by Dr. David Smith
Dr. David Smith is an adolescent and adult psychiatrist and the medical director of the Okanagan Psychiatric services for Interior Health. This series of columns on common child and youth mental health issues is a project of the Child and Youth Mental Health and Substances Use Collaborative, jointly funded by Doctors of BC and the government of BC. The Collaborative recently received a national award from the College of Family Physicians of Canada and the Canadian Psychiatric Association.
When it comes to young people, early identification and treatment of mental health or substance use issues can be critical. In my series of articles I have been recommending three main actions for parents who know or suspect their son or daughter is experiencing mental health difficulties:
1. Consult one or more of the informative BC websites and organizations available to you. You can connect with other youth and parents with lived experience through the FORCE at forcesociety.com or through the Kelty Mental Health Resource Centre at keltymentalhealth.ca or toll free at 1 800 665 1822. Other helpful sites are anxietybc.ca, mindcheck.ca, or cmha.bc.ca.
2. Talk to your family doctor — in recent years many general practitioners in B.C. have taken extra training in child and youth mental health diagnosis, treatment and management.
3. Call Service BC at 1-800-661-8773 to find the Ministry of Children and Family Development (MCFD) office nearest to you. You can also access the Child and Youth Mental Health and Substance Use service map at: www.health.gov.bc.ca/healthy-minds/cymhsu-servicesmap.html
In this column, I want to focus on MCFD’s Child and Youth Mental Health (CYMH) Services, which are offered in more than 80 locations across the province, and in particular their new intake process. The process streamlines and standardizes mental health screening and initial assessments for those under 19 years of age for quicker access to mental health resources.
Many families who’ve never connected with MCFD previously are surprised to learn that community-based CYMH services have been provided under the umbrella of MCFD for close to two decades. While family doctor visits, emergency room services, or hospital admissions all fall under the health system, if your child needs further assessment and treatment or ongoing community-based therapy, you may be referred to MCFD’s Child and Youth Mental Health Services.
Psychiatrists, like me, work both with the health authority and MCFD services, depending on whether we see your child in the hospital or in the community through the CYMH clinic.
Over the past 18 months the MCFD began a new intake screening and initial assessment process. Previously, access to services took anywhere from a few days to a few weeks. Now, under the new streamlined intake, the process typically takes a few hours.
It works very much like a walk-in-medical clinic. If you feel your child needs help, all you do is show up to the office closest to you with your child during the intake hours. (Teens can show up on their own without parents, if preferred.) See #3 at the beginning of this column for how to find your nearest clinic.
The administrative assistant will give you a form to fill out that asks for basic information, including symptoms and concerns. After the information is entered into the system, an intake clinician will review it and meet with you privately to engage in a brief pre-screening interview.
At that time the following options will be considered as next steps:
• Is an urgent response (such as hospital admission) required?
• Do you need some more information, parenting resources, and/or validation and support?
• Would a referral to another community service be better suited for your child’s and family’s concerns?
• Or is it appropriate to proceed to the full intake interview to understand more about potential mental health challenges?
If it is the latter, the intake clinician will continue with a more in-depth intake interview and screening process. All the while, the clinician will talk with you about the best way to meet your child’s needs, whether it is an urgent response, referral to others or acceptance into CYMH services. Those services may include anything from assessment, diagnosis and treatment by a specialist psychiatrist like me, or work with other mental health practitioners such as a nurse or clinical counsellor, especially for specific help like cognitive-behavioural therapy, or group therapy, among many options.
At the end of that first intake meeting you are then provided with a copy of a brief plan for initial supports and services — all in a couple of hours. While there may still be waitlists for specific treatments or specialized services, the intake process is greatly simplified.
As one parent recently noted about the new intake system: “I was pleasantly surprised at how easy and welcoming this experience has been …. I am grateful to the clinician for making us feel so comfortable and at ease while talking about some really tough issues concerning my daughter.”
This new process is expected to be fully available at all offices by the end of 2015 and will support approximately 80 per cent of BC children and youth seeking assessment through MCFD. For the smaller number of children or youth whose symptoms or concerns are much more severe or complex, the CYMH office may arrange alternative options for the first intake. This can include outreach, where a CYMH team-member would meet the child and family at home or in the community rather than having on the family to come to them.