SUNDRE – As society seems to be taking steps toward dismantling the stigma often associated with seeking support for mental health, there is a growing emphasis on complementing the more traditional preventative physical health-care model by opening doors to facilitate access to mental health resources as well.
“I think over the last few years we have definitely seen destigmatization of mental health issues and people are realizing the value of talking about stuff and not bottling it up so to speak,” said Dr. Jonathan Somerville, a physician on the team at the Greenwood Family Physicians clinic.
Recognizing the importance of preventing smaller issues from metastasizing into much bigger problems, Somerville agreed to team up with registered nurse Irma van den Hadelkamp, who works for the Peaks to Prairies Primary Care Network (PCN) in Sundre and Olds, when she approached him with a pitch that immediately captured his professional interest.
A few years ago, the PCN identified a gap in youth mental health resources after conducting a survey with doctors in the area, said Hadelkamp.
So when she was approached about the possibility of getting involved in developing a local youth mental health initiative, Hadelkamp said she didn’t hesitate.
“Definitely I was interested in it,” she told the Albertan on Tuesday, Dec. 5 during an in-person interview alongside Somerville in a staff break room at the clinic.
A follow-up survey was conducted to get a better understanding of how doctors are trained to address mental health issues in youth, she said.
“Most of the time, the doctors refer them to the psychiatrist,” she said.
That meant the wait-list for youth to see a psychiatrist was upward of six months to a year or more, she said, adding part of that stemmed from family physicians not necessarily being familiar with identifying whether medication might be a warranted part of treatment.
In other words, she said while family physicians are certainly able to provide help with for example counselling, they don’t always have the repertoire of knowledge required for prescribing medications to address mental health ailments.
Courtesy of a program offered through Peaks to Prairies, doctors and other health-care professionals like Hadelkamp were able to complete a two-day course that familiarized the participants with the kinds of available medications.
While mild to moderate cases can typically be dealt with in the home environment, more severe situations will likely require a psychiatrist. And first being able to better differentiate between mild, moderate and severe cases has also had a beneficial ripple effect of significantly reducing the wait-list to see a psychiatrist, she said.
As different PCNs began considering ways to implement the initiatives in their own communities, Peaks to Prairies was also “brainstorming what would work for Sundre,” she said.
That’s when she approached Sundre High School principal Scott Saunders and Dr. Somerville to discuss options.
“And they were like, ‘Yes. Yes please; we definitely need that.’ It was like, the sooner the better actually,” she said. “They really welcomed this.”
From there, they all agreed the school would be the best place to provide a monthly opportunity for students who were either referred to the program or perhaps sought it out on their own terms.
“They are in that safe environment anyway, they don’t need to go in somewhere else,” she said.
As the trial project launched only a few months ago in September, there’s an ongoing effort to track the extent to which the program is being tapped into and whether more visits might eventually be deemed worthwhile.
“The high school is working very close together with us, and so far they’ve actually made sure that our afternoons are full,” she said, adding parents and guardians are welcome to call her at 403-586-0371 if they have questions or are interested in meeting with her.
Overall, the focus is to get ahead of issues before they potentially spiral into an even harder situation to resolve.
“What we’re trying to target is early identification and intervention,” said Somerville.
“The idea of having it at the school is that it’s one less barrier. If they have something that they want to talk about, it’s easier because we’re coming to them,” he said.
“We’re involving the families without them having to take more time out to go to appointments,” he added.
“It’s a whole family approach, that is definitely our goal,” said Hadelkamp.
Considering many people also don’t have a family doctor, which can impose another hurdle to accessing mental health care services, the initiative through the school can open those doors.
“The whole idea is remove the barriers; get to us as easily as possible,” said Somerville, adding the only limitation for now is only having enough time available for monthly sessions.
“It’s just basically Irma and I – we don’t have any other doctors on board at this point that are able to help out,” he said.
While the school does have existing supports such as mental health workers and guidance counsellors, staff are only qualified to do so much.
“They have really good support in terms of the counselling and that, but when it comes to medication – if that’s needed in terms of more of a medical investigation, intervention, follow-up – that’s where we come in,” he said, adding the school has “a lot of the puzzle pieces already there, and we’re just one more kind of facet of treatment.”
Lines of communication are also kept open with a family physician if the student has one, said Hadelkamp.
“So we can make sure that their doctor is aware, and if it can go back to the family doctor, it will go back to the family doctor,” she said.
Asked what are among the more common concerns raised by students, she cited anxiety as well as depression, and sometimes ADHD.
But those issues are not isolated to Sundre.
“These are problems that are pretty universal right now. Like, provincewide, nationwide, probably worldwide,” said Somerville. “Definitely an increase in things like depression and anxiety. So, it’s not unique to Sundre.”
Among the tell tale signs a student is struggling with their mental health is when they start demonstrating trouble learning.
“That’s often where it’s highlighted first,” he said. “Something is affecting their success in school, or they feel it’s affecting their success. And it can be anxiety, it can be ADHD, it can be depression.”
There are various factors as to why these issues arise, but social media-induced stress or anxiety is certainly among them, they both agreed.
“We know that on a population level, social media for example is very detrimental to mental health,” said Somerville.
“It creates issues with comparison, so there’s a constant comparison of yourself to others. It creates issues with loneliness, because you have this sense that other people are happier or having fun, and you’re not,” he said.
And of course the temptation to just scroll through posts and check notifications scrambles attention spans.
“It’s a distractor,” he said about social media.
“We don’t go after folks and tell them you can’t use social media. (But) it’s definitely something that has to be considered.”
However, the pandemic also played a big role.
“The disruption of social groups, sports groups, and other peer groups that happened through COVID was also detrimental,” he said.
Accurately assessing where mental health issues stem from is crucial to determining the best course of action for treatment. And that does not necessarily automatically mean a prescription for pills.
“It’s one of our goals I think, is to always look at the big factors and not jump to medications, but to look at everything that’s contributing to the problem in the first place,” he said.
Both agreed that sometimes, just talking through an issue can go a long way toward alleviating anxiety.
Asked what are some of the challenges they face and whether there perhaps is a lack of support, Hadelkamp said, “I feel like the support is actually there.”
Citing as an example the Mountain View Family Resource Network, she said, “There are actually more resources than I thought there would be.”
The main hurdle, she said, is connecting students with those available resources. The program also requires a level of commitment, as a person can only get out that which they are willing to put in, they both said.
“You don’t want to make it an extra thing that they feel like it’s extra homework,” said Hadelkamp.
“But working on mental health is asking something from you. And if they don’t want to put that in, then it’s really hard for us to help them,” she said.
“But it’s so beneficial if they do.”
And recognizing that not every home life offers adolescents with an ideal situation, Somerville said, “We explore everything. Nothing happens in a vacuum, so everything needs to be looked at from all aspects.”
Somerville has found rewarding the “the level of engagement and interest, and building the connections with the school, building the connections with students’ families. I think it’s been very positively received.”
Acknowledging the pilot is still early on, he expressed confidence about its potential for success.
“I think it’s going to be good given the level of engagement. We wondered initially if we would be sitting there with nobody coming,” he said.
Word also seems to be spreading, with Hadelkamp reporting that River Valley School has also expressed an interest in the initiative.
“I’m just looking into that,” she said, optimistic about the possibility of rolling out a similar program for the elementary school in 2024.
Offering advice for either students or perhaps families and friends who are concerned about a student, Somerville said, “It never hurts to reach out I would say. There’s lots of things that could be a normal experience of life, and sometimes it’s reassurance that you’re not alone. These are common experiences; it doesn’t mean that every time you have sad day there’s an issue.”
Hadelkamp also urges against automatically jumping to judgemental labels of mental illness when someone is dealing with a bout of anxiety or depression that in many instances might be a temporary period they’re going through and can be resolved.
“Please reach out for help, there is help out there. That doesn’t always mean you need medication,” she said.
“Mental problems are not always a mental illness,” she said.
“I would even say mental health care is like physical health care,” Somerville added. “There’s a role to preventative health and reaching out before problems become illnesses.”
In other words, just as it is important to practise preventative physical health care such as exercise, it’s also worthwhile to practise fostering a healthier frame of mind, he said.
“I think it’s unfortunate we don’t get people that would maybe come because they want to stay in the best mental health,” he said.
“We’d be happy to talk about that too, just ways to maintain good mental health.”
