Getting factual information and a proper diagnosis from a mental health professional is an important place to start.

Despite the growing fight against stigma, many people are still reluctant to talk about what they’re feeling with others – even their doctors. But knowing the answers to questions can be empowering, and effective treatment can help put a life back on track.

Canadian Mental Health: Getting a diagnosis

The first step in getting a diagnosis is a comprehensive evaluation that considers symptoms in the context of other circumstances: genetic risks, medical history, possible environmental impacts, and how those symptoms have progressed.

Referring in part to the Diagnostic and Statistical Manual of Mental Disorders — a regularly-updated book that describes all mental health issues that can affect children and adults — a professional will work to find the root cause of your symptoms so it can be treated.

Finding the right solutions

When it comes to treatment, “we don’t strive to recreate the wheel — we just want to use what works,” said Jeffrey Waplak, Clinical Director for Stevenson, Waplak & Associates.  “We focus on evidence-based practices that are already proven.”

There are different types of treatment available, some medicinal and others are not. “We collaborate with each client to create a treatment plan that’s effective for them, based on what current research indicates,” explained Waplak. This could include:

• individual or group counselling (cognitive-behavioral therapy),
• a combination of therapy and medication,
• therapy and specific educational interventions (like coping strategies), or
• health-related strategies, like vitamin treatments.

Youth who come into care through Quinte Children’s Homes, have access to a residential treatment program that takes a multi-directional approach: Clinical care, child/youth work, and psychiatric and educational initiatives.

This is a leading approach to foster care based on evidence that shows a family-modeled setting leads to better outcomes for kids.

Canadian Mental Health continues to run up against many challenges — but things are changing. To find out how we can help, connect with us on Twitter or call 613-967-0545.

Joan Burton, then president of the Association, knew this was a problem — and, with a core group of volunteers, took steps to fix it. “I started a think tank to consider how to start a one-stop/all disorders resource centre.”

The result? The Links to Learning Resource Centre launched in 2000. Last month, the organization was recognized with the June Callwood Outstanding Achievement Award for Volunteerism.

“Joan has provided us with so many useful resources from the program over the past few years,” says Cara Pinchuck, Program Coordinator for Stevenson, Waplak & Associates, who notes that they first met Joan because one of her daughters attends Applewood Academy.

“It’s wonderful to see her efforts recognized with this award.”

A place to turn for help, resources

Burton says the resource centre promotes empowerment through support, education, information and materials. “We educate parents to be the best advocate for their child as they can be. They can borrow material to better-understand their child’s disorder, and we can link them with other agencies if the need arises.”

All of this is made possible through the hard work of volunteers.

“We are completely volunteer-run,” Burton says. “We have many who have committed a great deal of time and energy over the course of the Centre’s 12 years and are still active.”

For families who participate in the Links to Learning program, these committed volunteers have been a real gift. Angela Dobson says both her daughter, Cassidy, and her son, Thomas, have excelled in different ways since they joined programs in September 2011.

Soaring past autism’s limitations

Nine-year-old Thomas has autism; although he’s very intellectual, cerebral palsy prevents him from using his hands. Learning to read has been an ongoing challenge.

“Thomas learns by listening, and uses a computer program that reads to him. He’s in grade three and listens to books above a grade five level — he’s very smart, but his school had given up on teaching him to read,” Dobson explains. “But he’s so interested in learning, he understands beyond what the computer program can deliver.”

By teaching him audibly — and reading books by his favourite author, Jay Ingram — Dobson says a tutor at the Centre has helped Thomas get an increasingly firm grasp on reading, and taught him skills so he can learn on his own. “His tutor has truly been a Godsend.”

Devouring books for a little friendly competition

A key initiative for Links to Learning is Reading Rocks, a three-part program that combines tutoring, group sessions and a reading program — with prizes when goals are reached. It was developed by Burton’s daughter Melanie when she was 12, and it has been the perfect motivator for Dobson’s 7-year-old daughter.

“At the beginning of the school year, Cassidy had gaps in her reading abilities,” Dobson says. Now, she’s almost past her grade two level in reading ability.

“She is so motivated by the reading challenge; she has a friend in her group she competes with,” she explains. “Cassidy chooses to read every night before bed. Homework used to be such a chore, but now she actually does it herself; she understands how to learn.”

For more information about the services and resources available through Linked to Learning, visit their website at LinksToLearning.ca or call 613-968-8700.

*In the Photo: Board members from Links to Learning posed with the Minister of Citizenship and Immigration, Charles Sousa, after the awards ceremony. Pictured from left: Melanie Burton, Minister Sousa, and Joan Burton*

The Canadian Mental Health Association (CMHA) says each one of us can take steps every day to look after our mental health by finding some balance in our lives. The theme for this year’s Mental Health Week is Mental Health for All — with particular focus on three topics:

• Kids have stress too!
• Resiliency: at home, at school, and at work
• Mental health is everyone’s concern

Kids have stress too!

It can be easy to forget how much stress we felt as kids: social anxieties, homework, family issues, and more. Research shows that 90% of illness is caused by stress – in children, too. But often they don’t know how to cope.

CMHA suggests these four actions to help kids who feel stressed (learn more):

• Spending time with your kids is the most important thing you can do. Listen to them when they talk to you. Try to understand how they feel.
• Show your children you love them, with words, hugs and kisses.
• Do things with them. It will help them to feel they belong in the family.
• Do things as a family. Exercise is a great way to burn off stress. Make exercise part of your family life. Play ball or other games. Go for walks. Eat meals together. Talk. Share ideas, fun and how you feel about things.

Resiliency: at home, at school, and at work

Whether supporting kids in school or trying to manage in your own workplace, CMHA notes that the same skills will have an impact:

• Relationships and reaching out
• Emotional skills and emotional intelligence
• Competence
• Optimism

Learning how to use these traits with other coping skills helps build resiliency – the ability to solve problems, cope with challenges, and bounce back from disappointments (learn more).

Mental health is everyone’s concern

“Some 20% of the population will experience a mental disorder at some time in their lives,” the CMHA notes on their website. “This means that every single family in Canada will in some way be affected. Mental illness cannot be swept under the carpet.”
The CMHA has compiled a tip sheet of suggestions to put a bit more balance in our lives. These tips include:

• Working exercise into your regular routine
• Focusing on one task at a time, instead of multi-tasking
• Making an effort to remember positive moments in your life
• Sharing laughter with friends and family!

What do you do to keep some balance in your life? If you would like more information about Mental Health Week, visit www.mentalhealthweek.ca.

This position is a $1-million initiative created to focus on the stigma around mental illness. It is the first of its kind in the world, and could lead to higher quality of life for people facing a mental health issue.

Reducing stigma can improve results

Mental illness impacts millions of Canadians at some point during their lifetime, but stigma often prevents people from getting help.

“When individuals are freed from the shame of mental illness, they will step forward and seek treatment,“ said Jeffrey Waplak, Clinical Director for Stevenson, Waplak & Associates. “When people acknowledge their symptoms and get treatment in the early stages, we know they have better outcomes.”

Waplak notes that new research may also help pinpoint activities that could lead to greater awareness of mental health issues and perhaps increased funding — something that is badly needed with our current economy.

“It is vital that we end the stigma for men and women, regardless of age or social class. Mental illness shows no preference across our community or friends, and help needs to be available.”

Position held by world-renowned researcher

Heather Stuart, PhD, will serve as the first research chair; she is an internationally-renowned professor of Community Health & Epidemiology at Queen’s who has focused much of her work on stigma reduction.

Stuart is currently working on a number of projects, including a collaboration with Statistics Canada to incorporate a stigma assessment module in future national health surveys.

This is the latest investment by Bell Canada, part of a $50-million commitment to mental health in Canada that included the annual “Bell Let’s Talk Day” fundraiser on Feb. 8. For more information about the research position, read the full related news release.

But for a lot of youth, days spent in a classroom mean frustration, distraction and angst – not just for the student, but also for his or her teachers and parents. This can stem from any number of issues: disruptions at home, learning disabilities, mental health issues, or simply a need for a different style of learning.

Identifying the right solution for specific needs

A 2009 article from the Toronto Star’s ParentCentral.ca cited a number of reports that showed “poverty and its effects on learning are an increasing concern. There are higher incidences of attention and behavioural problems. Statistics show roughly one in five Ontario children and youth has a mental health problem and, often, these are concurrent with learning disabilities.”

Sometimes, a different approach is needed.

“The educational system can’t meet every student’s needs at the same time,” noted Terry Stevenson, corporate director of Applewood Academy for Progressive Learning. Applewood Academy is an independent school in Belleville that focuses on individual learning plans that help youth succeed in school. It has recently worked with an increasing number of students from both local school boards and other independent schools like Albert College.

“Applewood offers a different learning environment, and with the professional resources that we have on hand, we can work with each individual as well as their parents and teachers to better address specific challenges,” Stevenson said.

Applewood offers a solution, he noted, that can help kids adjust back into the system. “It’s important to note that we don’t offer tutoring, however,” Stevenson added. “What we offer are mental health or behavioural strategies that can assist in the classroom.”

A solid education provides a good foundation

Having an education is one of the best indicators of success, leading to higher rates of employment, earning power and independence. Outside of Applewood’s approach in the classroom there are things you can do at home if you’re concerned about youth in your care:

• 5 Tips for Behaviour Management at Home explains how you can adopt some of the same strategies used in our classrooms to approach disruptive behaviours.

• Childhood Nutrition Impacts Education highlights how critical lifestyle and good nutrition is. Diet is one of the first things we review when we start working with kids.

What advice would you offer to parents advocating on behalf of a child?

The survey interviewed almost 1,000 people living with a form of dementia, and highlighted that many people delayed talking to their doctor when they first suspected something was wrong because they didn’t recognize the warning signs: “Almost half of respondents (44 per cent) waited at least a year to see a doctor because they thought their symptoms were simply ‘old age’.“

Warning signs of dementia

Dementia is an umbrella term that describes a number of diseases including Alzheimer’s disease – the most common form – vascular dementia, and Mild Cognitive Impairment (MCI). Risk of dementia increases with age, and while people in their 30s and 40s have been diagnosed it more typically affects those over the age of 65.

While symptoms can vary from one person to another, the Alzheimer Society of Ontario offers a list of 10 warning signs. The three most commonly identified symptoms include:

• Memory loss that affects day-to-day function. We all forget appointments and minor details. Memory loss should become a concern when it begins to impact an individual’s daily routine.
• Disorientation of time and place. As with memory loss, it’s normal to momentarily feel disoriented – forgetting why you walked to a particular room, for example. The Alzheimer Society notes that it is significant disorientation that may be a warning sign. For example, “a person with Alzheimer’s disease can become lost on their own street, not knowing how they got there or how to get home.”
• Changes in personality. The Alzheimer Society notes that personalities change as people age, but those with dementia may become uncharacteristically withdrawn, suspicious or confused.

What to do if you think it might be dementia

There is currently no cure for diseases like Alzheimer’s, but there are ways to treat and manage the disease. Also, despite the list of warning signs, many of the same symptoms can be traced back to depression, medications, or other treatable causes. Only a professional can help make this distinction and create an effective treatment plan.

If you’re concerned about yourself or a loved one, a family doctor can play a critical role in helping to get a proper diagnosis; nearly half of survey respondents were diagnosed by their family doctor.

Stevenson, Waplak & Associates also offers dementia screening through our office in Belleville. Please contact us if you would like more information.

To learn more about Alzheimer’s disease, dementia and the resources available in your community, the Alzheimer Society has 150 offices located across the country – with 38 in Ontario – that can provide information and support.

“Mental Health First Aid has the same purpose as traditional first aid – to save lives,” said Sandy Allen, Program Director, Mental Health First Aid (Canada). One in five Canadians will have a mental health issue at some point in his or her lifetime, and professional help may not be available. This training is intended to help people learn what to do to support or aid someone experiencing a mental health problem until help arrives.

Initial help to someone who needs it

Adopted by the Mental Health Commission of Canada in early 2010, Mental Health First Aid (MHFA) training is a concept that began in Australia as a way to help improve mental health literacy.

The training is not meant to show people how to be therapists, but it does teach appropriate first steps to take before professional help arrives, if it’s needed. MHFA shows how to:

• Recognize the signs and symptoms of mental health problems.
• Provide initial help.
• Guide a person towards appropriate professional help.

“Mental health problems are more common than most people realize, especially depression, anxiety and misuse of alcohol and other drugs,” Allen said in a news release about the program.

“The stigma associated with mental health problems often hinders people from seeking help. MHFA Canada teaches people to react in a calm, confident and appropriate way to provide the best help they can.”

What issues does MHFA cover?

MHFA uses guidelines set by an international panel around a number of issues, including depression, suicidal thoughts and behaviours, psychosis, panic attacks, problem drinking and problem drug use.

Find a program near you

There are currently two programs available: one offering basic skills for adults, and another for adults who interact with you. Courses are available in the Quinte region and throughout the province of Ontario. For more information, go to http://www.mentalhealthfirstaid.ca/.

• the number of Canadian children in foster care is climbing,
• the preference for family-based care is increasing while the availability of foster families has failed to keep pace, and
• child welfare in general has room to improve.

What happens next – how can foster care be improved to help more kids succeed?

In 2008, researchers at the Child Welfare Institute (CWI) at the Children’s Aid Society of Toronto considered this in a detailed report, The Future of Foster Care. This report looked at the current foster care environment, interviewed experts working in foster care and related fields, and included an extensive review of documents that had been produced since 2000.

The Future of Foster Care

Focused primarily on foster care in Ontario, The Future of Foster Care looked at international systems to highlight a number of findings – some for future consideration, and some that supported work already in process.

For example, researchers observed that:

• The preferred model of care – with the best outcomes for kids – is family-based, with an individual care plan for every child.
• Foster care should move towards a more professional approach, with mandatory training and better compensation for foster parents.
• More attention should be given to outcomes: placements that work well or don’t work, transitioning from care, and ensuring kids who need help in school get it so they can finish high school.

The report also included findings that

• encourage more collaboration among Children’s Aid Societies and other organizations related to care,
• look at ways to improve foster parent recruitment and support, and
• consider other changes that could make foster care more positive for kids.

Treatment foster care is one solution

While the experts interviewed didn’t have one particular opinion about how regular foster care and treatment foster care – like that offered by Quinte Children’s Homes – might collaborate, they did agree that the needs for collaboration among foster care providers is growing: “With the advent of kinship care and permanency planning, the foster care population is beginning to serve a narrowing group of children and youth who have increasingly specialized needs.”

What positive changes would you like to see in the foster care system?

In Canada, 9.2 of every 1,000 kids are in foster care – statistically speaking, a higher ratio than the U.S. system. But those in care are still just a portion of children in this country; how well do Canadians care for all our kids? Turns out we have a bit of work to do.

Child welfare assessment puts Canada in the middle

The Canadian Coalition for the Rights of Children – a group that includes UNICEF, Plan International Canada, and World Vision – recently released a report that cited a number of evaluations that carried one theme: In most areas of child welfare, Canada can do better.

For example, the report highlights challenges with:

• Child Poverty: Canada ranked 20th of 30 industrialized countries.
• Early Childhood: Canada ranks very low among countries who are part of OECD (a global development organization) for access to, quality of, and funding for early childhood development and care.
• Adoption: Canada has a lower rate of child adoption than the United Kingdom and the United States.

A report card by UNICEFalso puts Canada in the middle:

• Educational and material well-being:  Canada ranked well in these areas – within the top 10. These look at a number of factors like how easily youth move from school to employment, or a family’s financial situation.
• Family and peer relationships: Among industrialized countries, these relationships are where Canadians ranked lowest – 18th spot of 21 countries evaluated. When it comes to the amount of time children spend with their families, for example, just 50% of Canadian kids reported talking to their parents on a regular basis.
• Behaviours and risks: Another area for improvement, the report notes that “Canada is the only country where the level of cannabis use among 15-year-olds is above 40 percent.”

How foster care fits

Child welfare is a question for other experts, but these reports help show the context of Canada’s foster care program. While children in care face their own set of challenges, we believe the move towards family-based and child-centered care – the model we follow at Quinte Children’s Homes – keeps our focus on improving the critical areas that help kids succeed.

Sources

• Trocmé, N., Fallon, B., MacLaurin, B. & Sinha, V. (2011). The changing nature of substantiated maltreatment investigations in Canada.

• Mulcahy, M & Trocmé, N. (2010). CECW Information Sheet #78. Children and Youth in Out-of-Home Care in Canada. Montreal, QC, Canada: Centre for Research on Children and Families, McGill University.
• Lajoie, J. & Léveillé S. (2007). The well-being of children in wealthy countries: UNICEF Report Card 7. CECW Information Sheet #52E. Montreal, QC, Canada: McGill University, School of Social Work.
• “Key Points about the CCRC Alternative Report”, Canadian Coalition for the Rights of Children. November 1, 2011
• “Frequently Asked Questions”, Canadian Child Welfare Research Portal.

Basic definitions like what a child is (age range) and why a child would be placed in out-of-home care change from one region to the next. Some countries rely on institutions over family-based care.

Three models of care used internationally

A report done for the Children’s Aid Society of Toronto – Child Welfare Institute highlights three different models of foster care used internationally:

The child protection model, used in countries like Canada and the U.S., focuses on the safety of at-risk children and families. The report notes that under this model, foster care is often stigmatizing.

The family service model, used in a number of countries including France and Germany, aims to minimize stigma and keep the family together.

The community caring model is used by groups like the First Nations people in Canada and the Maori in New Zealand. This model keeps children with relatives or within their community. The report describes this as a holistic approach that carries no stigma.

Support for family-based care

Within Canada’s child protection model there is growing support for “family-based care” – working to keep kids in a family environment instead of an alternative like a group home. This is the model we follow at Quinte Children’s Homes, which is why our foster parents – Parent Therapists – play such a critical role.

Unfortunately, as the number of kids in care has increased the number of new foster families has not kept pace; among other factors, people often see being a foster parent as altruistic and more volunteerism than professionalism.

Research increasingly shows that family-based care gives kids the greatest chance of success in life. One white paper in the U.S. noted that “preparing to become an adult is incremental; the process begins in childhood and continues into the teen years and beyond. Young people generally learn key life skills…in the context of family.”

Without that family environment, the paper argues, youth are left to develop these skills on their own – usually with poor results: they often don’t pursue education, end up in jobs that don’t pay a living wage, end up in jail, or face any number of social challenges like homelessness and addiction.

A future blog post will look at child welfare in Canada – both in and out of foster care. This can vary significantly from one country to the next – and compared to other wealthy countries, it seems Canada still has a lot of room to grow.