GENERATION DISTRESS
Children and youth are calling for help amid rising levels of anxiety, depression, suicidal thoughts and self-harm — a crisis that the pandemic has only made worse
One in seven Ontario students in grades 7 to 12 say they harmed themselves on purpose in the past year.
One in six had serious thoughts of suicide.
One in three say that there was a time in the past year when they wanted to talk to someone about a mental health problem but did not know where to turn.
The numbers are worse than before. Data obtained exclusively from the Centre for Addiction and Mental Health (CAMH) show the alarm over youth in distress is getting louder. And COVID-19 is intensifying the problem.
“(Young people) are feeling nervous, feeling hopeless, feeling restless … feeling nothing can cheer (them) up,” said Hayley Hamilton, a senior scientist at CAMH who co-authored a new study of responses from more than 14,000 students provincewide.
The rising distress captured in the survey, done before COVID-19, has likely only worsened during the pandemic.
“With (COVID-19) we really have this cascading effect,” said CAMH senior scientist Joanna Henderson, one of the survey’s co-authors.
Today, the Star and the Investigative
Journalism Bureau (IJB) launch Generation Distress: stories that will reveal spiking demand for youth mental health services, the pressure on educational institutions and governments, and innovative solutions emerging to address the crisis.
This generation of children and young people is making unprecedented calls for help amid rising anxiety, depression, suicidal ideation and self-harm that are undermining their academics, personal relationships and careers. In growing numbers, they are taking their lives.
Our series starts with the troubling new CAMH data gathered from youth in grades 7 t through12, as well as a scientific survey of 6,000 post-secondary students across Canada and the United States.
The survey, conducted for the Star and IJB journalists by trend-tracking firm RIWI Corp., found nearly 30 per cent of students said their failing mental health has caused them to consider self-harm and suicide. And the pandemic pushed up depression levels among Canadian respondents by 35 per cent.
Together, these two exclusive data sets add to a growing body of evidence showing a youth mental health crisis across North America.
On Nov. 2, a first-year Univversity of Toronto student end- ed his life — the fifth suicide made public at the school since June 2018.
Suicide is the second leading cause of death in Canada for those between the ages of 15 aand 24, and the second leading cause of death in the United States for those between the ages of 10 and 19.
“We’ve seen a sharp increase wwith kids in acute distress, kids coming to emergencies with self-harm or suicide ideation,” said Daphne J. Korczak, a psychiatrist at the Hospital for Sick Children. “These are situations where children become so o overwhelmed and distressed, tthey don’t want to carry on in their t lives.”
Of the 14,000 public school students surveyed by CAMH,15 per cent said they harmed themselves on purpose in the past year. That represents an estimated 127,800 Ontario students when extrapolated across the province. And the 16 per cent who had serious thoughts
about suicide in the past year (representing ( 140,300 Ontario students) is a record high since monitoring began in 2001.
One in five respondents — 21 per cent — indicated “serious psychological distress,” up from 17 per cent in 2017 and reaching a new high since tracking of this indicator started in 2013. The 35 per cent of students
wwho said they couldn’t find the help they needed to address their challenges — a projected 348,700 Ontario students — is aalso a new high since CAMH
started asking the question in 2013, when the level was 28 per cent.
“There’s a point in time where they needed to talk to someone about mental health challenges aand they had nowhere to turn,” said Hamilton. “To me, that’s a statement.”
Mardi Daley, 26, a CAMH yyouth engagement facilitator, struggled to get help for mental health challenges beginning at
age 16.
“I don’t think our system has the capacity,” she said. “It took multiple attempts over a num- ber of years to find something actually suitable to my needs. AAs you get older, the risks get
higher. If you can’t get support,
yyou could lose your job and if you y lose your job, you could end
uup homeless with a lot of other
issues before you.”
The CAMH results were gathered between November 2018 and June 2019, prior to COVID-19.
“For me, the big concern is, if
these numbers are like this be be-t
fore f the pandemic, what are they like now?” said survey coauthor Tara Elton-Marshall.
College and university students across Canada experienced a worrying deterioration of m en health over the
demic’s first wave, according to the RIWI data that was collect
ed from late February to early
October. Depression among the Canadian post-secondary students jumped to 27 per cent from 20 per cent prior to the outbreak.
“As the pandemic continues, anxiety reports drop but depression looms larger,” said Neil Seeman, founder of RIWI Corp. “I find that interesting, offering new insight into the pathway from stress to depression, especially among vulnerable groups amid an environment ravaged by expanding inequities, jobs precarity and a general angst.”
As Ontario declared a state of emergency on March 17, Julia Paulson found herself spiralling.
“In-person therapy sessions have been cancelled indefinitely,” the 24-year-old Carleton University student wrote in her diary. “Hardly the first time I’ve had to deal with my crises all on my own.
Hardly the first time there’s been nowhere to turn ... I’ll get through it how I always get through it. Day-by-day. Hour-by-hour. Minute-byminute.”
She struggled to find the motivation to eat or do school work.
“I have two assignments due in less than a week that I haven’t even looked at yet. I keep lying in bed for hours, but I never sleep. I’m so tired,” she wrote. Even before the pandemic, mental health challenges were already boiling over on campuses.
About half of respondents across North America said a stressful academic climate pervades their campus and that mental health services at their school were not responsive to their needs.
Faced with a shortage of mental health services and long wait times beyond campus, many young people feel they have nowhere else to turn. And what ww they are getting on campus is t not enough.
One-third said they had to wait weeks or months to get a mental health assessment at their school.
Amanda Legault, a 22-yearold who recently graduated from Ryerson University, said her calls for help on campus during her undergraduate de- dd gree were met with long delays, gg including a two-month wait for an appointment earlier this year.
“Times in my life that I was struggling, like severely struggling, I would be told that I would have to wait for like two months,” she said.
Kevin Yu, a business student at Ryerson, said he waited five months for a counselling appointment, which finally happened in April.
“The semester is essentially done and so a lot of the mounting pressure I felt no longer applies to the same degree,” said Yu. “It’s definitely disappoint- YY ing.”
In a written statement, Ryerson said it could not comment on individual cases but that in general there is no wait list for initial counselling appointments because there are “several same-day appointments available every day that are booked on a first come, first serve basis” as well as emergency appointments for students cc in crisis. Students requiring ongoing therapy can face wait times which depend on “student needs and urgency.”
Long waits can worsen mental health problems in young people, said CAMH’s Henderson. “If you put them on a wait list, they lose a semester of school and that leads to other prob- aa lems.”
While 27 per cent of post-secondary respondents said they have contemplated suicide, 30 per cent said they’ve considered quitting school and 29 per cent have considered selfharm. Fourteen per cent have thought of admitting themselves to hospital and 35 per cent say they’ve considered “self isolation.”
In most of the mental health metrics measured by RIWI — from depression to eating disorders — Indigenous post-secondary students in Canada fared worse. Canadian respondents who identified as Black or Hispanic/Latinx also experienced higher than average rates of post-traumatic stress disorder.
Cynthia Wesley-Esquimaux, the chair of truth and reconciliation at Lakehead University, aa said she’s not surprised by the numbers.
“There’s still a lot of inequity in the systems that … address Indigenous needs,” she said. “Until those systems can actually be corrected, until funding of education on First Nation communities is equitable to funding off reserve …you’re always going to have people fall- ww ing off the edges and not having their needs addressed,” said Wesley-Esquimaux, who is WW from the Chippewas of Georgi- f na Island First Nation, about 100 kilometres north of Toronto.
“Indigenous kids, Black kids, kids of colour are the first ones kk to encounter inequity. They’re the first ones to be made fun of, tt they’re the first ones to be treat- t ed differently at school.” Kim Hellemans, chair of Carleton University’s neuroscience department and a specialist in mental health research, said social cracks are amplified during a crisis.
“We’re going to see so many more problems coming out of this pandemic,” she said. “It is disproportionately affecting vulnerable populations.”
The RIWI data also revealed key differences between how COVID impacted Canadian post-secondary students and their American peers. Since COVID-19 hit in March, a sense of “isolation” increased for Canadian respondents — to 22 per cent from 19 per cent — while falling two percentage ww points for American respondents.
“The challenges brought on by the pandemic are also likely to tt increase with the second wave of COVID-19 infections,” said Eric Windeler, founder and executive director of Jack.org, a national youth mental health organization created in the name of Windeler’s son, Jack, who died by suicide. “Canada’s ww youth continue to face a crisis of yy access for much-needed youth mental health services.”
Not every anonymous respondent of RIWI Corp.’s webbased, random survey answered each question. The data has a confidence interval of 95% and a margin of error between 0.1 per cent and 4.1 per cent.
Paul Kurdyak, a leading international expert in youth psychology at CAMH, sees mean- cc ingful differences between today’s stressors and those he faced as a teen.
“When I was in high school, aand if I were having a hard time, and a I was prone to depression or anxiety, that hard time would end (at) 3:30 (p.m.),” he said. “The 24-7 scrutiny that occurs in social media, when overlapping with somebody who’s depressed or anxious, is a really bad combination, because there’s no break.”
Those seeking help often lurch around a health-care system ill equipped to meet the
rising demand, said Ilan Fischler, chief of psychiatry at Scarborough Health Network, wwho fought his own mental
health battle while a university student.
“I don’t really think there’s a mental health system per se. Iw
think there’s a lot of providers dedicated to their patients. But
fall f through the cracks.”
Even those who do get access to care aren’t d getting the kind of help they g need, said Hellemans.
“Our students are like the canary in the coal mine. They’re
are still developing, they are facing unique stressors … If we don’t do mental health well as a population, we’re certainly not going to do mental health well with a student population.”
Meaningful change is needed, she said. But it isn’t just the responsibility of universities
to the policy-makers to change the way that we fund mental health.”
Santa Ono, president of the University of British Columbia, said that while collaboration
bringing change, it is “naive” secondary institutions to argue
“That view is … shirking responsibility because the wellness of every member of our university is important and should be our responsibility … Anybody who deals within di- that need mental health
support know that you have to make it readily available.” Data Analysis by Andrew Bailey With files from Charles Buckley and Giulia Fiaoni, Investigative Journalism Bureau This series examining youth mental health is part of a cross-border investigation involving the Toronto Star, the Investigative Journalism Bureau (University of Toronto’s Dalla Lana School of Public Health), NBC News, the National Observer and journalism faculty and students from the following universities: Stanford University,
University, University of Missouri, Syracuse University, City University of New York, University of British Columbia, Ryerson University, Carleton University and the University of King’s College. See the full list of contributors at thestar.com.