They say when one door shuts, another opens – but in the case of mental health and addictions services, the problem is that the door hadn’t always been in plain sight.
Dr. David Pilon, Specialty Mental Health Services Program Leader with Capital Health Addictions and Mental Health Program, says our healthcare system is divided between pediatric/youth settings and adults settings. Having separate facilities allows our physicians and staff to offer focused care for their demographic. However when it comes to transitioning from youth-based services at the IWK Health Centre (0-19) to adult-based services at the QEII Health Sciences Centre (19+) the transition is not as smooth as it could be.
“Given that we know that probably70 per cent of mental health challenges have their onset before the age of 25, it’s a critical time in those young adult years,” says Dr. Pilon, who spent three years working on recommendationsto better connect the IWK Mental Health Services with the programs at Capital Health.
“We wanted to helpconnect the services so we didn’t lose people in this divide between services that end at the age of 19, and services that begin at 19.”
He and his colleagues identified that theideal approach would require collaboration between the IWK and Capital Health, but they lacked the resources to be able to make it happen. It was at that point that Dr. Pilon was contacted about a very special gift.
Fred and Elizabeth Fountain wanted to honour the memory of their son, Alex, by making a generous gift to the QEII Foundation. The donation would fund the Stay Connected Mental Health Project – a five-year project aimed at creating better pathways for young adults living with mental illness, supporting their transition from youth-based services at the IWK to adult-based services within Capital Health.
“It was a moment of serendipity,” recalls Dr. Pilon. “We had been feeling thwarted by not having the capacity to do things the way they should be done, and then suddenly the financial support came together.”
Dr. Pilon says the Fountains reflected“tremendous personal courage and generosity” with their donation. Their son, Alex, took his own life after battling mental illness, a trauma and a tragedy that no family should ever have to experience.
“They wanted to honour their son’s memory by contributing in a positive way to other youth who might be experiencing mental health problems – andtotheir families – so they can receive the care they need,” says Dr. Pilon.
He says that a successful transition requires much more than simply sending a referral letter from one hospital to the next, this program is going to fill in the missing pieces.
The first step is a Youth Readiness Program, which aims to help teens encourage self-management and self-advocacy for their healthcare needs, in addition to the treatment they are receiving.
“Young people need to have help in learning how they can identify warning signs, manage their own symptoms, and cope with the impacts of mental illness,” says Dr. Pilon. “They need to be able to communicate with their family members about what they might require, and their family members need to know how to support them.”
The second component focuses on family mentoring, because Dr. Pilon says family members haven’t always received the support they require in order to assist their struggling young adult loved one.
“Families have an important role of care and support, and we wanted to connect them with other families who have successfully transitioned their young adult loved ones,” says Dr. Pilon. “This helps them to learn how the process works, and helps them to stay hopeful about how things may turn out.”
There are more than 50 mental health and addiction services between the IWK and Capital Health, so it’s critical that the young adult transitions into the service that’s right for them. The third part of the program is making sure that clinicians understand each individual’s needs, and uses a new service landscape map to determine the bestroute for their continued treatment.
In order to make the transition more seamless for the young adult, Dr. Pilon says they’ll provide some overlapping contact between the IWK and Capital Health services. Since clinicians do not traditionally visit other settings to jointly treat patients, Dr. Pilon says that this will be a new recommended approach to care. A transition coordinator will be hired to support the project.
“We’re thinking of this as a culture-shifting initiative where we’re changing how our two systems work together,” says Dr. Pilon. “This is a five-year project so we have time for our practices to evolve, and for the culture of how we work together to become more collaborative.”
Laura Garsten volunteers as a peer mentor at Laing House – working with youth with mental illness – and has worked to boost awareness of the Stay Connected Mental Health Project. She believes the transitional program will “make it less daunting” for these young adults.
“If you’ve been at the IWK for a long time, you know the ropes – and you know the people you’re dealing with,” says Laura. “To have to suddenly go to a new place – especially if you already have anxiety or psychosis that you’re dealing with on a daily basis – will add to your stress.”
Dr. Pilon says that the Fountains also wanted to integrate the local universities into the project to find a way to connect their counselling and health services with our health care services. He’s met with local universities over the last few months, and they’ve discussed ways to better collaborate when students have care needs that may surpass what is available on campus. Several other university initiatives are planned, as well.
Having devoted his entire career to mental health, Dr. Pilon says that one of the greatest limitations in society is that we have not found a way to encourage and inspire people to move beyond the stigma of mental illness and to seek the help that they require.
“There’s likely three out of four youth with mental health disorders who don’t receive the treatment they require – and as a result, we have a significant number of individuals who are suffering in silence,” says Dr. Pilon. “So these early years are really critical years to intervene and to ensure that we do the best job we can – to make these services accessible, decrease the stigma, and help peoplerealize that mental health problems are no different than physical health problems.”
“There is no health without mental health – and addressing mental health needs is no different than addressing a stomach ailment or a broken leg.”