Physical distancing measures have been an important tool in slowing the spread of COVID-19. These measures, however, are having dire implications on people who use substances – a population that is seeing record number deaths from drug overdose in the last year. Media attention of the overdose crisis has focused on adults, even though in 2019, 20% of opioid-related deaths were in youth and young adults.
Youth are in a particularly precarious situation during the COVID-19 pandemic. Developmentally, adolescence is characterized by increased social interaction and engagement with peers. During the pandemic, youth are being asked to spend more time at home and are losing the typical experiences of school and extracurriculars. This shift may have significant impacts on youth mental health, and may be a contributing factor to an increase in substance misuse.
In 2020, Saskatchewan (and much of the country) had a record-setting year for drug toxicities and overdose. Saskatoon’s Police Chief Clive Weighill has said that the COVID-19 pandemic and the loneliness and isolation that comes from it is contributing to these numbers. There is a need for services to adapt to the ongoing COVID-19 crisis but a shift and improvement of the system overall is needed beyond.
The Canadian Association of Mental Health says that there is a powerful tool in combating mental health and substance use in youth and that is through using the voices of youth themselves. Dr. Henderson, Director of the McCain Centre for Child, Youth and Family Mental Health, says that “it is time youth with lived experience are recognized for the expertise and leadership they can bring to mental health research and to service planning.”
Canadian youth have been having a difficult time maintaining positive mental health as social isolation continues. The feeling of being disconnected from others has caused some youth to have heightened social anxiety, feelings of loneliness, and to be lacking motivation.
The loss of extracurricular activities, such as sports and school clubs, have left many youth feeling lost and without places where they can meet new people, try new things, and be themselves. The declining mental health of Canadian youth may not come as new information, as youth mental health has been worsening since the initial lockdown in Spring 2020. As isolation continues, parents have been worried about their youth, who are missing out on social environments and milestones that support proper development in their adolescent years.
Youth are being encouraged to stay connected with their peers through phone or video calls, online game nights, online movie nights, or physically distanced time outdoors. Although this is not the same as social interactions used to be, youth are being encouraged to adapt as much as possible until they are once again able to be in close proximity with their out-of-household loved ones. Caregivers are being encouraged to support youth as much as possible during this time by encouraging their virtual social interactions and starting conversations about mental health, confessing their own vulnerabilities as well to let youth know they are not alone.
Provinces throughout Canada are taking action to end the controversial practice of birth alerts. The Northwest Territories has instituted a ban on birth alerts more than a decade ago. Alberta, British Columbia, and Yukon followed suit in 2019. Having the highest per capita rate of children in care in Canada, Manitoba ended their practice of birth alerts as of June 30, 2020, along with Ontario. Saskatchewan began reviewing their birth alert practice in 2019, and along with PEI, has officially banned them as of February 1, 2021. Birth alerts are still practiced in Quebec, and are currently under review in New Brunswick, Nova Scotia, and Newfoundland. In Nova Scotia, advocacy for ending the practice is growing.
The call to end birth alerts was largely influenced by the practice’s discrimination against Indigenous peoples. In Saskatchewan, 439 children aged 30 days or younger came into government care between 2015 and 2019. Out of those 439 newborns, 341 were Indigenous. This practice has been damaging to the already distrusting relationship between Indigenous peoples and the health care and child welfare systems. Efforts and funding have instead been focused on developing and/or improving community-based and culturally safe services to identify and support at-risk parents during and after pregnancies. Organizations such as Sanctum 1.5 in Saskatoon have had an impact in these efforts.
Have a Heart Day is a child and youth-led reconciliation event in Canada that occurs on February 14 to help ensure First Nations children have the opportunity to grow up in a safe home, receive a good education, be healthy, and be proud of who they are.
COVID-19 has changed the way Have a Heart Day 2021 will be celebrated. Instead of the usual public events, it is being encouraged that teachers, students, families and households celebrate the day within their classrooms, at home, or online.
First Nations Child and Family Caring Society has provided several ideas for children and families to celebrate Have a Heart Day while still abiding by COVID-19 restrictions:
Events like Have a Heart Day are creating a movement where the Canadian landscape is one where First Nations children are able to grow up with honour and possibilities.
Housing is not often affordable for youth and families in vulnerable contexts. A new 10-unit apartment complex in Charlottetown, P.E.I. has been built to support youth transitioning out of care at age 18. Youth ‘aging out’ of care may report feeling as though they have nowhere to go or that they do not currently hold the life skills needed to live on their own. The apartment complex has on-site staff to provide support for life skills training, such as cooking, cleaning, budgeting, and organizing. The units are bachelor-style apartments, and tenants may stay for up to 18 months, paying affordable rent based on their income. There are also other tenants in the building who are not a part of the program, but utilize the apartments’ affordability.
Housing costs have increased heavily in recent years, causing many youth and families to live in quality-inferior housing as this is all they are able to afford. Housing instability put new mothers in jeopardy of losing custody of their children. According to the Quint Development Corporation in Saskatoon, Saskatchewan – which supports mothers who are either close to losing custody of their children or have lost custody of their children and are working towards reunification – many supportive housing options are not widely available for mothers with children, as the homes are often not large enough for families. According to their 2019/20 annual report, out of their 209 affordable housing tenants, 87 are children.
Youth transitioning out of care in provinces with no moratoriums in place have been having amplified difficulties finding affordable housing during COVID-19. Children growing up in foster care may have been apprehended as a result of a birth alert, which many mothers receiving support from Quint Development have experienced with their children. As Saskatchewan’s decision to end birth alerts became official on February 1, 2021, community organizations have been calling for more support for vulnerable families, starting with establishing firm foundations through affordable and supportive housing.
Canada is currently experiencing a mental health crisis among its youth population which includes high rates of mental illness, suicide and delays in accessing services. Young people aged 15-24 are more likely to experience mental health crises than any other age group. These issues are being exacerbated by COVID-19 and reform of the mental health system is critical as we continue to move through and emerge on the other side of the pandemic.
Funding for youth mental health initiatives is important as it’s reported that 70% of adults with mental health issues develop symptoms in adolescence. Prevention and early intervention is key in managing the progression of mental health concerns and in supporting youth as they move into adulthood.
Affordability is an issue within the mental health system and youth in lower socioeconomic groups are three to four times more likely to report poor mental health. Some agencies offer free psychological support, but wait times can be long. Privatized psychological care is expensive and is not accessible to youth living in lower socioeconomic demographics. Affordability is also a barrier to youth who may be
trying to access services without a parent or guardian’s support.
Service providers should be using evidence-based modalities with youth and should be offering virtual or tele-services to underserved youth. COVID-19 has highlighted the feasibility of online services which can offer a farther reach than standard, in-person options. The new opportunities that are available with virtual services need to be met with an investment in research and clinical guidance to ensure that the programming is within the current best practice standards.
Mental health services within schools are not able to meet the demand and tend to focus on academic issues. More research and youth engagement is required to properly service the mental health needs of youth in schools.
Holistic models of mental health care are emerging and center around the severity of a person’s illness and the stage of development they may be in. Services in emerging models are holistic in that they include in-person, virtual and outreach care, and also extend into early adulthood to ensure a smooth transition to adult services. Youth engagement should be used in the development and evaluation of
mental health services – it provides opportunities for youth empowerment and can offer vital insights and benefits for individuals, organizations and communities.
The Saskatchewan Alliance for Youth and Community Well-Being offers free mental health toolkits that can be accessed online at https://saycw.com/resources/toolkits/. Topics of the toolkits range from mental health and substance use to culture, sexual identity and general wellbeing.