Kids, Poverty and Mental Health: Anxiety a growing problem

Tyler Chabot offers a shy smile as he talks about the social anxiety disorder that tookover his life.

I feel like I lost three years of my life, he says.

Three years is a long time when youre only 18, an age when most teens are hangingwith friends, developing social skills and deciding on their future. Instead, Tyler wastrapped inside his house, paralyzed by the anxiety that was slowly creeping into his life.

It began in Grade 5 when he was transferred to the gifted program in another school.The pressure was overwhelming and he immediately asked to be moved back.

Once back, however, he became the kid from gifted who couldnt cut it. That madehim the perfect target for bullies, says Tyler, who remembers being viciously bulliedand beaten on a regular basis.

I needed help but I didnt know how to ask for it, he says.

The bullying continued on and off into Grade 8. He finally stopped going to school.

"I would pretend to go then Id take the bus back home," says Tyler.

Pressures at school and home

On top of school pressures, he was worried about whether his mother, a single mom,could pay the bills. He began spending his days playing video games while his mother was at work, dropping into school once or twice a month so they didnt call home.

A lot of the days I just crawled into bed and stayed there, he says.

Last year at the advice of a social worker, Tyler enrolled in the Hamilton-WentworthDistrict School Boards System Alternative Education program located at the formerVincent Massey School on Macassa Avenue on the Mountain.

A lot of the days I just crawled into bed and stayed there.- TylerChabot

The school is also the location for an innovative treatment program for teenssuffering from profound social anxiety. Chilled is a 10-week evidence-based programwhich uses cognitive behaviour therapy to reinforce positive changes in behaviour.

Anxiety disorders are the most common mental health problem among children andyouth and affect approximately six per cent. Twenty-two percent of children will beaffected by anxiety in their lifetime, with the most common being separation anxiety,panic disorders, phobias and post traumatic stress disorders. Those involved in treatment locally say they are seeing more and more cases of anxiety. They arent sure if that is more people seeking help, more access to services or just signs of a growing problem.

Regardless, all agree its important to address symptoms of anxiety early, as they can lead to more severeproblems, as it did with Tyler. For kids living in poverty, that isnt always easy.

Parental stress an issue

A McMaster University study by Dr.Ellen Lipman and Dr. Michael Boyle showed thatchildren and youth who live in poverty are at three times higher risk of developing amental health problem with anxiety being high on the list.

Thats largely due to the toxic stew of stressors surrounding them as well as problemsaccessing services. Children also pick up on the anxiety their parents are experiencingaround such things as paying bills and they tend to model the behaviour they see intheir parents.

How you see your parent respond has a huge impact, said Dr. Karen Francis, ClinicalDirector of Child and Youth Mental Health Ambulatory Services at Hamilton HealthSciences.

How you see your parent respond has a huge impact.- Dr. Karen Francis, ClinicalDirector of Child and Youth Mental Health Ambulatory Services at HHS

If mom comes home and freaks out every time she opens a bill, I dont know knowhow were going to pay this months rent, being exposed to that is going to increase thechilds anxiety.

The longer a family lives in poverty, the higher the chance of them having mental healthdisadvantages, according to the study, which also showed the neighbourhood whereone lives can have an impact on a childs mental health.

According to the study, lower income neighbourhoods tend to have less access tohealth care which means parents can face more challenges getting help for their child.

Mental health professionals in Hamilton rely on theEarly Development Instrument (EDI), to help determine where services are most needed. The EDI is a school readiness measurement tool developed in Hamilton which has been used since 2002 to analyze information on more than 5,200 kindergarten students every few years.TheEDIis now recognized internationally as the most effective tool for measuring the whole child and is used across Canada and around the world.

The EDI measures a childs abilities in such areas as social/emotional health, communication skills, general knowledge and language and cognitive development.

With the Chilled treatment program, most sessions are held in the classroom but students are also taken out into the realworld to test what theyve learned.

Randy Shiga, social worker with the System Alternative education program, who ran theChilled group Tyler was in, said when the students are thrown into real life situations,it forces them to confront their fears. One of those situations involved Shiga sitting in acrowded mall food court with the students where he stood up and yelled to a pretendperson across the room while waving his hand.

The students cringed in embarrassment but, said Shiga, They lived through it and ithelped them put into practice what they learned.

We say to them, whats the worst that can happen? They say theyll throw up or faintor something but none of that happens. They get through it and they see that, saidShiga.

For Tyler, the program was a godsend that turned his life around. He points to thetwo-minute impromptu speech he gave to a roomful of strangers, that was part of theprogram, as an example of how much hes changed.

I talked for seven minutes, he says, smiling. They had to tell me to stop.

Shiga said they started running Chilled about four years ago and offered two programslast year. This year they are on track to run four so far but, saidShiga, the demand isthere for many more.

The need is always there. Were finding that we could easily fill up the groups.- RandyShiga, social worker, theSystem Alternative

The problem is funding is only available to cover a coordinatorfor three hours a week to oversee the program so any social workers who are part ofChilled have to squeeze it in with their regular workload.

Otherwise, Shiga said, if they were able to offer more programs, he is sure they wouldall be filled.

The need is always there. Were finding that we could easily fill up the groups, saidShiga.

I dont know if the number of cases of anxiety are going up or if more kids arecoming forward because the stigma around mental illness has lifted a little or if werejust more aware of it. What I do know is that the cases are more complicated now.Follow-up studies on students who took the Chilled program showed that 80 per cent hadsignificant improvement. Tyler counts himself among those.

I cant believe what I missed in those three years. School is fun to go to. I have yet tomiss one day.

A similar anxiety program called Cool Kids is offered to elementary school students.

While secondary students most often struggle with social anxiety, for younger studentsits often about separation anxiety and not wanting to leave their parents.McMaster Childrens Hospital out-patient unit sees about 1,000 children and youth a year,approximately one-third of whom present with some type of anxiety problem.

More complex

Francis said the kids theyre seeing these days have far more complex cases of anxiety.

More than half have an anxiety disorder combined with another disorder.Were seeing young children who are six, seven, eight-years old who are worried aboutgetting into university, said Francis, adding that more complex cases of anxiety may berelated to higher demands that are placed on kids today.

Even kids in kindergarten have more academic activity so its a lot of pressure.

Theres also the chronic exposure to information kids have through social media outlets.

Seventy per cent of adult mental illness begins in childhood which points to how manychildren are slipping through the cracks, said Francis. Without early treatment, childrencan miss school and fall behind and also miss out on developing valuable skills,including social skills.

As Francis, said, Its not just that it gets in the way of their life, it gets in the way of theirability to develop appropriately.

The Early Development Instrument (EDI) was the first tool designed to measure a childsoverall health development and readiness for school.Because it is considered alegal document, CBC Hamilton had to receive special approval from all stakeholders for its usein this series. CBC Hamiltonis revealing Hamilton'sEDIdata for the first time.

Themapshows the neighbour percentages for emotionalvulnerablity, one of the five domains it measures.EDIdata is used to help decide where social and mental health services are best located.

The map below shows the percentages forvulnerablity in any oneof the five domainsmeasured by EDI. This data is broken down by census tract. The data in the grey areas is "shielded" because the numbers of children studied is so small individuals might be able to be identified. This shows how localized the data can be and how it can be used to help determine where services are needed.