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What is Mental Health?

Mental health (like our physical health) is a resource for living.  It allows us to learn, work, play and find enjoyment in life. It helps us through tough times.

From a child or teen’s point of view, mental health means things such as…

• I feel like I have things to live for
• I feel hopeful and good about the future
• I like myself
• I’m satisfied, content or happy with life
• I feel that people care about me
• I feel in control of my life

What is Mental Illness?

People have mental health problems or mental illnesses when problems with thoughts, feelings or behaviours get in the way of functioning at home, school or work. 

Everyone feels sad or upset from time to time.  But when these feelings are so strong that it’s hard to carry on at school or home, then there may be a mental health problem.

From a child or teen’s point of view, mental health problems (or mental illnesses) can mean some or all of the following:

• I don’t like myself
• I feel that others don’t care about me
• I feel sad, irritable, worried or angry a lot
• I feel powerless, and not in control of my life
• I don’t feel good about the future

Mental health professionals can help children and youth deal with problems with thoughts, feelings or behaviours like:

• Mood problems (anger, anxiety, depression)
• Eating disorders
• Psychosis, schizophrenia
• Addictions (including problems with drugs, alcohol, gaming or gambling)
• Coping with stresses with relationships, school, work and home

Overcoming Stigma 

People often feel ashamed, guilty or embarrassed about having a mental health problem. And parents may feel embarrassed about having a child with a mental health problem.  People may believe that the illness is a sign of weakness or that they really have no good reason to feel the way they do. Parents may feel guilty, that they’ve done something to cause a child’s mental illness.  As a result, this stigma can get in the way of getting help. 

Note that you can be the best parent, and your children may still have mental health struggles.

It’s probably a lot healthier if we all started looking at mental health the way we look at physical health.  If our child or teen has stomach pain that makes it hard to go to school, we go to our doctor. We don’t blame ourselves or feel embarrassed. 

For the same reason, if our child or teen is having emotional pain, or troubles with thoughts and behaviours, it makes since to get help for that too.

Ways to Find Mental Health Help Include 

• Telephone Crisis Lines. 
  • Crisis lines are a telephone number that you can call in a crisis (e.g. when a person is feeling suicidal, or their behaviour is out of control) as well as if you have any concerns (even non-urgent ones) about mental health. Some crisis services can offer mobile crisis, whereby someone can actually come to your location. Some services offer chat or texting services. Crisis lines can also tell you where to find help in your area. 
  • Examples
    • KidsHelpPhone (1-800-668-6868) is a Canada wide, free, national, bilingual, confidential and anonymous 24-hr telephone and online counselling service for children and youth. 
    • Crisis Services Canada (1-888-456-4566) is a Canada wide crisis service for adults. 
• Information and Referral Services (I & R). 
  • Want to talk to someone and ask them where to get help for a particular issue? You can call an Information and Referral Service. Examples include 211 (across most of Canada) and there are others in each province as well.   

• Family physicians or pediatricians
  • One good place to start is by taking your child or teen to see your family doctor or pediatrician.  Your doctor can check to see if there are any problems with your child or teen’s physical health, and refer you to mental health services as needed.
    
    
• Your child or teen’s school. 
  • Speak to the teacher if your child or teen is having difficulties at school (poor grades, behaviour problems or conflict with classmates).  In some cases, schools can offer help like resource teachers, social workers, and school psychologists. For students attending college or university, there is help available through Student Health Services at your university.
     
• Children’s Mental Health Centres. 
  • In many provinces there are 'children's mental health centres' that specifically provide services to children, youth and families. 
     
• Hospitals
  • Many hospitals provide various mental health services. You may need a referral from your child’s doctor for these services.
     
• Family Service Centres. 
  • These are non-profit, charitable organizations that provide services like counselling for children, youth and families. They generally charge a fee for their services, but have a sliding fee schedule based on family income.
    
    
• Addictions Services. 
  • Does your child have issues with addictions? If so, there are specialized services that specifically help with addictions. To find an addictions treatment service, one way is to ask your health care provider, or contact an Information and Referral Service 
    
    
• Support and Advocacy. 
  • Are you looking for peer support? Want to talk with other people with lived experience? There are various self-help, mutual aid and support/advocacy organizations that exist for specific conditions and issues. Many have national, Canada-wide organizations, as well as local organizations in each province and even for major cities. You can start by contacting a national organization, and seeing if they have a local chapter or support group. 
  • Examples include
    • Schizophrenia Society of Canada (https://www.schizophrenia.ca) 
    • Mood Disorders Society of Canada  (https://mdsc.ca)
    • Autism Canada (https://autismcanada.org)
    • Anxiety Canada (https://www.anxietycanada.com)
      
• Children's Coordinated Access & Referral to Services. 
  • Is your child seeing a professional and still struggling? In some communities, there are "coordinated access / referral" programs for children/youth who are still struggling despite seeing a professional. Children and youth must be referred to this program by a professional who works with them (for example, a teacher, social worker, doctor, or psychologist). This program helps children who have: 1) Very complex mental health problems; 2) Severe difficulties even with the support of many community services.

Mental Health Professionals in Private Practice

While many mental health professionals work in hospitals or community organizations, others may work in ‘private practice’.

In most cases, when you see someone in private practice, you must pay a fee for services.  But if you have an extended health insurance plan through your workplace, you may get back at least part of that fee.

Therapists in private practice may have shorter wait times and you also have more choice about who exactly you want to see.  It’s important to make sure that your therapist is qualified to provide mental health care.

Who is qualified to provide counselling/therapy?

Therapy and counselling can be given by any professional who has training in therapy or counselling.  This usually means professionals like:

• Psychologists
  • Clinical psychologists have a Masters degree in Clinical Psychology.  
  • Can provide a psychological assessment, and diagnosis mental health conditions (including learning issues such as ADHD)
  • Can check for learning problems (like ADHD or learning disabilities) though a Psychoeducational Assessment.
    
  • Psychologists and psychological associates can provide all manner of psychotherapy and psychological treatments, however do not prescribe medications. 
  • To find one, contact the Canadian Register of Health Service Psychologists (CRHSP) (http://www.crhspp.ca/) 
• Physicians (psychiatrists, paediatricians or family doctors)
  • Psychiatrists are medical doctors (MDs) who specialize in the evaluation, diagnosis and treatment of mental health conditions
  • They provide treatments such as medication and other treatments such as psychotherapy (counselling/therapy)
  • To see a psychiatrist, you’ll need a referral from another physician. Note that psychiatrists are generally covered by provincial insurance plans, and thus you do not need to pay.
• Registered nurses (RNs)
  • RNs generally work with a health care facility (such as a hospital) and provide various types of mental health treatment and support.
    
• Social workers
  • Social workers are professionals with university degrees (a Bachelor’s or Master’s degree in social work BSW or MSW).  
  • They can:
    • Provide support and intervene in a crisis
    • Give counselling and therapy
    • Help connect youth and families to community resources, financial assistance or other helpful programs
• Psychotherapists (provided they are appropriately licensed and regulated)
  • In Ontario, all professionals calling themselves “psychotherapists” are regulated by the Psychotherapy Act. The Act protects the public by making sure that only competent, trained and licensed professionals can give therapy. In addition, other trained professionals not in the above categories may also give therapy, as long as they have demonstrated sufficient training, and as long as they are members of the new College of Psychotherapists and Registered Mental Health Therapists (as defined by the Health System Improvements Act of 2007.)  This includes physicians, psychologists, social workers, nurses, among others.
    Please remember!  In many places, anyone can advertise themselves as a therapist or counsellor, even if they have absolutely no training at all. Do not see a (non-regulated) therapist or counsellor who does not belong to a regulatory body or professional association.  There is no way to check their competence, and if you run into problems, there is no way to deal with your complaints.

• Child and Youth Counsellors (CYC)
  • Child and Youth Counsellors work with children and youth in hospitals, schools, private homes and group homes. Working with other mental health professionals, they help design and implement therapeutic programs.

• Speech language pathologists (SLP) 
  • Does the person have problems with speech, or communication (such as social communication)? 
  • Speech language pathologists can help people with speech or communication problems.
    
• Occupational therapists (OT)
  • Does the person have problems with sensory issues, coordination issues? Do they have problems functioning in day-to-day activities? If so, then OT may be helpful. 

What is Counselling or Therapy?

There are many types of counselling or therapy. The most common are “talk therapies” where you talk with a professional to find ways to deal with your stress and problems.

Common types of talk therapy:

1. Cognitive behaviour therapy (CBT):

• Helps children and youth change the negative, depressive thoughts and behaviours that contribute to depression, and replaces them with more helpful thoughts and behaviours.

2. Dialectical behaviour therapy: 

• Helps children and youth build skills so that they can: Focus on what is happening in the moment (mindfulness)
• Communicate more effectively and have more positive relationships with others
• Learn to cope with upsetting feelings
• Control their emotions a little better

3. Interpersonal psychotherapy (IPT):

• Helps children and youth resolve tension and conflict that can contribute to depression.

4. Solution-focused therapy:

• Focuses on children’s strengths.  It helps them to focus on what they would like to change in their future, and what they can do to ‘get there’.

5. Other types of therapy involve music, art, hypnosis, or other techniques.

What therapy is ‘not’:

Please remember that therapy is not simply a therapist ‘talking some sense into’ a child or teen, or telling them what to do.  Instead, it is a process of working together on goals that everyone agrees to. It is essential that the children, youth and parents feel they are all working toward the same thing.

Ways to provide therapy: 

• Individual therapy:  this is one on one counselling with a mental health professional.  This is very common when adults seek help with a mental health problem.  With children and youth, the family plays a much larger and central role.
• Family therapy means that the patient and other family members meet with the therapist together. No matter how problems like stress or depression started, they usually always affect the family.  So the entire family is part of the solution
• Group therapy means that the patient and others with similar issues meet together with the therapist. Although it may seem scary at first, it is a powerful way to get help and support. After all, who else knows and understands better than others going through a similar experience?

Goals for therapy

Goals that children, youth and parents often have for therapy (although there are many others):

• Better moods (for example, feeling happier, less anxious)
• Better behaviour
• Doing better at school
• Getting along better with others
• Everyone getting along better at home

What You Can Do Before Seeing a Mental Health Professional

The First Visit

During the first visit, mental health professionals will ask questions to learn more about your situation and learn whether or not they can be helpful to you.

This is also your chance to ask questions to make sure the professional is someone you want to see. Here are some questions you might want to ask:

Questions about the Professional

• “What is your training?”
• “What is your experience in situations like this?”

• Treatment questions
  • “What type of treatment would you recommend?”
  • “How long will the treatment take?”
  • “How will this help?"
  • “Are there any side effects or problems with what you are recommending?”
  • “How many visits are needed?”
• Costs
  • “Do we need to pay for this service, or can it be paid some other way (for example, OHIP or extended health insurance plan)?

Confidentiality

In general, everything that a patient says is confidential, which means the professional cannot share that information with others unless the patient gives permission. But there are a few exceptions.  Mental health professionals must share information if they are concerned that 1) Someone’s life may be in danger, and/or 2)  a child (a person up until the age of 16) who has been, or is at risk of being abused or neglected.

By law, youth are allowed to make treatment decisions for themselves if they understand the consequences of these decisions.  This includes deciding who can see their health information. If youth don’t want to share information with you or others, mental health professionals will respect their wishes.  At the same time, therapists will work with youth and families to rebuild communication.

What If Its Not Working Out with your Professional? 

If you do not feel comfortable with your mental health professional, then let them know how you are feeling. A competent professional will be able to explore this with you, in a way that doesn’t leave you feeling blamed or bad.  You might say something like, “I am very grateful for all the help you have provided. However, I feel that we are stuck. / I don’t feel comfortable with ___ / I don’t think this is the right fit” etc.  Approaching it this way, you may be able to work out a solution with your therapist. Or you may wish to try to find another professional to work with.

About This Document

Reviewed by the Mental Health Information Committee at the Children’s Hospital of Eastern Ontario (CHEO) and by members of the Child and Youth Mental Health Information Network (www.cymhin.ca).  Special thanks to Vera Klein, Parents’ Lifelines of Eastern Ontario and Cynthia Clark, Schizophrenia Society of Ontario, Ottawa Region.

License: Under a Creative Commons License. You are free to share, copy and distribute this work as in its entirety, with no alterations. This work may not be used for commercial purposes. Contact the Mental Health Information Committee if you would like to adapt these for your community!

Disclaimer: Information in this fact sheet may or may not apply to your child. Your health care provider is the best source of information about your child’s health.