Dr. Perry Adler heads the Jewish General Hospital’s Vicki and Stan Zack Family Teenage Health Unit and its Teenage In-House Psychology Service (TIPS)

Clinical psychologist Dr. Perry Adler, who heads the Vicki and Stan Zack Family Teenage Health Unit at the Jewish General Hospital (JGH), paints a stark picture of the toll the last few years have taken on young people.

“The pandemic was tough on all ages but was most difficult for those aged 10 to 20,” he said. “It’s a time when kids are trying to individualize themselves from their parents, but instead the pandemic put a bell jar over everyone. They were prevented from doing so many things.”

As a result, he said, they suffered losses and missed experiences that can’t be retrieved, which can lead to depression and other mental health problems.

The effects of the pandemic added to long-standing and growing mental health issues in young people from the use of social media, which is also isolating, Dr. Adler said.

“You see it all the time – parents and kids out but all looking at their phones, not talking to each other. As a result, they’re not practising their social skills which can in many cases lead to social anxiety when they do need to be social.”

That’s why, Dr. Adler said, the work of TIPS is so important – the Teenage In-House Psychology Service within the JGH’s Teenage Health Unit. It is a vital service that is financed by JGH Foundation donations. “We really appreciate the funds we get from donors,” said Dr. Adler. “They support innovative programs that are important for early intervention, critical workshops for staff in schools, and helpful resources for teens.” The services are needed more than ever.

“Now we’re having a pandemic of mental health problems, especially among young people. It’s the worst I’ve seen.”

Feeling insecure and lacking trust

Many youths face great insecurity and lack of trust, to the point where, Dr. Adler said, they worry that even their best friend doesn’t like them. “Youth have a greater sense of mistrust. It’s very concerning if you feel you can’t trust even your best friend.”

The TIPS program offers 16 sessions of cognitive behaviour therapy, though many can achieve important progress in 8 to 12 sessions. Therapy usually starts with weekly sessions, which are then spaced out as patients progress, so most individual programs last five or six months. TIPS also refers patients, if needed, to further treatment through services in their locality, and helps them get into those services when needed, though some don’t need further help after their sessions. Group therapy is offered to those waiting to start their individual psychotherapy. These group therapies take a trans-diagnostic approach to teaching strategies to better regulate strong unpleasant emotions and reduce the urge to engage in non-suicidal self-injurious behaviours or suicide.

Most TIPS participants have depression and anxiety issues, but others can include obsessive-compulsive tendencies, personality disorders, psychoses, mania and eating disorders. More and more teens, he said, are presenting now with issues related to their sexual orientation and gender identity, which can lead to anxiety and social problems.

Governments at all levels greatly underestimate mental health disorders and their impact, Dr. Adler noted. Right now, in the public system there’s often a 6-18 month wait for psychotherapy, he said, adding, “It’s outrageous.”

On top of that, there are very few resources available for teenagers, a gap the JGH is working to fill, even though it is daunting, Dr. Adler said. “Our work is like trying to fill a huge repository. We have shovels and every shovelful helps, but what we really need are a bunch of backhoes.”

Mental health outreach in schools

Along with providing therapists, donor funding allows for program development and outreach to schools. The Teenage Health Unit gives workshops to school staff to help them identify and manage teens facing behavioural and mental health issues. The Teenage Health Unit also conducts visits to high schools, providing interactive bio-psychosocial education, answering questions students submit anonymously, and informing them how to book appointments for help.

The Teenage Health Unit is not just helping young people in the Montreal region. It has conducted workshops with the Cree School Board in Mistissini where there is just one psychologist serving a very large and often isolated population. “Our program is training teachers to recognize and address problems young people are having and to catch them early on,” said Dr. Adler. “We’re trying to be proactive to get them earlier and get them treatment.”

One issue still faced is attitudes towards mental health disorders. “There is certainly less stigma surrounding getting help for mental health problems now, but unfortunately it still exists,” Dr. Adler said. Another challenge can be that sometimes students are keen to access care, but parents are reluctant because of their own attitudes or cultural background.

In Quebec, however, anyone age 14 or older can get the medical care they want without their parents knowing. “As a result, nobody else needs to know they are getting treatment,” said Dr. Adler. “We prefer that parents are involved, but it’s not necessary. Often, our treatment helps teach them to be better communicators with their parents.”

Donations are also helping the staff in the Teenage Health Unit to communicate more effectively with their teen patients. Funding has permitted the program to overcome a problem staff have with youth being notoriously bad at answering “old-fashioned” phone calls. Teenage Health Unit staff have now been provided inexpensive cell phones and plans that allow them to reach patients by text – their much-preferred means of communication.

To make a donation to the Jewish General Hospital Foundation, please go to www.jghfoundation.org