Health and Social Development. 

"That ability to have a file that is shared between them is something that government has got to do a better job of." 

Second, there aren't enough mental health professionals — and more brochures aren't going to help, he said. 

"It's not really a navigation problem. It's a lack-of-service problem. If you want to tell someone how to get to the hotel that has vacancies, that's a navigation problem. If there's no hotel, that's not a navigation problem."

And third, Lamrock said the province has to turn some of their pilot programs into actual, integrated systems where people know where to turn.

Emergency rooms not the solution

Sharpe said emergency departments aren't the solution. That's why he was pleased to see the recommendation that additional resources be made available for community-based mental health services. 

"And that's key." 

Partners for Youth launched a program almost two years ago to connect young people with private therapists. Sharpe said the group is currently providing services to 150 young people and pays for up to eight private sessions. 

"And from the time a youth makes a referral to the time that we have them connected to a therapist is seven days," said Sharpe. "So that's a reduction from six months if you're going through the provincial system."

Sharpe said the need for mental health resources for young people continues to increase.

"It's an epidemic. We realize that the strains on young folks and the challenges around youth mental health are, if anything, becoming more difficult and getting worse."

'It just takes being human'

Kayla Breelove Carter, a clinical traumatologist, said the recommendations from last week's inquest are a step in the right direction "but I think that there's a bigger gap that is being missed here." 

She said the most important first step is to create "a cultural shift in our attitudes" about mental health. 

She said things won't change "until our systems can be humanized by really understanding mental health and to start valuing mental health as not something separate from physical health." 

She said the system has to move toward a "more compassionate and trauma-informed and culturally informed and human-centred approach."

Breelove Carter said she continues to hear "that people don't feel as though that they're being seen and being heard and being believed … So to me, that's compassion. To me, that's just being human."

She said the "take-a-number" approach leaves people feeling "dismissed." 

"Oftentimes, if someone just takes the time to sit with someone and just to help them feel validated and heard — that alone is a trauma-informed approach to a situation. And it doesn't take much." 

Breelove Carter said improvements have to be made soon because "we have a mental health pandemic. We have a situation where, as human beings, we are unwell."

She cited a recent survey of New Brunswick young people that showed a decline in youth mental fitness. 

"Half of them show symptoms of depression and anxiety during the last 12 months," said Breelove Carter.

"We're seeing numbers such as seven out of 10 youth are still feeling uncomfortable going for help and two out of 10 don't know where to go for help — and those are the youth that feel safe enough to disclose these things."

Even since Lexi's death in February 2021, Breelove Carter said she's heard from parents who feel their child hasn't gotten the help they need.