Dots can be hard to connect, especially when it comes to addressing the continuing challenge of teen mental health. The state of services in New Brunswick is replicated right across Canada, especially outside our major cities. Ten years ago, some 1,200 parents and ordinary citizens launched a New Brunswick movement to create a Centre for Excellence for children and youth with complex needs. In the wake of the tragic March 2021 death of 13-year-old Lexi Daken of Fredericton, it’s fair to ask why, since then, so little has changed for teens in crisis.
The images of that day stay with you. Mobilized by Fredericton parent Maureen Bilerman, hundreds of Dots for Youth advocates descended upon downtown Fredericton to form a human chain, connecting the dots, fingertip-to-fingertip, from the Victoria Health Centre to the Provincial Legislature. That demonstration was sparked by an equally disturbing personal story, but it drew powerful inspiration from a truly ground-breaking report, Connecting the Dots, produced in February 2008 by then Child and Youth Advocate Bernard Richard.
What happened over the past decade is a cautionary tale packing some profound lessons. Shocking and disturbing incidents stir outrage, visionary plans for systemic change appear, the momentum dies down, competing regional interests’ surface, and it all comes unraveled en route to effective implementation.
“Sadly, not much has really changed, “says Bernard Richard, looking back over the past ten to twelve years. “We are still a long way from achieving the goals and implementing the recommendations set out in Connecting the Dots. Despite repeated commitments, revolving door governments, not much has transpired in filling the holes in our community-based network of support for teens in crisis.”
Richard’s report proposed systemic reform, far ahead of its time. Breaking with the conventional social service model, he singlehandedly put “integrated service delivery” on the child and youth services agenda. Back then, it was considered revolutionary to recommend reengineering the system to focus on student needs rather than the priorities of competing government departments.
Seeing that children and youth at-risk were falling through the cracks, Richard proposed integrating services and focusing psych-social- medical resources. “The one child, one file” concept made perfect sense, but takes years to put in place in a siloed system. “Everyone should have access to the same case file, and no one should have to tell their story over and over again,” he insists. “No one would be missed if there was true integrated support and one case manager per file.”
Successive governments, Liberal and Conservative, have bungled the most important file – the proposed Centre for Excellence, one critically-important project which had the potential to turn the situation around in child and teen mental health services. From 2011 to 2015, a province-wide network for service excellence gained momentum and a consensus formed around locating the hub in Moncton or Fredericton, closest the hospitals with youth psychiatric services.
The May 2015 provincial decision, since rescinded, to build a Centre for Youth Services in Campbellton, essentially ignored the demographics of teen mental health case-loads and ran counter to the vast majority of the community feedback.
Long-time advocates like Dots.NB founder Maureen Bilerman were distraught over the decision and its ramifications. “It’s a sad day for families and youth in crisis,” she said in a series of media interviews. “Shock, disbelief and disappointment” were the words she used to describe her reaction. “Most of the youth-at-risk are from the urban centres of Saint John, Moncton, or Fredericton, and it makes no sense, so it must be a political decision.”
Political advocacy for teen mental health reform may not have reshaped the system, but it has continued to raise awareness and generate plenty of activity. When Bilerman chose to step back, after a decade of pressing for change, her Dots NB organization merged with the longer-established Partners for Youth Alliance, also based in the provincial capital.
Youth in Action mental health activities peaked in the 2018-19 school year, just prior to the pandemic. Some 74,400 students were exposed to mental health activities, held province-wide for two days, dubbed “Ring a Bell” and “Bell Let’s Talk.” Specific programs were delivered in 7 high schools, and some 200 students participated in one-time mental health presentations.
Most students surveyed gave the high school mental health sessions an “Apple” rating, indicating that they found them to be positive experiences. Raising awareness is beneficial, but reaching the students most in need of help remained as elusive as ever.
The Pandemic dealt a significant blow to such school initiatives. School closures in March of 2020 interrupted communications and the Partners for Youth group reportedly experienced “radio silence” from youth and educators in the partnered schools. Students and teachers were, according to the agency, “overwhelmed” and “treading to keep their heads above water.”
School shutdowns adversely affected those who needed guidance, counselling, and supports the most. The Partners for Youth 2019-20 annual report put it rather bluntly: “Many students who had difficulties with Mental Wellness ahead of school closures had fallen off the school’s radar completely.” That has the makings of a youth social service crisis.
The Fredericton agency’s Executive Director John Sharpe has seen it all, over thirty years working with youth-at-risk. Many investigations and reviews have echoed the findings of a 2009 report by Justice Michael McKee, all painting a similar picture of a system that’s “overwhelmed, understaffed and inadequate for the care of youth.”
“We don’t want to rebuild the system,” Sharpe recently commented. “We want a new system… we want a transformed system. What that means is we have youth, family and community at the centre.” Waiting for champions has turned this reform drive into an exhausting decathlon.
The road to youth mental health reform is paved with good intentions, but initiatives either run out of high-test gas, are diverted into cul-de-sacs, or get co-opted by research groups chasing government grants. Far too many reform initiatives end up being ‘studied to death’ or kicked down the road through the commissioning of yet another government report.
What’s really standing in the way of the needed changes? “The outrage is now at an all-time high,” according to Dots for Youth founder Bilerman. “What we lack,” she believes, “is the capacity for transformational change management. Models exist and we could pull it off here in New Brunswick.” Let’s hope the ‘Powers That Be’ are listening.
What’s the situation in your province, district or local community? To what extent are the service gaps visible in New Brunswick present in your community? What does it take to “connect the dots” and establish a full continuum of support services from childhood to adolescence and on into adulthood?
Educhatter 