The following is the third of a four-part series on mental health focusing on depression, self harm and suicide.
Considering next week’s start of the school year, when youth mental health issues can be most prominent, the Advertiser felt it was appropriate to dedicate this part of its series to the youngest, and perhaps most vulnerable, of those suffering with mental health issues.
Growing up is hard enough.
Mental health issues for youth today are anything but child’s play. Understanding the signs can be tricky – for both children and their families.
For parents or guardians, knowing when to seek help, or even where to find it, can be a daunting task. But it doesn’t have to be.
According to the website for Children’s Mental Health Ontario (CMHO), it is estimated that nearly one in five Ontario youths under the age of 19 experiences a mental, emotional or behavioural disorder that is severe enough to seriously affect their daily functioning at home, school or within the community.
The good News is that early diagnosis and treatment can lead to better outcomes for children later in life.
“Anxiety and depression are the leading concerns that we see for children and teens,” said Brett Friesen, a therapeutic clinician and manager of child services for Centre Wellington with the Canadian Mental Health Association’s (CMHA) Waterloo Wellington Dufferin branch.
Formerly known as Trellis Mental Health and Developmental Services, the organization offers a range of free services and programming designed to support families and children, ranging in age from infancy through to 18 years of age, focused on moderate to severe mental health care.
“Sometimes children come into service because there are mental health issues and concerns within the family and they are needing help and support,” said Krista Sibbilin, Children’s Services manager for ages six and under. “We do have outreach services to provide support in the community.”
Friesen notes that in this region the most prevalent issues his team sees relate to self-harm, suicide, depression and anxiety.
“Anxiety and depression are two separate disorders but they often work together,” explains Anita Matthews, a crisis worker who is part of CMHA’s Mobile Crisis Unit.
Sibbilin adds, “Depression can come out in various ways.”
She points to internal and external behaviours that may be indicators of a mental health concern, such as children who do not engage with their peers, are alone often, and/or are not sleeping or eating in regular patterns.
Sibbilin notes important factors such as the child’s home life play a role, including both biological indicators of mental illness within the family, as well as the environment they call home.
“The ones we worry about are the quiet ones,” said Friesen. “The ones in the classroom that the teacher figures have no problems.”
Working in conjunction with schools throughout the area, Friesen and Sibbilin credit the work of local schools’ child and youth workers and school personnel for playing a vital role in assisting with mental health support plans for children.
“We’ve been able to intervene with the schools,” said Friesen. “We rely on the child youth workers to identify children and they help us as part of our safety planning or treatment planning.”
The CMHO advises that family awareness and early identification are often the first steps to effective treatment for children and youths with mental health disorders.
The organization’s online resource says, “It’s easy to recognize when a child has a fever. But a child’s mental health is different. It can be difficult to distinguish between ‘normal’ problems that all children and adolescents experience from time to time, and behaviour that may be indicative of a mental heath disorder.”
When sad, angry, fearful or defiant behaviours last for a long time, they may be a sign of a bigger problem, creating emotional or behavioural illness that will affect a child’s daily routine at home and school.
“There are no straight lines in children’s mental health,” Matthews said. But as with her colleagues, Matthews feels early diagnosis and support is key. “We want to err on the side of caution.”
Self harm, or self injury, refers to deliberate acts that cause harm to one’s body, mind or spirit, such as cutting the skin with razor blades, glass, scratching, piercing the flesh, hitting oneself or burning the skin. Cutting is the most common.
Friesen explains that self-harm is a coping strategy that some youth use to deal with their intense emotions.
“It’s something we are seeing is growing in our practice,” Friesen said, noting the act of self-harm often relates to a traumatic event in a child or youth’s life, or a sense that there is a lack of connection with a responsive adult. “So this becomes a coping mechanism.”
Matthews adds, “It’s become a trend. It’s all about coping.”
She notes that while cutting and burning are solitary self-harm practices; the act of branding a mark is becoming a more common group behaviour. Either way, it is something youth try hard to hide.
“Kids are protective of these things that are more private,” Friesen confirms, noting that as they enter their teen years, adolescents are developing their private selves. “It is deep and intense emotions that they want to keep private.”
He adds that in many cases, the youths want to protect their parents too, from knowing the self-harm is occurring.
In other situations, parents aren’t able or prepared to cope with the reality of the act. That is where CMHA can offer help, by working with families and individuals.
“We want parents asking, “what is this about?” said Matthews, noting teenagers in a self-harm situation “are limited in their perspective.”
“Cutting is not necessarily a suicidal ideation,” she adds. “In many cases it’s not. But we don’t want kids to get to that level.”
Friesen recognizes that teenagers are at a point in life where their peers have the greatest influence, which is part of adolescence.
“But they need parents to come back too,” he said.
Suicide is a real, pressing concern with teenagers today, with the pressures of home, school, peers and the emotions that go with it.
In documentation provided by the CMHA, the organization reminds readers: “Suicide is about escape. Someone who thinks seriously about suicide is experiencing pain that is so crushing, they feel that only death will stop it.”
Adding depression to the pressures and stresses associated with growing up can create suicidal feelings.
“If they begin to have thoughts or begin to develop a plan, the risk is great,” Matthews said.
She notes events such as a recent relationship break-up or a poor decision made at a party can lead teens to a reactive suicidal situation.
And social media, issues of bullying and exposure to technology in a fast-paced life are not helping.
“Their world is more complex,” Matthews said, noting that with social media, youth have gone from contact throughout an average school day to now having 24-hour access.
“If they don’t have a coping mechanism already in play on their part, they are more likely to contemplate suicide,” Matthews said.
She added, “We do know if kids or adults that have an experience with a suicide [in their family or friends], if their situation is enhanced.”
While times have changed, the stigma around mental health issues is changing too – as are the openness of dialogue and resources to seek help.
“Now we’re better at recognizing it,” Friesen said. “The stigma has changed somewhat and I think as the stigma is reduced, we’ll see more and more openness.”
Through programs and counselling services and a 24-hour crisis hotline serving Wellington County, there are many options for children, youths and those who care for them.
Acknowledging that the system for mental health support can be challenging, Friesen assures families that CMHA Waterloo Wellington Dufferin is the place to start.
“We will definitely help you get to where you are going,” he said. “We can be that point of contact. We are the place to be.”
The 24-hour Wellington Dufferin Crisis Line is available at 519-821-0140 or 1-877-822-0140.
CMHA Waterloo Wellington Dufferin in Centre Wellington is located at 234 St. Patrick Street East in Fergus. For service information contact 519-843-6191.
In Wellington North, visit 392 Main Street North or contact 519-323-4004.
How to read the signs
Possible youth behaviours indicating an underlying mental health issue
The Children’s Mental Health Ontario (CMHO) website includes the following list of things parents should watch for in their children’s behavior. While it is not always the case, CMHO officials state these characteristics or behaviours could be an indication of underlying mental health issues or disorders:
– getting significantly lower marks in school;
– avoiding friends and family;
– having frequent outbursts of anger and rage;
– loss of appetite or difficulty sleeping;
– rebelling against authority;
– drinking a lot and/or using drugs;
– not doing the things he or she used to enjoy;
– constant worrying;
– experiencing frequent mood swings;
– not concerned with his or her appearance;
– obsessed with his or her weight;
– lacking energy or motivation;
– hitting or bullying other children;
– attempting to injure him or herself;
– intensity that persists for long periods; and
– inappropriate behaviour for the child’s age.
*Children and youths with the most serious mental health disorders (such as severe psychosis or schizophrenia) may exhibit distorted thinking, excessive anxiety, odd body movements, abnormal mood swings, acting overly suspicious of others, or seeing or hearing things that others don’t see or hear.