“What’s Up” Walk-In Clinics: Less Waiting, More Talking

There is reason for growing optimism now regarding mental health services for children, youth, and families in Ontario. Last week, the Ontario government announced $2.1 billion in additional mental health funding over the next four years. This adds to the $3.8 billion spent annually on mental health services.

In addition to the much-needed additional funding, there are also a growing number of mental health services designed to specifically meet the needs of children and youth in Ontario. These services are vital to the families served by children’s aid societies in the province. Approximately 46% of families receive child welfare services in Ontario because of adult mental health challenges, which includes addiction. Recent child welfare research indicates 30% of children and youth in care in Ontario over the age of 10 have been diagnosed with an emotional, psychological, or nervous disorders. A strong mental health services system that supports children and youth will help to stop the cycle of trauma being passed down through generations.

I recently had the opportunity to discuss the issues of youth mental health with Myra Levy, the Director for Clinical Services and Darren Fisher, Project Manager Lead Agency Strategy, from East Metro Youth Services (EMYS).

“Across the board in all our counselling programs, we see a lot of children, youth, and parents who are involved in the child welfare system,” Levy said.

In Toronto, there are six ‘what’s up’ walk in™ clinics across the city offering an accessible way to meet the mental health needs of children, youth and their families. EMYS delivers one of the six ‘what’s up’ clinics located across Toronto and takes a lead as the secretariat for the ‘what’s up’ walk in network, which includes providing logistical and strategic support. The other ‘what’s up’ walk in sites are run by Skylark Children, Youth & Families, Yorktown Family Services, YouthLink, Griffin Centre and The Etobicoke Children’s Centre. ‘what’s up’ walk in clinics offer an innovative barrier-free mental health model to meet the mental health needs of children and youth.

“Many parents are asked to utilize the walk-in as part of the reunification process when their children are returning home moving back with their parents after previously being moved from the parent’s care,” Levy explained. “At the same time, children and youth are often asked to come to the walk-in to discuss their feelings about either being taken out of their home or being reunified with a parent and strategies they can use if they feel overwhelmed during this process.”

‘What’s up’ clinics offer 45 to 60 minute confidential counselling sessions to individuals with no fee, no appointment nor health card necessary. All sites offer services from birth to 24 years old, with some sites offering services up to 29 years. Each of the six agencies who run a ‘what’s up’ walk in is working to address barriers for their communities. Clinics hire and train staff to work with clients of all ages, and work to recruit staff who can offer services in languages other than English.[1]

Offered as single-session rather than a traditional series of appointments, the goal is for counsellors to use evidence-informed therapeutic approaches to focus on their client’s primary concerns, and co-develop a plan to address them in a way that feels comfortable. The quality and outcome of services is monitored using the Partners for Change Outcomes Management Scale (PCOMS), and clinics are evaluated quarterly. [2]

Myra Levy explained that one of the advantages of single-session clinics is that “services [are] on an as needed basis, this means that clients do not have to commit to any long-term therapy to access services.” Individuals are also welcome to return multiple times if they feel the need.

“What’s up” walk in clinics focus on addressing any concern “that’s on [their] mind.”[3] Clients come to talk about a variety of issues, but the most talked about are anxiety, depression, family conflict and school-related issues.

According to EMYS, there are 5,000 counselling visits to the ‘what’s up’ walk in each year across all locations and only 6% of people who use the clinic are referred to long-term intensive services.

The ‘what’s up’ clinic model is a good example of how to address the challenge of wait times in Ontario. According to Canadian Mental Health Ontario 120,000 children and youth wait up to 18 months for mental health services in the province. [4]

Darren Fisher, Project Manager, EMYS, emphasized that a current policy-level challenge that negatively impacts children and youth seeking mental health treatment is that “government ministries continue to fund and mandate programs that function as silos. This results in fragmented services, and a lack of coordination among sectors.”

In terms of solutions, Fisher suggested that there be more access to mental health services and education at schools across the province. Secondly, service providers need to have a better understanding of the social determinants of health, and how they impact people so that we move towards a more holistic and integrative approach to treatment.

Fisher also emphasized how barrier-free options to accessing mental health, such as “what’s up” walk in clinics, are a leading opportunity for children and youth seeking mental health care. Ideally this will be paired with to system-level change in the near future.

For more information about ‘what’s up’ walk in, children, youth, families, and caregivers are encouraged to go to http://www.whatsupwalkin.ca.

[1] http://emys.on.ca/getting-help/walk-in-clinic/

[2] http://www.whatsupwalkin.ca/for-professionals/

[3] http://emys.on.ca/wp-content/uploads/2014/02/whats-up-walk-in-flyer.pdf

[4] http://kidsmentalhealthcantwait.ca