BY CRAIG GILBERT
There is a feeling of powerlessness at the Child and Family Centre in Greater Sudbury these days.
Dani Grenier-Ducharme, one of two Child and Family Centre mobile crisis intervention workers for all of Sudbury, is the front line in children's mental health services here.
He has an ever-growing, prioritized waiting list for children aged 0-18 in need of treatment from Children's Aid Services.
That list has 175 names on it and it takes four to six months to get to the top, according to CFC executive director Susan Nicholson.
Grenier-Ducharme has been watching the waiting lists grow, the services being reduced and children suffering for it for some time now.
Â?It's all prioritizing,Â? he said. Â?It's a tough, because it becomes 'Well, there's him and her and him, but also X, Y and Z over here, so what's in between?' I (deal with the crisis situation) and refer them to the waiting list so my job is done, but the problem won't be resolved for 12-18 months.Â?
And who do they call in the meantime? Crisis.
Â?We service the worst of the worst, but the worse are still waiting,Â? he continued. Â?At times, it's difficult to turn the switch off at night.
Â?How do you say 'I understand your concern, but we can't intervene at this level'?Â?
Grenier-Ducharme described the sentiment among his coworkers as powerlessness.
Â?We shoulder the full weight of our clients and it's a lot of weight on out shoulders. We're trying to push cases through, but we're always running into walls.Â?
Nicholson and clinical director Dr. Bertrand Guindon have submitted a deficit budget to the Ministries of Child and Youth Services and Social Services - a no-no, according to the province.
The centre managed to reduce a $370,000 shortfall for 2004 to $135,000 with more cutbacks and layoffs.
They have a meeting with ministry officials May 18, three hours after the provincial budget is to be tabled.
Nicholson hopes for more money, but isn't overly optimistic.
As is the case at the Northeast Mental Health Centre (NEMHC), which the CFC was divested from 14 years ago, funding has been flat-lined for over a decade.
Â?We're cutting the lean now, not the fat,Â? said Guindon.
Â?We have always prided ourselves as a cost-effective agency and it hurst that we can't do it anymore,Â? Nicholson added. Â?It's amazing what we can do with what we are given.Â?
The centre has been making do with administrative changes and resource shuffling, but for the last two years it has been too much.
Administrative costs account for 10 per cent of the budget. Clinical front-line staff has been reduced by 42 per cent since 1999, including five layoffs last year and another three this year.
To balance the budget, another three clinical staff will have to be let go.
That would leave 17 clinical staff on the centre's three teams (francophone, Aboriginal and anglophone/ethnic).
In total, the centre employs about 90 people, full time and part time. It provides clinical counseling and intervention services to 1,800 children and youths and their families each year.
That means the centre touches 5,000-6,000 people in the community annually, accounting for the young person's family (one parent, one sibling is the basis for the conservative estimate by Guindon).
Core funding has decreased by eight per cent since 1993. The number of children needing treatment has doubled over the same period.
Â?The most vulnerable kids in our community are suffering - we are serving the poorest and the most disturbed,Â? Guindon said.
Â?So with a six-month wait, it's not a death sentence, but we sentence them to something much worse.Â?
What's worse is with current funding levels, there is no room for preventative programming.
The mental health network is very tight-knit in Sudbury, but the centre is the primary hub for children's mental health services within the city, where NEMHC services the region and outlying areas, Guindon explained.
There are four basic groups Guindon divides the centre's clients into.
As the provincial government directed in 1996, the more severe the case, the more likely it will receive attention.
At current levels, however, the centre doesn't do any prevention at all, so neither it nor its clients ever gets ahead.
Eventually, cases move up the severity list, and eventually into the adult mental health system or worse, the justice system.
Â?We're being set up at the moment,Â? Guindon said.
Â?Our workers will have sustained work forever because we're not preventing.Â?
Without treatment, the 533,000 children in Ontario with at least diagnosible mental health disorder are at greater risk of being involved in violence, delinquent from school, addicted to a substance, becoming pregnant young, homeless or committing suicide.
Suicide is the second leading killer among youth aged 10-19, and mental disorders are the third highest source of direct health care costs in Canada.
Â?When we fail, the impact is on the community, child welfare, the hospitals ... they fall back on the most expensive interventions. What changes are the numbers, the reality of it is all the same.Â?