Written by Dr. Bina Nair
Child and Adolescent Psychiatrist
Medical Lead, Concurrent Addiction & Mental Health Program (CAMP)
A 15 year old female is referred to us by her mother. Jane* is struggling. She lives with her mother, her father is not involved, and a year prior, she was sexually assaulted by another teen at a party. This brought up memories she had of being abused by a cousin when she was little. Upset by all of this, Jane started drinking alcohol to drown out the memories. She started to smoke cannabis daily to ease her anxiety while in public as she feared people, their intentions, and their judgment. And she started to cut. Her arms, legs, and stomach so that the pain she felt deep inside building up could come out. A previous high achiever in school, she now was not attending school consistently and her marks dropped. Her mother, scared for her child, started bringing her to the Emergency Room at the Stollery every time Jane cut and had thoughts to hurt herself, reaching out for help. Each time they were discharged as Jane was deemed not ill enough to admit to the hospital. Concerned, her mother heard of CASA through friends and called CAMP, the Concurrent Addiction & Mental Health Program at CASA. Jane was seen every week or two by a therapist, priority was to ensure Jane felt safe and comfortable, connected and engaged to the therapist so that she could start to open up about her past. This was difficult at first, as Jane could not trust easily. At the beginning, she cut frequently, and continued to have visits to the Emergency Room. But within time, the trust was built. She felt safe to share. Jane also met with the doctor, who helped settle her anxiety and sadness with medication. Over time, Jane worked with the therapist to identify how her past had affected her, how she managed all those feelings with the cutting, alcohol, and cannabis. The cutting and thoughts to hurt herself became a distant memory, the alcohol use and cannabis use decreased. Through her work, she learned how to cope, how to react to her feelings and thoughts in positive healthy ways, and she was able to begin the healing process. During this time, she began going back to school, she reconnected with her father, and became closer to her mom. She had goals and dreams that at the beginning of her journey with CAMP felt so unachievable. But now, those goals and dreams were becoming a reality. Today, she is strong. She understands who she is and where she wants to go. She has been accepted to the University of Calgary and plans to pursue psychology, to give back to those that are struggling. She is looking forward to being on her own and to building her future.
The Concurrent Addiction & Mental Health Program (CAMP) team has been seeing youth and their families since 2013. The team consists of Mental Health Therapists, a Nurse, a Psychometrist, and a Child and Adolescent Psychiatrist with a specialization in Addiction Medicine. CAMP was developed to service youth who have concurrent disorders in Edmonton and surrounding area. We see youth under the age of 18 struggling with mental health issues along with substance and/or alcohol use or concerns with social media/technology overuse. Often, the youth we see come from extremely chaotic and traumatic backgrounds and could be deemed high risk within the system. Many have legal charges, are involved in prostitution, gang involvement, and are homeless. We also have many youth that are involved with Child and Family Services, and many that need to be stabilized quickly due to their addiction with detox, either voluntary or involuntary. We work with youth to ensure safety and stabilization, all within a harm reduction approach. Many of our youth are polysubstance users and our team is well-versed in working with youth that present with different substance use. We initiated obtaining Naloxone kits for youth that may require it and provided psychoeducation around such for our team.
We have had success stories with youth reaching a steady state of sobriety and going on to post-secondary training. But we also consider success when a previously disengaged youth continues to come to appointments at CAMP.
Every day, this team deals with the crises and the challenges this population present with. Often, we hear stories of trauma that no child should have to endure. And even though it is heartbreaking, each team member strives to support the youth in a compassionate, empathetic, non-judgmental way. We have youth that present to our offices high and intoxicated and instead of turning them away, they are welcomed into our offices, and offered a safe place to ground themselves. Daily, youth are given snacks and food as they may come to their appointments hungry, gift cards to stores so that they can buy clothes, school supplies (or whatever they may need), calls are made to community supports to ensure our youth have shelter, can attend a supportive school environment, and to repair broken familial relationships. The team goes above and beyond normal therapeutic supports to ensure the well-being of the youth. As a team, we strive to provide an environment where the youth feel safe and comforted. We offer youth individual therapy, group therapy, family work, and consultation with a psychiatrist. Our most recent group was an all girls’ group where 6-8 girls met weekly at CAMP to share their stories, learn about addictions and mental health, and build positive coping strategies. One youth shared with the team that initially she did not want to come as she was nervous and scared people would judge her. But at the end, she was sad the group was ending, as it became “her family.” We hope at one point to also be able to build a wellness room for our youth, a calming sensory place where youth can go when they need some space. As a team, we have taken it upon ourselves to advocate for a warm, inviting therapeutic work environment, and strive to make improvements in our office space.
Within the constraints of financial funding, the team works together cohesively and collectively to advocate for the population we serve. We have future goals to expand our team and program to include more therapists, a full-time nurse to provide sexual health education, nutritional counselling, and prevention work, and a community outreach worker to meet the youth who cannot access services downtown. We also in the future would like to expand CAMP to include day treatment and inpatient treatment to be the first comprehensive concurrent treatment program in Alberta. So many families are impacted by addiction and mental health and would greatly benefit from a program that not only offers outpatient programming but further intensive treatment.
*Jane is a pseudonym to ensure the youth’s confidentiality