
                           MENTAL HEALTH ON HOLD

                              By CAROL GOODWIN
                         Kitchener-Waterloo Record

     KITCHENER, Ont. - Colleen Sayers of Toronto was 21 when she
     committed suicide in 1989.

     An inquest jury later concluded that her death, which ended a 10-
     year struggle with mental illness, was caused by ``fragmented and
     ineffective care.''

     When Colleen's 15-year-old sister Denice Ryan showed symptoms of
     severe depression last year, her mother saw the nightmare beginning
     all over again.

     The third time a suicide attempt put Denice in hospital, Brenda
     Ryan refused to take her daughter home.

     ``I demanded appropriate mental health treatment for my child,''
     she says. ``I told them, `I am not abandoning my child, but I am
     not bringing her home till she has her needs met.'''

     The showdown stretched into its fifth month before Denice was
     finally accepted into a program of intense individual, group and
     family therapy at the Yale Psychiatric Institute in New Haven,
     Conn.

     Perhaps what is saddest about her case is that it is not unique.

     An estimated 10,000 young people in Ontario - and countless more
     across Canada - are waiting for mental health treatment for
     neurological disorders or emotional trauma resulting from death of
     a loved one, or physical or sexual abuse.

     The choices for treatment are few.

     ``If a child is sick or hit by a car, he has the right to immediate
     health care,'' says Brent Willock, head of the Canadian Association
     for Accessibility to Psychological services.

     ``But if a child is severely abused . . . he or she may have to
     linger for two years on a treatment waiting list.''

     All too often those that do find treatment find it far from home -
     and expensive.

     Several troubled youngsters are being treated for mental health
     problems in St. Joseph's Medical Centre in Burbank, Calif. Ontario
     taxpayers will pay about $71,250 for each patient's approximate
     three-month stay there.

     A 17-year-old Kitchener boy who has suffered borderline psychotic
     tendencies for years will undergo treatment at Yale for at least
     two years. The cost is $24,732 a month.

     In 1990, the Ontario health plan, which pays 75 per cent of out-of-
     province health bills, spent nearly $7 million for mental health
     treatment in the U.S. for young people under age 20. Last month,
     Ontario's NDP government moved to limit out-of-country spending by
     proposing a still-to-be-announced ceiling on payments for U.S.
     services.

     Problems of limited alternatives for mental health care near home
     are similar in other provinces, says Ryan, who was prompted by her
     daughter's death to form a group called Parents Empowering Parents
     (PEP).

     Waiting lists for treatment in the Maritimes are even longer than
     those in Ontario, she says.

     In Alberta, the provincial government spent $4 million on out-of-
     country bills for youngsters receiving mental health treatment,
     says David Summers, a psychiatric nurse in the adolescent unit at
     Calgary's Foothills Hospital.

     ``There are extensive waiting lists here,'' he says. ``The amount
     of hospital resources allocated to children's mental health is very
     modest.''

     Part of the problem in finding help for young victims of mental
     illness is that some of them are caught between two bureaucracies.

     ``The vast majority of children with emotional problems are dealt
     with through the department of social services, which are very
     backed up and tend to be quite ineffective at times for children
     and adolescents who have psychiatric disorders,'' Summers says.
     ``It's not appropriate that they are dealt with by community social
     workers.''

     Ryan, whose work on the issue has taken her to national
     conferences,  politicians' doors and hearings of various advocacy
     groups and committees, agrees.

     ``In 1977, it was determined that the issue of children's mental
     health was not a health problem, but a social issue caused by
     inappropriate or dysfunctional family life,'' she says.

     ``Trauma is a major factor. But what about the poor child who has a
     chemical imbalance in the brain. That's not a social problem
     although it may create a social problem. Looking at the social
     problem will never resolve the health problem.''

     Dr. Peter Lang, a Kitchener child psychiatrist, sees children as
     young as six displaying destructive behavior, including one who
     blew up cars by placing a rag in the gas tank and setting it
     alight.

     He also sees children under 12 who have tried to commit suicide by
     hanging or swallowing poison.

     As the only child psychiatrist serving a population of 300,000, he
     finds trying to find appropriate treatment for his patients is a
     daily frustration.

     Then there is the frustration experienced by parents. Families
     facing a crisis don't know where to turn when they encounter the
     long waiting lists for counselling and therapy, says Dieter Kays,
     director of Lutherwood, a Kitchener-area residential treatment
     centre for emotionally disturbed youngsters over age 13.

     Faced with waiting lists when their child is violent or self-
     destructive, parents are told to seek quicker solutions through the
     courts.

     While a judge can't order treatment for an adolescent whose crime
     may be the result of an emotional disorder, the youth can be
     ordered to reside at a facility like Lutherwood, where receiving
     treatment then depends on how ill he or she is compared to others
     waiting there.

     ``Twenty-five per cent of our residents are here because of court
     orders,'' Kays says.

     Lutherwood has a six-month waiting list for its residential program
     and usually rejects referrals from outside the region.

     Notre Dame of St. Agatha, a mental health centre in the area for
     children under 13, has a year-long waiting list - and that's after
     screening out requests from Toronto, says executive director John
     Young.

     As various commmissions document its horrors and costs, the issue
     of children's mental health is gaining increasing attention.

     Reaching for Solutions (1990), a special report commissioned by
     federal Health Minister Perrin Beatty, examined child sexual abuse
     in Canada and made 74 recommendations focusing on prevention,
     community-based treatment and changes to social attitudes.

     In Ontario, a 1991 report called Children First found the various
     child-support services in the province - child welfare services,
     child treatment, child and family intervention services, community
     support services and services for young offenders - under
     ``considerable stress.''

     ``The severity of the problems and the treatment needs of the
     children are significant,'' it said. ``Services are too fragmented,
     overspecialized and overburdened. At the same time there are
     serious financial restraints.''

     In British Columbia, a youth secretariat has been set up to address
     gaps in services to children and adolescents.

     Like other professionals in the field, Young of St. Agatha's says
     prevention is an important key to solving the problem.

     Most of the children at St. Agatha's, originally an orphange, are
     victims of abuse. ``In a sense, all these children are orphans,''
     Young says sadly.

     But despite the evidence of increasing concern, there remains an
     overwhelming sense among many that far too little is being done.

     The June 1990 inquest into Colleen Sayers' death made 21
     recommendations to improve children's mental health services. One
     of them proposed a central placement service to help keep
     professionals up to date about treatment services. Another urged
     elimination of the overlap between the social services and medical
     bureaucracies.

     The recommendations were sent to more than 80 agencies.

     ``I wrote to every one of the agencies,'' says Colleen's mother.
     ``Not one recommendation has been carried out.''
