It matters in wellness; it matters even more in crisis
Reprinted from the "Families and Crisis" issue of Visions Journal, 2017, 12 (4), p. 5
How can we best support families of young people with mental health challenges when they’re in crisis? We help prevent them from going into crisis in the first place—and when that isn’t possible, we see them, we hear them and we treat them with kindness.
The irony of our current service systems is that they seem to be designed to deal with crisis once crisis is in progress rather than to avert crisis altogether. Our systems have a limited capacity to promote mental health, prevent mental illnesses or intervene early on. And there is no integrated system of care for child and youth mental health—just a loose patchwork of services. Because of this, we can pretty much guarantee that more young people and their families will be in crisis in the short and long term, not fewer.
Nearly 13% of children and youth in Canada and BC experience clinically important mental health symptoms and associated impairments at any given time. That means that roughly four students out of every classroom of 30 will struggle to learn, make friends, participate in activities and function in their families. Yet more than two-thirds (86%) of children and youth with mental disorders do not receive specialized mental health services.1
With kids, it’s easy to dismiss early warning signs of mental illness as developmental or parenting issues, or as just a “phase” they are going through. But we know that an estimated 70% of mental illnesses originate in childhood and adolescence.1 Without timely intervention, there can be significant consequences for the individual as well as his or her family and community, across generations.2
Historically, expert-based systems have treated parents as part of the problem, not as part of the solution. This is particularly the case in child and youth mental health, where big investments are made in parenting programs that are designed to get children to “cooperate.” Systems approaches can leave families feeling blamed, judged, dismissed, invisible or ignored. This shuts down any opportunity for families to explore what they need to know or do for their kids, or for the family as a whole.
A parent once told me that when a service provider—the only one of all the professionals she had ever dealt with—said to her, “Your life sounds like hell,” it meant everything to her—she felt seen and heard for the first time, and she felt the kindness in his words.
Until very recently, the recognition and valuing of families as assets in child and youth mental health, and the intentional involvement of families as partners in child and youth mental health care, has largely been absent in our systems. Yet family-centred approaches are considered best practice in early childhood development and in child and youth physical health care.3
Broadly speaking, “family” refers to an interactive group of one or more relatives, partners, close friends or supportive persons. In other words, “we are all family members, whether our family is natural or chosen, large or small, temporary or permanent, conventional or unconventional, resilient or fragile.”4 Our experiences with family shape us. Family-centred approaches to mental health care recognize this and the central importance of family in the lives of children and youth. Such approaches focus on the strengths, assets and capabilities of young people and families.
So why is it important to support families when their kids are in crisis?
When young people are in crisis, the caring people in their lives are also feeling that crisis. As human beings, our desire to be seen, heard and treated with kindness is amplified when we experience a mental health crisis—just ask anyone who has been there. When the health care community understands that the family of the person in crisis is also experiencing crisis—and makes the extra effort to see and hear family members and to treat them with kindness—working well together is possible. This in turn makes a huge impact on how a young person and his or her family move through a crisis and bounce back. This sort of approach isn’t just a “nice to do”; it’s a “need to do.”
The focus of our work at the National Institute of Families for Child & Youth Mental Health is the transformative power of bringing youth, families and professionals together as partners in creating enhanced mental health for children and youth. We provide knowledge, tools, support and resources to develop the sort of caring, connected relationships among young people, families and service providers that make working well together a possibility.
FamilySmart™ equips youth, families and professionals with what they need to work together through what are often the very difficult challenges that children and youth face when their mental health is compromised. This practical knowledge is important at every stage of a mental health challenge, but it is especially important when young people are in crisis. Good working partnerships between health care professionals and primary care providers are fundamental to the mental health of children and youth: they can save lives.
I invite you to join us: learn more about the FamilySmart™ program at www.familysmart.ca.
About the author
Keli has a 28-year-old son who was diagnosed at age 10 with bipolar disorder. For 17 years, Keli has promoted early intervention. She co-founded the FORCE Society for Kids’ Mental Health in BC within a year of her son’s diagnosis and was its Executive Director from 2000 to 2013. She co-founded the National Institute of Families for Child & Youth Mental Health in 2009 with Dr. Jana Davidson. In 2015, Keli became President and CEO of both organizations
Waddell, C., Shepherd, C., Schwartz, C. & Barican, J. (2013). Child and youth mental disorders: Prevalence and evidence-based interventions. A research report for the British Columbia Ministry of Children and Family Development. Vancouver, BC: Children’s Health Policy Centre, Simon Fraser University.
Waddell, C., McEwan, K., Shepherd, C.A., Offord, D.R. & Hua, J.M. (2005). A public health strategy to improve the mental health of Canadian children. Canadian Journal of Psychiatry, 50(4), 226-233.
MacKean, G., Spragins, W., L’Heureux, L., Popp, J., Wilkes, C. & Lipton, H. (2012). Advancing family-centred care in child and adolescent mental health: A critical review of the literature. Healthcare Quarterly, 15(Special Issue), 64-75.
Government of British Columbia. (2015). Families at the centre: Reducing the impact of mental health and substance use problems on families. A planning framework for public systems in BC, developed by the Family Mental Health and Substance Use Task Force. Victoria, BC: Author.