The Office of the B.C. Representative for Children and Youth has renewed its call for a comprehensive provincial child and youth mental health strategy in the wake of another youth failed by B.C.'s mental health services.
Missing Pieces: Joshua's Story, the latest report from the representative's office, details the life and untimely death of 17-year-old "Joshua"— a pseudonym chosen by his mother. Described by his family as an "intelligent, caring," young person who loved his cat and wanted to help people, Joshua struggled from an early age with severe mental health issues that manifested in self-harm and multiple suicide attempts.
Despite interventions from mental health, child welfare, and education professionals, as well as an engaged and supportive family, Joshua committed suicide in summer 2015 after a nearly five-month stay at BC Children's Hospital.
In a press conference with reporters recently, the office's Bernard Richard said the sole recommendation for preventing situations like Joshua's is a comprehensive, adequately resourced mental health strategy for children and youth. The report gives the province 12 months to develop, and 24 months to implement, such a strategy.
It's a recommendation the office first made in 2013, one echoed by the government's select standing committee on children and youth last year.
"The system needs an overhaul, it's time to get on with it," Richard said.
Both Children and Family Development Minister Katrine Conroy and Mental Health and Addictions Minister Judy Darcy said they have accepted the recommendation and are working on a province-wide mental health strategy with particular focus on kids, youth and Indigenous communities. They expect to meet the 12-month deadline.
"We absolutely agree that we have to collaborate across government, and across service providers, to create a system that supports families like Joshua's with the full range of mental services that they need," Darcy said.
Missing Pieces is clear a comprehensive mental health strategy may not have saved Joshua's life. However, it would address the significant gaps in supports he received.
Joshua's mom first contacted the Ministry of Children and Family Development when her son began self-harming at age two. From age eight to 11, mental supports from the child and youth mental health branch ended four times without follow-up when health professionals determined Joshua had made sufficient progress.
He first attempted suicide at age 11, and by age 13 he was refusing to go to school. Another referral to child and youth that year never resulted in supports because the clinician could not reach the family.
A third suicide attempt in 2015 landed him in BC Children's Hospital for 122 days. Less than a month after he was admitted, Joshua's care team, including ministry and hospital social workers, were unable to develop a post-release care plan because Joshua had no place to live as his mother was "overwhelmed" and unable to care for him.
Missing Pieces calls out the lack of "step down" beds in B.C. for youth like Joshua who are ready to leave the hospital but still need supervision and supports. There are also no residential alternatives to hospitalization for youth, known as "step-up" treatment, in B.C.
Additional youth mental health and addictions treatment beds opened this year, with more coming in the 10-bed Child and Adolescent Psychiatric Stabilization Unit at Surrey Memorial Hospital later this year. As have more "Foundry Centres," where at-risk youth can access mental health, addictions, employment and education services.
Darcy would not say what supports families like Joshua's could access while waiting for a strategy, nor if government could meet the 24-month strategy implementation deadline. But she says government is "100 per cent" committed to completing the strategy.
"There's nothing more pressing than to ensure that our young people get the support in life that they need," said Darcy. "We will be giving it everything we have."
This news story first appeared on www.thetyee.ca on Oct. 5. Katie Hyslop is The Tyee's education and youth reporter.