cityscape New Mental Health Walk-In Clinics are Much Needed for Toronto’s Youth

Mental health care for youth has been historically hard to access. CAMH is changing that.

For years, young Torontonians have not had the means to easily access mental health care. At schools, there are often long wait lists just to be assessed. Services can be costly and out of reach for those who need it most. And while there are online and telephone mental health services in addition to those offered in community settings, it is still not enough.

Now, Toronto’s Centre for Addiction and Mental Health has made young people’s access to mental health services a priority. The organization recently announced three new mental health walk-in clinics across the city are now available for young people ages 11 to 25.

Since one in five Canadians will have mental health illnesses and issues in any given year (and the numbers are even higher for Indigenous Canadians), these clinics are a step in the right direction—making access to mental health services for a vulnerable population easier.

Young people aged 15 to 24 are the most vulnerable age group to experience mental illness, including anxiety disorders, depression and schizophrenia, and/or struggle with substance use. Yet, only one in three young Canadians that need mental health care will receive it. The CAMH mental health clinics can change that, but it won’t happen overnight.

The underserved needs of youth with mental health can be attributed to several factors. In part, stigma and shame surrounds the notion of seeking help, especially in marginalized and racialized communities. Even language barriers or hectic work schedules can get in the way of receiving care. But if the suicide crisis in Attawapiskat, in which 16 people attempted suicide in two days, is an indication of anything, it’s that youth are falling through the cracks, fast.

The Globe and Mail’s 2015 #OpenMinds series shines a light on youth who have been left in the dark. Wency Leung wrote a story about a mother who struggled to find mental health care for her young child, Jacob Hartley, who, at age 9 “became fixated with the idea that other people’s DNA could infect him and change who he was.” Barriers such as long wait times had Jacob and his mother in and out of hospital emergency departments, support groups, and resource centres—all short-term care solutions. About three-quarters of mental health issues emerge in childhood and adolescence, and if they are addressed earlier, the chances of positive outcomes are higher.

The CAMH walk-in mental health clinics then serve as an opportunity to practise early intervention as opposed to late registration. “These clinics will be a one-stop shop, providing immediate access to evidence-based mental health care in the community, says Peter Szatmari, Chief of the Child and Youth Mental Health Collaborative at CAMH, SickKids, and the University of Toronto. “By co-locating service providers from hospital, primary care, and community agencies in a youth-friendly setting we can better address barriers that are most apparent for youth.”

One of those barriers is what Michael Kirby of the Toronto Star calls a “two-tier system in child and youth mental health.” There is government-provided health care, but it generally only covers psychologist support provided by psychiatrists. Moreover, the average waiting period for an appointment with these providers is one year. The other option is to pay out of pocket for private practitioners, which is a choice that only families with the financial means can make.

This can be a source of stress for youth, especially tho who are marginalized and/or from low-income neighbourhoods. According to a 2006 research report [PDF] on equitable mental health care access in racialized communities conducted by various multicultural health organizations such as Access Alliance, people of colour often have more negative than positive experiences accessing mental health care. One participant described the experience of trying to get help:

“When you go to a doctor, you’re there for 5 minutes and he writes a prescription for you and out you go. There’s no time to discuss the way the problems, the ups and downs, even the side effects of the medication. It’s like ok there is a prescription for the side effects and they go away and out. You’re just in a rush, and you’re in and out as quick as they can get you out.”

The reality is that many family doctors are not trained nor do they have the resources to give young people with mental health issues and illnesses what they need. Instead, they are increasingly being prescribed medication. According to a May report [PDF] from the Canadian Institute for Health Information, “one in 12 youth were dispensed a mood/anxiety or antipsychotic medication in 2013–2014—and [that] has increased over time.”

The concern is not just that long-term care can’t end with prescriptions for every youth. There is also limited evidence about the risk, safety, and effectiveness of those medications on children and youth.

The CAMH mental health walk-in clinics can bridge this gap by matching services to a range of needs youth experience. The locations of the clinics are also a bonus, located at East Metro Youth Service in Scarborough, Delisle Youth Services at Yonge and Eglinton, and at the South East Toronto Family Health Team at Danforth and Woodbine.

The price tag is another bonus: the addition of walk-in clinics won’t cost billions of extra dollars every year. According to the 2012 Mental Health Commission Report, mental health problems and illnesses cost the Canadian economy at least $50 billion per year. (To put that figure into perspective, $50 billion represents 2.8 per cent of Canada’s 2011 gross domestic product.)

In this age where older generations believe that young people have nothing to complain about nor struggle over, it is important for young people to have their experiences validated. Having access to spaces where professionals will listen, help, and guide them in the form of walk-in clinics can encourage young people to seek the right help that they need with fewer barriers.

A previous version of this story incorrectly stated that the government covers therapy by psychologists, not psychiatrists. Torontoist regrets the error.