I had no plans to write about Mental Health Awareness Week, but there’s this conversation I recently had with a male paediatric psychiatrist that struck a chord. It continues to disturb me, because it rang true. So, I need it off my chest so to speak. I need it out of my head.
Get Loud for Girls? You might be wondering why just girls? It’s Mental Health Awareness Week and I want you to get loud for everyone. Get loud for the 1 in 5. BUT, I want you to think hard about whether Mental Health Awareness and Care is equal for males and females, especially when it comes to children and youth. Sit with that for a moment and let me share the broad strokes of this conversation I had recently.
I was sitting there in the doctor’s office during a regular appointment for my one daughter. It was a bi-annual thing. The appointment to double check her medicines, her height and weight, and discuss her growth trajectory and behaviour at school and home. To be honest I view these appointments as perfunctory. I resent having to remove my child from school sometimes to discuss her strengths and shortcomings in front of her. It is maddening. But I do it because it is the only game in town, and because she has followup care. She also has a caring doctor that is involved. Does he always understand exactly what I am telling him about her needs? No. Definitely not. But we meandered through half a dozen experts before finding this one. So, here we are on a recent spring day talking attention deficit disorder and learning disabilities, anxiety, gender and lifelong outlook.
Towards the end of the appointment, I asked a question regarding my other daughter. My oldest has had anxiety disorder for years. She manages and does extremely well most of the time. We have done all the things, from play therapy to art therapy to medication and youth mental health group treatment and cognitive behavioural therapy. Stressing again that she does extremely well. BUT, that said she needs to be followed.
Despite my experience as a parent of children with special needs, and all the health care gaps we have seen and fallen into, I anticipate that a person in Canada with any diagnosis gets care. Diagnosis, treatment and followup care. Anxiety medications are serious. All medications are serious actually, especially in kids. And yet nobody follows her.
How can that be you ask? Well when you complete the intensive youth anxiety treatment group at the hospital they discharge you. They suggest your family doctor can follow your child and write the prescriptions out. And that is all well and good. Until your family doctor says – wait what is the follow up plan?- the outlook? the longterm? Then he stops because he questions why there is not continuity of care for a young girl with generalized anxiety disorder. And this is not his expertise. He clearly feels uncomfortable.
So a massive chasm opens up again. We begin questioning AGAIN where is this going and why is nobody following this girl? And why is children’s mental health care so bloody hard to navigate and access. Truth. We were told years ago that the expert at London Health Sciences who diagnosed my older daughter would not be able to follow her. SHE works out of Toronto as well and is stretched super thin. We would have stood on our heads and sung the alphabet in Mandarin while juggling flaming swords with our feet to get assessment and diagnosis at that point.
While taking care of my youngest girl and gathering her prescriptions, I ask her current specialist who is not accepting new patients, about the side effects of a medication. He confirms immediately that YES, that what you are describing is a definite side effect of a stimulant medication. That needs to be checked out and monitored or she needs to come off of that medication under doctor’s supervision. On a whim, I tell him her story that she has no specialist and the family doctor is leery to even write her prescriptions.
He offers to take her referral if I direct the family doctor to do it quickly. But first he says – I am not surprised. Not surprised at all. Family doctors receive very minimal training in mental health issues and treatment, he says. Many doctors will not tell you but the last thing they want to take on is a young girl with mental health issues. Eating disorders, and puberty and mental health and anxiety – all of these issues have them running scared. And they can be hardest to treat in young girls. His words. Not mine. A specialist with decades of experience working in mental health care in Ontario.
That one conversation has stuck with me months later. It was my WTF moment? Because health is health and doctors are sworn to help care for their patients, regardless of their diagnosis, age, colour, disability, ability, race, gender…..right? ROLLS EYES, SHAKES FISTS at the heavens.
Well there’s theory and then there’s reality. And months of searching for a person to follow a child with anxiety shouldn’t be this hard. His observation actually rings true. It gives me context for all the challenges we have had over the years, which I thought were related to diagnosis. But never ever considered might have something to do with gender.
So this week I am getting Loud for Mental Health Awareness Week. I am also getting loud for Girls. BECAUSE if you need health care you should get it and 1 in 5 people have mental health issues or disabilities. Be honest, we all know someone with a mental health diagnosis. I know 5 or 6 people in my extended family alone and 3 of those were/ are girls.
The ability to access timely and appropriate mental health care for both of my daughters has been challenging often and I have written about that. Here’s one of the first pieces I wrote about my daughter’s anxiety for Today’s Parent magazine. Change is happening. Awareness grows. But we need so much more still. …We need to invest in is education and training for young doctors. In fact we might consider incentivizing some to step into children’s mental health so kids, and in particular young girls are not left vulnerable and under serviced.
GET LOUD and USE the LOUD:
So Get Loud. Get Loud for children and adults and Get Loud for Girls. But don’t get loud for a day or a week. USE THE LOUD UNTIL the gaps are filled and girls don’t have to shout, or self harm to be seen, diagnosed, treated and followed.