Michael Garron Hospital’s child and adolescent mental health unit has been consistently full since the new year as the COVID-19 pandemic drags on, with kids in virtual school most often filling those beds.
Dr. Susan MacKenzie, a staff psychiatrist and assistant director of Child and Adolescent Mental Health Services at the east-Toronto hospital, said demand for youth mental health services at Michael Garron and elsewhere in the city has increased as children grapple with isolation a year into pandemic lockdown measures.
“Since January or so, the kids we’re seeing most in the in-patient unit are the ones who have been in virtual school, some of whom are not leaving their bedrooms for days or weeks at a time,” MacKenzie said.
The increase in demand for the hospital’s in-patient, outpatient and community youth mental health services program — which serves a large population of newcomers and low-income families — prompted the Michael Garron Hospital Foundation to hold a fundraising event for these services over the weekend, raising $429,000 for youth mental health programs, though the foundation said it’s still accepting donations.
It’s the second targeted fundraising event the foundation has hosted since the pandemic — the first was focused on the hospital’s emergency response fund and raised $250,000, said Michael Garron foundation spokesperson Abigail Brown.
For MacKenzie and Adina Hauser, the clinical lead for the hospital’s Transitioning Youth Program, every dollar counts as they see first-hand how COVID-19 has affected the most vulnerable in Toronto’s east-end.
East Toronto, which comprises 22 neighbourhoods — five of which are deemed neighbourhood improvement areas by the City of Toronto for their low equity score — has a higher percentage of clinical visits for mental health diagnoses than the City of Toronto as a whole, Brown said. Forty per cent of the community are newcomers to Canada, including the highest rate of refugees in the city, and 20 per cent are low-income.
Many of the children and youth who were recently admitted to Michael Garron’s in-patient mental health unit, MacKenzie said, are those who are living in intergenerational homes and who had to continue school virtually to avoid bringing COVID-19 home and infecting their vulnerable relatives. Some have dealt with the challenges of contracting COVID-19 or having a family member fall ill, Hauser said.
The unit has six in-patient beds in total, MacKenzie said. At times, the hospital has had to utilize overflow beds in the pediatrics unit to keep up with demand.
“We have a number of youth who have had COVID-19 and had real risk to themselves and their family members, and it’s so much harder for them to focus on their own mental health and care when they’re caregiving for others,” Hauser said.
The youth, MacKenzie added, “have been very isolated in particular,” and have had limited opportunities to spend time outside the home. This isolation has negatively impacted their mental health and has affected their engagement with school, their sleep schedules and their overall well-being.
“The longer this goes on, the more we worry about this,” MacKenzie said.
Pandemic isolation has exacerbated some existing mental health challenges for youth as well, MacKenzie said, especially with the cancellation of most extracurricular activities. In some cases, this prolonged anxiety has morphed into depression and suicidal thoughts among youth.
“Some of these suicide attempts are more significant and severe than what we’ve seen before,” MacKenzie added. “There’s a lot of despair and a lot of hopelessness.”
For Hauser, whose team helps connect in-patient and outpatient youth and adults with community mental health programs for prolonged support, COVID-19 has brought unique challenges when it comes to connecting youth with the services they need.
Hauser’s program, which began in September 2019 and is funded entirely by grants and donations, previously met youth where they are in the community, whether it be a park, their porch, or even a local Tim Hortons, to help them as they tried to navigate the mental health system.
“[COVID-19] has restricted the amount of face-to-face contact that we’re able to have with our clients, and we know that when people are struggling with their mental health, that face-to-face human contact is so important,” Hauser said.
While the program still tries to engage with youth and adults in-person, especially during a mental health crisis or through Michael Garron’s emergency department, most of programming has shifted virtually, whether it be video call, text, or phone calls.
This has been challenging for many youth, Hauser said, especially those between the ages of 16 and 29 who are struggling to navigate “a really convoluted mental health system,” she said. For some, the shift to virtual has been especially difficult as they don’t have the privacy or technology they need to connect with mental health service providers.
“Sometimes the technology doesn’t work, or they’re on screens all day and then continue to use screens with their clinician,” Hauser added. This, coupled with privacy issues, impacts the help youth are able to access as the pandemic drags on.
Despite the barriers, the program is exceeding its uptake expectations since it launched in 2019. Hauser said originally, it was projected that around 250 youth and adults would access the program over its first three years. As of March, uptake has exceeded 360 people, Hauser said.
“We’ve seen way more than what we initially anticipated, and we haven’t even begun to make inroads with larger parts of our East Toronto community because we’re a new program,” Hauser said.
And there have already been positive outcomes in the program’s first year and half, Hauser added. Emergency room visits have gone down among participants by 80 per cent compared to six months prior to enrolling in the Transitioning Youth Program.
“Our theory is they have someone they can call, and they don’t need to use the emergency room as their point of contact,” Hauser said.
Both Hauser and MacKenzie anticipate the mental health challenges for youth in East Toronto will only worsen as the pandemic continues, and ensuring both programs are well-funded is important to continue to meet that surge in demand.
“I only hope that we can continue this work for years to come, because it’s making a major difference in our community,” Hauser said.
Nadine Yousif is a Toronto-based reporter for the Star covering mental health. Her reporting is funded by the Canadian government through its Local Journalism Initiative. Follow her on Twitter: @nadineyousif_
Nadine Yousif, Local Journalism Initiative Reporter, Toronto Star