No evidence but plenty of runaround in Ontario Shores’ decision to cut adolescent long-stay beds

When James Martin, a former program facilitator at Whitby Mental Health Centre (now Ontario Shores Centre for Mental Health Sciences) sent a letter to the Minister for Child and Youth Services asking about funding for the hospital’s adolescent programs, the Honourable Laurel Broten sent him a tersely worded letter suggesting he instead contact the Central East Local Health Integration Network.

The funding is linked to plans affecting an adolescent residential rehab program that the hospital has run for more than 40 years. Youth from across the province with three to seven prior hospitalizations are admitted to the program. In the past it has claimed success with teens for which the mental health system was a revolving door.

When Martin did just that, asking for a record of consultations undertaken by the hospital and evidence to support the changes, he received a letter back from James Meloche, a Senior Director at the CE LHIN.

Instead of giving Martin what he asked for, the LHIN told him that Ontario Shores had “engaged in an extensive review of their Adolescent Inpatient Services through a process that included dialogue and input from community healthcare providers, users of Ontario Shores Services, hospitals, community agencies, Ministry of Child and Youth Services, school boards, family services, as well as representatives from the Child and Youth Worker profession at Ontario Shores.”

Meloche also omitted answering his question regarding clinical evidence.

In fact, we had heard this before – from Ontario Shores itself. It’s almost word-for-word from a letter sent by Glenna Raymond in December to Keith Lindsay, President of the Ontario Association of Child and Youth Counsellors.

Our local has asked for the specific consultations and evidence-based practices for weeks. They were told it had to be prepared, even though one would have to wonder why evidence used to make a decision had to be prepared AFTER the decision was made?

This week we tried again to access a detailed record of the consultations and evidence from the Central East LHIN. We were politely told that Ontario Shores would be willing to provide it to us. We still don’t have it.

Remarkably, Ontario Shores told OPSEU’s steward on the unit the delay is because the evidence and consultation list had to be instead given to the communications department to deal with the adverse publicity surrounding changes to the units. Have they never heard of the photocopier?

Meanwhile, time is ticking on the layoffs of 28 Child and Youth workers, who will be finished by mid-April.

When we contacted the American Academy of Child and Adolescent Psychiatry – purportedly the source of this evidence according to a Dr. Wilansky-Traynor – they said they too would like to know what evidence Ontario Shores is using from their organization.

Reviewing the AACAPs guidelines for adolescent residential care, it is hard to make the connection between its recommendations and Ontario Shores’ decision to layoff CYCs, merge the short and long stay programs, and reduce access to the long stay program.  

Even though this program is not covered under the accountability agreement between the LHIN and the hospital, the Meloche letter does acknowledge that the LHIN was “apprised of the service changes.” So why are they so reluctant to share what they know or ask needed questions?

Given the LHINs were created to look at the big picture in regional health care planning, why is it they are so hands-off when it comes to a program that is province-wide in scope? The long stay program is the only one of its kind in Ontario.

Further, why is no one asking why a group of Child and Youth Workers, who are among the list of consulted, are unaware of being consulted? In fact, the workers tell us they cannot find anyone who admits to being consulted on the specific changes to the long stay program. That includes referral hospitals and agencies to the program.

And of course, as we have seen before, consulting does not necessarily involve listening.

In the letter from CEO Glenna Raymond to Keith Lindsay, she says the consultation was about increasing access to specialized assessment, stabilization and treatment services – in other words, making more short stay beds available. That’s very different from consulting on whether to effectively gut a long-stay adolescent residential rehab program that has had success for more than 40 years.

It’s time the Minister of Health and the Minister of Child and Youth Services put a stop to this nonsense and demand some real answers from Ontario Shores.

One response to “No evidence but plenty of runaround in Ontario Shores’ decision to cut adolescent long-stay beds

  1. Sandy Brown RN; CYC

    I retired as Clinical Coordinator of Adolescent Services in 2006 after 28 years with the programs. I am gravely concerned over the destruction of all programs in the hospital. The replacement of CYCs by nurses is a concept made without knowledge of the skills and training of CYCs. Nurses recieve minimal training in psychiatry at University, (in fact McMaster does not include a specific psychiatry course but rather mixes concepts in other courses) and recieve minimal clinical experience in psychiatry prior to graduation. Child and Youth Counsellors on the other hand, spend 3 years at college studying specifically child and adolescent normal and abnormal behaviour and psychology and its its management / treatment. All of the CYC clinical placements are in child and adolescent settings that deal with kids who are not coping in life for many reasons.
    I say the release of CYCs is based on lack of knowledge only to be kind actually. The management at Ontario Shores and the Professional Nurses Committee have been given this information for years but refuse to acknowledge any non regulated clinician providing specialty treatment and service to mental health clients. This includes CYC, Behavioral Therapists, Developmental Service Workers, Recreational Therapists to name a few. They are determained to run a Tertiary Care Facility like a General Hospital, a direction obviously mandated or at least supported by a very unknowledgeable LHIN. Who are these people accountable to???
    Concepts that Neuberger says are “state of the art ” have been embeded in adolescent programs for decades. Individual treatment programs developed by CYCs and measured by CYCs are well and beyond any program in the facility and even beyond ” state of the art ” in terms of suitability for youth, effectiveness , measureability and transferability.
    My heart is with the CYCs and Adolescent Services but I fear that the destruction of services for youth and adult clients is so extensive, that Ontario Shores will become the ” Haiti of Mental Health Services “

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