ADHD and anxiety when he was in Grade 2, while in a school-based treatment program. The diagnosis and subsequent treatment – medication and weekly counselling – was done by a psychiatrist who worked with the program.
As the end of the year, in discussing his transition back to his home school, for a referral to a child psychiatrist in the community for follow-up. M was on several medications and I was concerned that his family – a general practitioner – wouldn’t be sufficiently familiar with them to ensure adequate follow-up, especially since the vast majority of her patients were adults. Moreover, despite improvements in his behaviour, he still had frequent bouts of rage and aggression. M has never been a child who talks about his feelings easily, but he had made some progress with the psychiatrist. His dad and I felt strongly that it was important he continue with counselling on a regular basis. Given the complexity of his challenges and the necessity for ongoing monitoring of the meds, we felt a psychiatrist was the best option.
But when I asked for the referral, I was told it wasn’t possible. There simply wasn’t anyone outside the program to refer him to.
Despite living in a city with a children’s hospital affiliated with a teaching program, there was a severe shortages of children’s mental health services, including psychiatrists. The best we could do it go back to our family doctor and request M be placed on a waiting list for psychiatric services through the children’s hospital.
That was 3 years ago.
The closest we have come to getting M into see a psychiatrist has been a 90 minute consultation with a doctor who worked one day a week for the school board (who has subsequently resigned, apparently because the workload was too intense).
At the present time, M’s ADHD meds are supervised by a pediatrician who specializes in ADD/ADHD. His family doctor manages the anxiety medication. He sees a psychologist to help him deal with his anger and to talk about things that are bothering him.
We are lucky to have health insurance, so it is not a question of money. It is a question of resources. More properly, a lack of them. If M was over 12 and in crisis, it would probably be easier to get him help. Ironically, if he was charged with assaulting another child or a teacher, we would probably be able to get him into see a psychiatrist (presently, he is too young to be charged as a youth).
We are not the only family caught in this limbo. I know a parent who practically had to camp out in the emergency room to get help for her 9-year old who was in crisis.
According to the literature and child experts, children like M are highly vulnerable to mental health issues as they get older. Added to the fact that there is a strong history of depression in my family, I want to do everything I can to help him now. So that he doesn’t end up in crisis. I want to be proactive, and head off potential problems now, rather than wait and see what happens.
So why should anyone else care about whether or not my child has timely access to mental health services? Or any other child?
Because they are the future. Future employers and employees. Future taxpayers. And as a friend recently reminded me, our future caregivers. We will all benefit by ensuring that every child grows up to be a healthy, contributing member of our society. This means acknowledging that some children need a little extra help. It will require financial resources. But if we consider that a high percentage of people who are currently in the criminal justice system have mental health issues, doesn’t it make sense to intervene early?
Despite the fact that there is an acute shortage of mental health services in my community, I am still going to push to get M the psychiatric care I think he needs. In the short-terms, we will continue to rely on our patchwork of services. Hopefully, the powers that be will begin to invest more in children’s mental health. I can’t control the future, but I want M’s to be as bright as possible.