Child psychologist says demand for service in Nova Scotia is skyrocketing

Jennifer Nunn first noticed her daughter was struggling with mental illness when she was in elementary school. 

"Our daughter was sitting on the floor, rocking back and forth and just kept repeating, 'I can't. I can't. I can't,' Nunn said.

"And you wonder, 'What can't you do?' They can't do anything. They just can't move."

Six years later, her daughter has been diagnosed with severe anxiety, depression and selective mutism, but Nunn said her daughter has still not received adequate mental health care. She is no longer able to attend school, and, at 16, Nunn worries she is missing out on important stages of life. 

Out of pocket

Nunn regularly drives her daughter from their home near Antigonish to the Halifax area for appointments with her psychologist. She said it has been extremely difficult to get appointments through the public system, so she pays out of pocket to attend a private practice. 

Since COVID, even private practices are feeling the strain of increased youth mental health struggles.

Dr. Kiran Pure, a child psychologist at Dr. Pure and Associates, a private practice in Dartmouth, said the waiting list for families trying to access mental health care for their children has never been higher. 

In the past year, Pure's practice has received up to 25 referrals a day and those in line might have to wait 11 months.

"When you have a child or a teenager who is referred for anxiety and depression with suicidal ideation, and you have to tell them that the first time they can get services is March....To me, that's a concern," Pure said. 

She said not only are there more referrals, the manifestations of mental illness are more acute. 

She said she is seeing more anxiety and depression in teens 13-18, more suicidal thought, more substance use and abuse, higher instances of sexual abuse in girls under 10, and more eating disorders. 

Pure said this number has been worsened by the pandemic. Before COVID, her practice would get around 1,800 referrals per year. Since last June, they've received 3,200.

She said many clinics have even closed their waiting lists. 

"The impact of COVID-19 has been substantial on children and teens," she said. "Children who experience mental health issues, if they don't get the care they need, then they'll carry those issues into adulthood and there's going to be a long term effect."

Pure has formed a community with five other child psychology offices, and they try to share the referral caseload, but any urgent case is referred to the IWK. 

"I can only speak for my network but we all feel the same thing that across the board we're not able to provide the services that are needed," she said. "We're trying our best."

'Families are suffering'

Nunn said it is shocking that parents are supposed to pick up the slack that health-care professionals are unable to provide. 

"The parents are supposed to deal with the illness," Nunn said. "And we're not trained. We're not doctors. We don't have the ability to fix this problem." 

"You know, it's crazy because you just wouldn't send someone who has a physical illness home and say, 'We'll see you in a couple of months and we hope you get better.'"

Nunn understands children cannot just remain in the hospital, which is why she believes the creation of long-term treatment centres for children with mental illness is crucial in the province. 

She believes her daughter would make faster progress with consistent daily treatment, but she would have to go to Alberta or Ontario to access a private centre. 

Lobbying the government

Nunn is part of a family support group facilitated by the Nova Scotia Health Authority called Families Matter. She said the group has met with various politicians, including MP Sean Fraser, to discuss a variety of issues, notably the need for treatment centres. 

In February, the provincial government announced the creation of the first Office of Mental Health and Addictions. 

Nunn said she has been trying to get in touch with Dr. Sam Hickcox, the chief officer of the new office, to schedule a meeting to relay the experiences of her family. She said she left a message for him six days ago and has not heard back. 

In an email, the Office of Mental Health and Addictions said it was unaware of this message. 

A statement said the health authorities are "making significant improvements to wait times for services with additional investments from government, but we know we can do better. Government included $12.3 million in its budget for new mental health supports, including single brief intervention sessions to improve access to mental health services when they're needed most."

Teachers seeing effects

Maria Keramaris teaches grades 10, 11 and 12 at a high school within the Halifax Regional Centre for Education. She said she has noticed more mental health issues and heightened anxiety in her students. 

"I'm talking about really energetic, really motivated kids. And it's like a complete 180, where they can't concentrate, they can't meet deadlines," Keramaris said. "They are struggling with the unknown and what's going to happen."

She believes the uncertainty of the pandemic and the flip-flop of school closures and reopenings has had a massive impact on students who are already at a complicated stage in life. 

"I can't even begin to tell you the number of emails I get from parents that have said, either we're keeping our kids home for the rest of the school year because they're dealing with mental health, or they've gone on medication," Keramaris said. 

Pure believes there is no easy answer to this problem, but she said schools could be a key part of the solution. 

Currently, certain schools in the province have school psychologists, who provide services that differ from those provided in a private clinic or hospital. These psychologists are focused on helping students succeed in school. 

'Dream wish'

Pure said school psychologists and guidance counsellors are doing a great job, but they don't do mental health therapy. 

"I wonder if there is a way to complement their service with clinical psychologists within the school system," Pure said. "That's probably a dream wish, but I think that it would be helpful to have clinical psychologists where the children are."

Both Pure and Keramaris suggested a dialogue be opened between teachers, the provincial government, and mental health-care professionals. 

"We've seen in the last year that we can do a lot of things quickly," Pure said. "So I'm hoping that we can figure out a way as a community and as a larger system of clinicians to provide that support to the youth."

Where to go for help

In addition to in-person services, the Nova Scotia Health Authority offers online mental health services.

People who are looking for support are encouraged to call their local clinic, the Mental Health and Addictions intake line at 1-855-922-1122 from 8:30 a.m. to 4:30 p.m. on weekdays or the crisis line. 

The province's toll-free Mental Health Crisis Line is 1-888-429-8167 and available 24 hours, seven days a week. People can also contact the Kids Help Phone at 1-800-668-6868 anytime of day.

If you're experiencing an emergency, call 911. 

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