Young, addicted and on hold (Canada)

Young, addicted and on hold

Thousands of youths wait for 86 addiction rehab beds funded by the province – none in Toronto – and it can take up to four months to get in for treatment
Apr 22, 2008 04:30 AM

Megan's parents were puttering at home on a frigid February evening when they got the call. They were told to come immediately and pick up their 16-year-old. She had been caught stealing cash from the store where she worked part-time. Police were involved.

It had been clear Megan was lurching out of control. Once a straight-A student who tutored her friends and loved sailing at summer camp, Megan (not her real name) had become someone who skipped school, took off from home, stole her mother's bank card. Her parents knew she was using drugs.

They sought help from physicians, a youth worker, hospitals, social services.

All they found were wait lists or overburdened staff who couldn't handle Megan's problems.

This is the reality of the Ontario health care system. For parents of a child needing urgent help with drug abuse or mental illness, there are few options.

Megan's parents bought a safe and changed the locks so she couldn't get into the house unless they were there. Some mornings they'd find their only child sleeping in their car outside their suburban Toronto home.

Tall and lithe, Megan dropped to 102 pounds. Her hazel eyes were bloodshot and raging, says her mother. "And when she was challenging me, there was hate in them."

That winter night, though, they learned how dire the situation had become. Megan disclosed she was using cocaine three or four times a day. She was stealing to support her habit.

"I could barely breathe," says her father, whose profession involves counselling and teaching. "It was pure shock."

They searched the Internet, worked their contacts and, by word-of-mouth, found a private addiction specialist. They paid hundreds of dollars a week to have Megan assessed and attend regular counselling. They joined a family support group.

"I could always see myself getting worse," says Megan, now 18. But still, she wasn't ready to stop.

The shortage of addiction and mental health services in Ontario is especially glaring for youth – like Megan – who are ill enough to require residential treatment.

As a last resort, Megan's parents drained their savings and took her across the border. She spent two months at a wilderness program in Georgia, another seven at a secure treatment facility in Utah. OHIP covered $85,000 because there are no programs in Ontario to deal with kids like Megan. The family spent another $80,000, including travel and legal costs.

Megan's father looks into his daughter's eyes as the family recounts the story. "We knew that if we didn't intervene, you would die."

She nods.

There are many worse off than Megan – street youth without parents to fight for them. Addiction physician Dr. Sharon Cirone sees them in the Shout Clinic at St. Joseph's Health Centre in Toronto. There are no addiction treatment beds in the province designated for homeless kids and Cirone says it's imperative these teens are included in discussion about the vital need for more public funding.

"I go to these kids' funerals, I watch them prostitute themselves and stick needles into their arms," she says. "It's these individuals who will cost the system millions of dollars over the course of a lifetime in money spent on incarceration, welfare, disability, homeless support services, emergency department visits and then to serve the needs of their own children."

Dennis Long, executive director of Breakaway, an Etobicoke-based family and youth support service, is angry that people without financial resources are dependent on a public system "which for all intents and purposes doesn't exist." Addiction is a potentially fatal disease and without treatment, many will be lost to jail, the streets, suicide. Megan's parents know this. While they want to remain anonymous to protect their daughter's privacy, this is why they are telling their story.

Megan does, too. Before she went into treatment, her friend, also a heavy drug user, told her she was lucky. He said he wished his parents could afford to send him somewhere. Four months later, he was dead.

According to the Ministry of Health, there are 86 provincially funded beds available for youth needing drug treatment, none in Toronto. Of those, 23 are part of a $3 million pilot project at Pine River Institute, a therapeutic school near Shelburne. OHIP covers treatment costs there but after 30 days, parents have to pay $80 a day – $14,400 for the average seven-month stay.

The remaining 63 Ontario beds cover a mishmash of age ranges; some are gender-specific; some are aimed at native kids. So a 15-year-old non-native girl whose family can't afford to pay may actually be in line for one of only 10 beds.

Wait times average two to four months – but when a teen reaches for help, quick response time is essential. There may only be a brief window. And in Ontario, youth 16 and over must consent to treatment. "A week later is no good. You can't keep a kid motivated and not provide immediate treatment," says Jennifer Blunt, director of development for Portage Ontario, a 52-bed treatment facility in Elora.

Those in the field say they have to work with what they've got. Karna Trentman talks to many desperate parents. She's a help line supervisor at the Drug and Alcohol Registry of Treatment (DART), a toll-free service that connects callers to drug and alcohol treatment services.

In the 12 months ending March 31, DART received 1,638 requests for referrals to residential treatment for youth under 24. It's an indication of the demand – DART is just one of many agencies people call.

"We hear a lot of frustration and anger at the system," says Trentman. "With a lot of parents, the kids are non-compliant so even if we had a place to send them, the kids wouldn't go."

Youth need a different treatment model from adults because they face different issues, their brains are still developing and they don't have adult skills or experience. They also have higher rates of concurrent mental health problems. Some start using drugs to self-medicate an underlying condition. In other cases, drug use triggers mental illness. Megan, for example, has been treated for severe depression and diagnosed with ADHD.

Gloria Chaim, deputy clinical director of the child, youth and family program at the Centre for Addiction and Mental Health, estimates 90 per cent of youth who come to CAMH seeking help with substance abuse also have other mental disorders. Yet there are no beds specifically for youth with concurrent disorders, says Cirone.

Sometimes, funding isn't in line with needs. At Portage Ontario, 32 beds are designated for kids in the youth justice system. Half are empty. At Pine River, the 23 OHIP-funded beds are full, with a wait list. But as of last week, 18 of the 21 private-pay beds were vacant.

Families can apply to OHIP to cover the cost of private treatment in the U.S. But OHIP doesn't cover private treatment here or in other provinces.

Last week, a group of parents held a news conference at Queen's Park to highlight the "shameful" situation. The group, dubbed the "Tragically O-HIP," called for more residential beds in Ontario, coverage for treatment in other provinces and a streamlining of red tape.

Among them was Claire McConnell, who despite 27 years working in mental health, was at a loss when it came to finding help for her own teen. She says at one point her daughter, hooked on street drugs and with multiple mental health diagnoses, was in the hands of seven professionals. None was willing to take the lead. The family later spent $70,000 on 18 months of private treatment.

Health Minister George Smitherman, who has gone public with his own story of abusing street drugs, has agreed to meet with the parents in May. In Ottawa, hopes are high that a $7 million 28-bed youth treatment facility will be announced soon. In 2012, CAMH is scheduled to open 12 Toronto beds for youth with concurrent disorders.

Some in the field are optimistic the government appears to be listening and has boosted base funding, but say much more is needed. Services like Breakaway haven't recovered from cuts made over a decade ago.

For Megan, it's one day at a time. She's finishing high school and has been accepted at college this fall to study social work. Her parents, pleased with her progress, weren't happy she came home from treatment earlier than planned. She relapsed once, smoked weed, but has been free of hard drugs for two years. They say they've all they can, and Megan has the tools.

"She knows it better than we do; we just hope she makes the right choices," says her mother.

Megan recognizes she is fortunate. On her bedroom wall is a picture of the friend she lost to drugs. His memory haunts her. She says it motivates her, too.
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