Current8:11 p.mWhat adolescent mental health promotion can learn from cancer care
As health institutions struggle to deal with an increase in mental health hospitalizations among young people, some health professionals think looking at how Ontario’s cancer care has improved since the 1990s could help solve the current mental health crisis. health.
“We know how to provide good health care in Ontario in certain areas, but we have never thought of applying that expertise and know-how to the mental health system,” said psychologist Dr. Paul Kurdyak. Current.
According to two new studiespublished Monday in the Canadian Medical Association Journal, the number of Canadian children visiting emergency departments or requiring hospital treatment for self-harm has increased significantly during the COVID-19 pandemic.
Dr. Natasha Saunders, lead author of one of the studies, said there was a 29% increase in emergency room visits for self-harm and a 72% increase in 10- to 18-year-olds during the pandemic. in hospitalizations for self-harm.
Saunders, who works as a pediatrician at SickKids in Toronto, said the study confirmed what he sees in his workspace.
“We see a lot of distress in young people, a lot of concerned parents, understandably,” she said. “It’s real, it’s tangible, and what this study really showed was that it put numbers behind anecdotes.”
Although the studies are alarming, Kurdyak — part of the same study as Saunders — believes it’s a worsening of a pre-existing problem, not a new one.
But what’s “exciting” this time around, according to Kurdyak, is that “we feel like we’re back at the beginning of Cancer Care Ontario.”
“Kids in particular are more comfortable talking about mental health [and] much more convenient to seek care,” he said. “Now we have to build a system that meets the needs.”
Kurdyak is the Director of Health Outcomes and Performance Evaluation at the Center for Addiction and Mental Health in Toronto.
“I think it’s safe to say that the reason these kids and their families are showing up in the emergency department is because they don’t know where to go,” he said. “And things have gotten to a point where they finally need an intervention.
Sheri Madigan, a psychologist and professor at the University of Calgary, said families struggle to find psychologists who don’t quite have a full caseload, so they go to the emergency room because they have nowhere else to go.
“What you’ll hear from a lot of professionals who treat children in the emergency room is that they also don’t feel like they have the capacity to serve all of these children,” she said.
“They don’t feel like they really have the services and the support and the training to be able to really give kids the help they need.”
We are in a really tough situation right now where parents are not getting the support and coaching they may need to support their young child.-Dr. Natasha Saunders, paediatrician
Learning from oncology care
Kurdyak draws a parallel to cancer care in Ontario, which he said “was a mess” before Cancer Care Ontario, the provincial agency responsible for improving cancer services, was established in 1997.
It was subsequently subsumed under Ontario Health in 2019 as part of the Doug Ford government’s controversial consolidation of health agencies.
According to Kurdyak, families struggled to access care because Ontario hospitals that provided cancer care operated independently of each other.
According to Kurdyak, Cancer Care Ontario created an oversight structure for all of these different hospitals. They established standards of evidence-based care and insisted that cancer care providers adhere to a certain level of quality.
“What made this happen was building critical system infrastructure; figuring out where cancer centers needed to be located so people could get the care they needed; putting services through one door,” he said.
“The end result is that it went from no oversight and no organization and access and quality of care largely depending on where you lived to getting … the same very good level of care no matter where you live in Ontario .”
Kurdyak says Cancer Care Ontario’s efforts have ensured a continued commitment to work to improve cancer care in Ontario — and that a similar guide should be considered for the mental health system.
“It’s going to take some time. But I think one of the key factors when we start is to … understand what services are out there, because we really don’t know.”
In addition, cancer was a highly stigmatized disease decades ago. Kurdyak saw this firsthand at age 13 when his mother was diagnosed with breast cancer.
“She didn’t tell her friends. She felt terrible during chemotherapy,” said Kurdyak, now 55. “She basically stayed in her bedroom and didn’t want to interact with her family until she felt better, and she only went out once. She felt like she could be.”
Kurdyak said that recently “cancer came out of the closet.” Once people stopped being ashamed to talk about their diagnosis, they felt empowered to speak up and demand better services.
Change to better
Currently, Saunders said there is no good answer for what parents should do if there are no resources to treat their child.
“I think families are often left on their own to navigate the system on their own to either pay privately if they can afford it,” she said.
“But we’re in a really tough situation right now where parents aren’t getting the support and coaching they might need to support their young child. So we have to change that.”
Kurdyak says he’s seen more debate and discussion about improving mental health facilities now than ever before — and crucially, politicians are taking notice.
“It’s not changing as quickly as I’d like it to … but when I think back to when I graduated I became a psychiatrist versus now, I don’t think we’re putting the genie back in the bottle.”
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