When I first got into occupational therapy, people told me to keep my options open, but I knew regardless of what my job title was I would spend my career working with kids.
I know early intervention can positively affect the trajectory of a person鈥檚 health throughout their life. That quick response can help children and families understand their challenges, learn new skills or adapt their environment for success.
Early on in my career, 80 to 90 per cent of my practice was working with kids with developmental delays as a result of a physical disability. Down Syndrome, cerebral palsy, spina bifida 鈥� diagnoses that, thanks to advances in medical care, occur less frequently in babies born today. But our clinical caseload didn鈥檛 diminish. What happened instead was the emergence of health conditions that can鈥檛 be seen on the surface.
So I got curious. Why were these children having trouble sleeping, self-soothing? Why were they struggling to manage mealtimes, feed themselves or play with their peers?
The answers lead to a key finding: children were having trouble keeping their brain in the 鈥渏ust right-zone鈥� of nervous system regulation. That鈥檚 the area of the brain from which we need to function most of the time to succeed at learning, playing and having healthy relationships.
There鈥檚 always a reason for a child鈥檚 behaviour 鈥� always a message behind that communication. The team I lead at Island Health has evolved our practice to look more deeply underneath and consider other factors in each of these children鈥檚 stories. Trauma is one such factor that is important to consider.
Trauma by its nature is complex. It can be defined as any event or circumstance perceived as overwhelming. What鈥檚 traumatic for me may not be for you based on our personal resilience, how severe an incident or circumstance was and what immediate support is given when it happens.
Observing violence in person or even via technology can be traumatic, as can coping with a parent鈥檚 illness or absence. These are just a few of thousands of possible examples.
In my career I鈥檝e seen mental health become the No. 1 issue facing kids on Vancouver Island. Last year in Victoria, more than 1,100 Island youth 19 and under visited the emergency room with a mental health or substance use issue.
The list of social determinants for this trend is long, from substance use to social media to key shifts in how our society functions. By necessity, many families are busier with both parents working. We live in bigger houses with fewer people in them, losing our 鈥渧illages鈥� 鈥� and the way we as a community wrap care around our children hasn鈥檛 kept up to these changes in pace and lifestyle.
One of the biggest opportunities we face in health care right now is the creation of youth-focused spaces that work across systems and agencies to provide integrated primary and mental health care for our children as early in their journey as possible. Part of our local solution will be the construction of a low-barrier youth health hub in downtown Victoria this fall. Access to services remains the biggest barrier facing kids and families in need of support today.
Our aim at the hub will be to provide youth friendly, stigma-free safe space, with collaborative care building on the strengths of each kid. Every door at the Victoria Youth Hub will be the 鈥渞ight door.鈥� This might include a family doctor, psychiatrist, nurse, counsellor, peer support worker 鈥� each helping youth to recognize their own strengths and realize their own potential.
Susan Gmitroski is manager of child, youth and family mental health at Island Health.
