Without family docs, youth with mental health, addictions issues fall through the cracks
Without a family doctor, local youth are falling through the cracks of the healthcare system. But two clinical counsellors in the city are working to change that, by providing counselling, intervention and mental health services to the area’s young people.
Through Saplings Mental Health Services – Laura Honey, a registered social worker and clinical counsellor along with Julia Hintermeister, a child psychotherapist – are working to fill the gaps in mental health and substance use programs for children, youth and young adults in northeastern BC.
Saplings offers a large variety of programming for children and youth in emergency mental health crisis and those dealing with substance abuse disorders.
Their programming is all cost-free, Honey told council on January 6, paid for by several funding streams including Northern Health, the Ministry of Children and Family Development, and the City of Fort St. John.
Since 2021, the pair have served over 500 children, youth and young adults in the community, Honey said.
“Five hundred. That number should shock you, and that number should alarm you,” Hintermeister said. “Children do not just wake up depressed at age 13, and they do not just wake up addicted to cannabis at age 15.
“Unhealthy systems are leading to unhealthy people in our town.”
Hintermeister told the story of a family who, without a family doctor, first had trouble getting care for their child during illnesses, then due to strained services and the lack of a family doctor, were unable to get early intervention for the child. The pattern continued when the child entered the school system, and it was clear the child needed services like speech therapy.
Again, this child fell through the cracks as Hintermeister says there are not enough resources in the school district and schools are also limited on what they can do without a diagnosis and assessment. For which one needs a family doctor.
Fast-forward to age 15, said Hintermeister, and the child is depressed, cutting and addicted to cannabis. But unable to access psychiatric services, without a family doctor. There’s a two-year waitlist for counselling.
Hintermeister said she shared this story because while “we’re navigating a mental health and substance use crisis, we cannot be focussing on catching people as they fall off the waterfall. We have to be providing lifeboats upstream.”
“This story is not fiction, it’s not unique and it’s far from worst case scenario,” Honey added.
“Youth today are consuming cannabis at an alarming rate. And when I say youth, you might think of a 17-year-old but I’m talking 12 to 14. They’re consuming daily cannabis use, and alcohol,” Hintermeister said.
Three years ago, the pair heard about youth who were coming out of hospital with suicidal behaviors who didn’t have access to follow-up support services. They began canvassing the community, and Honey said she was able to connect to Northern Health’s director of specialized services, Donna Ward, who provided the pair with their initial contract at Fort St. John Hospital’s ER, and Saplings Mental Health Services was born.
From then on, they began to collect data, and what they found was astonishing, Honey said.
“The number of kids that come through our emergency department in mental health crisis, is crisis level.”
Sapling’s currently holds the contact for youth forensic services through the Ministry of Children and Families, they’ve also secured funding from the city which has enabled them to put programs in the schools and create some parent support groups.
Fort St. John Hospital is a designated psychiatric facility, which means that if someone shows up at any of the surrounding small hospitals, they will be sent to either Fort St. John or Dawson Creek hospitals.
“We hold the contract, we see all of the children and youth that come through our ER,” said Hintermeister.
In addition to the youth, she said there are many adult psychiatric patients presenting to the ER daily, she said. There is supposed to always be a psychiatric liaison nurse available, but currently there is only one.
Saplings has 12 staff and an office off the ER to be available for the young people who come into the ER, but they are unfortunately only able to provide their services Monday through Friday.
“If a teen presents on the weekend, and they are deemed to be at risk to themselves, they’ll be kept over the weekend and I’ll come and assess them on Monday,” Hintermeister said.
The problem with accessing services for children and youth is compounded by the fact the mandates are not under the same umbrella. Community mental health services for those aged 19 and under, is the mandate of the Ministry of Children and Families, while the health authorities hold the mandate for addictions services.
“We can catch people coming through our emergency department, but we’re not allowed to offer community mental health services, because then we’re stepping on the toes of child mental health,” Honey said.
“Here’s our concern: that service minimally exists here in Fort St. John. They have one clinician out of what they’re supposed to have is a team of eight.
“If you’d like to get your child into a publicly funded mental health program through the Ministry of Children and Families, you’re waiting three years.”
“You can’t get psychiatry without a family doctor, so even if you get into that counselling services, you won’t get psychiatry,” Hintermeister added.
Councillor Sarah MacDougall agreed that the upstream approach is the way to go if any headway is to be made in this crisis, and asked what the city could do to help.
While early intervention is always best, the CDC’s decision in the United States to move back the developmental milestone guidelines is going to make it more difficult to pick up on a child’s needs before they age out of the five-years and under program in Fort St. John.
Ideally more supports are needed at the school district level, including speech and language, occupational therapy, and psychologists. Hintermeister believes the resources are there, but the staffing levels aren’t.
“The teachers are seeing the kids, the teachers know what the problems are,” said Hintermeister.
“We have to make it appealing to live here,” she said, noting that neither she nor Honey are from Fort St. John originally.
“We stay here to help this community. But if we didn’t have childcare, if we didn’t have partners who also worked, all of those things that make it hard to keep professionals here.”
Check out the website or Facebook page for more information about Saplings Mental Health Services, and the programs they offer.