Remember those spray-painted squares at school? Now imagine the 4th square was painted over in favour of new snakes and ladders instead of hopscotch. You thought you were playing hopscotch, but every time you try to leap across the 4th square, you fall to the ground. Someone changed the rules on you mid-game.
This is undoubtedly the case for over 160,000 young adults in Ontario with serious mental illness trying to navigate the gaps in adequate mental health care.
Approximately 1 in 12 young adults ages 15 – 24 struggle with a serious mental illness that will directly impact their future success. Yet the gaps in Canada’s mental health services are well documented, and year-long wait times for programs over a mere 6-8 weeks show no signs of improvement.
Individuals with serious mental illness are at high risk of homelessness, substance use, unemployment, hospitalization, and police or paramedic interventions. It is estimated that young adults 13-24 years of age make up 20% of Canada’s homeless. A study conducted by the Canadian Observatory on Homelessness found that 85.4% of homeless youth were experiencing a mental health crisis, and 42% of homeless youth reported at least one suicide attempt.
The impact of mental illness is devastating for each individual; however, Ontario’s support systems are burdened with added cumulative costs, as we flounder to bridge the gap between what our youth need and what is available in mental health care.
Simply put, there is an enormous cost to supporting young adults with mental illness and homelessness within Canada’s current fragmented framework. A 2017 study published by the Canadian Medical Association, calculated the cost of supporting a homeless individual in Canada ranged from $30,000 to $59,000, with the bulk of the cost distributed towards ambulatory and psychiatric services, such as emergency room visits. The social and communal costs attributed to serious mental illness are unsustainable and inadequate to aid individuals in need.
Looking at the lack of adequate mental health care and consequent overloading onto other support services, perhaps one would suggest increasing the capacity of counselling or residential programs. It seems logical that if more people can access these services, we could quickly alleviate these issues.
Unfortunately, fixing the hopscotch pattern is not as simple as painting all the squares bigger.
One potential improvement is advancing the current model of residential mental health treatment programs. Current residential mental health treatment programs are often 30 days to 8 weeks in length and are our most intensive form of care available. Treatment-oriented residential programs are typically considered when other, less intense treatment in the community has already been attempted or individuals are living in unsafe environments or at risk of homelessness. However, studies have shown the commonly touted shorter, “30-day” treatment courses are insufficient and that longer treatment durations (3-6+ months) are generally attributed to better outcomes for mental health and substance use disorders.
For example, the NIDA-funded Drug Abuse Treatment Outcomes Study (DATOS), has shown that program participants that dropped out of residential treatment before 90 days had relapse rates similar to individuals who only attended treatment for 1-2 days. In a study comparing short (2 months) and long-term (12+ months) residential treatment programs, it was found that after discharge, long-term program participants were more likely to maintain abstinence and less likely to experience homelessness. In addition, participants in the long-term program had decreased psychiatric hospital use in 6-month follow-ups to treatment and three-quarters of participants had a decrease in the severity of substance use disorders
One of the long-term residential treatment program models with profound success is rural-residential treatment and recovery-based programs. One of the first of its kind, the Massachusetts Gould Farm treatment program has been shown to reduce hospital stays related to mental illness, the need for emergency services, homelessness, incarceration, and unemployment. A review of patient outcomes also showed that these positive benefits were not limited by patients of certain ages, gender, education, fee level, or psychiatric diagnosis.
Clearly, one of the obvious gaps in Canada’s mental health care services is our lack of comparable long-term residential treatment programs. Over three years, Ontario has sent 50 individuals to the U.S. for long-term residential treatment at Gould or similar programs at the cost of $4.3 million. There are, of course, many more individuals who would benefit from these services. By investing in building a comparable treatment model in Ontario, we can expand access to these services and reduce the costs by an estimated 50%.
Eli’s Place, a rural residential treatment and recovery-based program modelled after The Gould Farm, will help close this gap in Ontario, by providing long-term care for young adults in need. Like the leading Gould Farm, Eli’s Place programs look towards incorporating therapeutic care, work, skills training, and life-skills development to support young adults during their stay. In a safe, communal environment, participants will build strong connections with staff, fellow participants and volunteers and learn how to manage their mental illness and maintain their mental wellness. Participants and families will benefit from continued support during a 6-month residence followed by a 12-month transitional support program as participants find their footing in the community.
Of course, building an entirely new treatment centre will not be easy, nor will it be an instant fix for the challenges young adults and Ontario’s mental health services face. It will be an arduous journey, an odyssey, so to speak, as teams of volunteers, fundraisers, families, and clinical staff come together. For our first endeavour, Eli’s Place is eagerly preparing to launch a capital campaign in 2022, which will enable us to secure a home for Eli’s Place. Slowly but surely, we hope that as Eli’s Place comes to life, when one more individual trips and falls, they will find aid instead of falling through the gaps.
Eli’s Place will be a rural, residential treatment program for young adults with serious mental illness. To learn more about our mission and our proven-effective model click here.
Carmen Li | Eli’s Place Peer Advisor
My name is Carmen; nice to meet you! I am currently working in a food allergy lab as a research student at SickKids Hospital. In my spare time, you can catch me trying new recipes or outdoors on a hike.
“Sometimes navigating your mind feels like competing in a triathlon without knowing how to walk, run, jump, swim, or all the fun bits you were already supposed to know already. Know that you don’t need to go about it all on your own.”
