Episode 8

Tova: Welcome to Inclusion Revolution here on Eastlink TV.  I’m your host Tova Sherman and I’m very pleased you could join us this week because we have a very important topic to discuss, youth living with mental health challenges and we’re very lucky to have Andy Cox here because Andy Cox is an advocate for mental health youth working through the IWK, so welcome Andy Cox.

Andy: Great to be here.

Tova: Andy, before we go any farther, and I and I completely ruined your title (laugh), can you first tell me if I said that right and if not please clarify the role that you play, you know, obviously at the IWK health and addictions, I believe, services.

Andy: Yeah, it is, it is a unique role, mental health advocate, ah, I work in mental health, our programs, we have 15 to 20 programs, um, residential program, day treatment, in patient psychiatrist crisis, etc. and my role, I’m available to all those programs to work with youth around any rights issues we’re having say on the, on the in patient unit or any complaints or concerns, helping the youth be part of the treatment team, being equal to the conditions.  I also help ah the youth navigate any systems, I help them em, hook them up with community resources and I do systemic advocacy as well.

Tova: Can you explain what systemic advocacy is just so that we’re all on page.

Andy: Yeah, sure.  Yeah, so I am, um, I love working with youth but, but with mental health being um, you know it’s kind of behind the other illnesses, catching up, there’s, there’s a lot of work to be done so I’m involved with committees within our hospital, in Nova Scotia but also nationally, I’ll give an example, we have a new mental health of Canada and the main goal is to just redo mental health services in Canada and make it right.

Tova: That’s pretty broad ah mandate, and is this committee been going on quite a while?

Andy: Ah, we ah, we were first ah formed in ah ’07, a lot led up to that um, ah, but we started with 3 priorities, one being um, a national strategy, we were the only Country not to have one so National Strategy, redoing mental health.  Number 2, a 10 year anti-stigma campaign, another one is ah, we have a mental wholeness’s project, um, where trying to create a ah what we’re calling partners, so like a social movement, like some of the other illnesses ah have, to not just raise money, but awareness and fight stigma, yeah.

Tova: That’s, that’s exciting, so you really, really are everywhere in a sense, hands on in both what you now have identified as systemic as well as hands on directly with clients.

Andy: Yes, yes.

Tova: So that’s pretty exciting.  Now as an advocate, what is your responsibility or role if a young person has been, well first of all, how does someone find you I guess and then we’ll talk a little bit about what they’re going to find when they find you.

Andy: Right, right, OK, first of all, we’ll talk about the program in general, um, if a, if a youth needs help, we have a clearing house where they can phone 464-4110, ah, and they ah, they call or a parent or a doctor, teacher calls and assessment takes place over the phone and then, and then they ah hopefully the youth is referred to the right program.  I kind of as an advocate, I kind of help as they, when they, when they, the youth get into the programs to make sure ah you know the right issues or complaints, um, if um a youth doesn’t feel like they’re in the right program, I try to help them, see if that’s the case or not.

Tova: A lot of mediation in terms of the, the, the institution and the individual and their family and there’s a lot of mediating between that it sounds like.

Andy: Yeah, it’s a great, it’s great, part of the item become often addictions as teen, um, um, but I’m also advocating for the youth cause I’m kind of in between and that works, that really works.

Tova: Pretty exciting stuff I guess, at least I hope so.

Andy: Yeah.

Tova: Oh Good, I’m glad, I would hate for you to go “whatever”.

Andy: Yeah.

Tova: But I know that’s not the case with you.  Now Andy as a person myself who lived with mental health growing up and was often stigmatized as a result, I’m particularly fascinated in, in, what your, where, if any, if at all, your efforts lead or touch on the issues of stigma because I know you’re dealing with the age that certainly experiences, for me I know that high school was hell.

Andy: Um hum.

Tova: And anyone went to highschool with me, you know why.  So, (laugh), but it was, it was really hard for me and I wonder what, if anything, you were able to do in that roll, that affects that or is that just outside the realm of what you do.

Andy: Nope, I work with ah youth if they feel they’re having a hard time getting back into school, getting descrimiated against.  Mental health is still, people are being discriminated against.

Tova: Oh yes.

Andy: Getting back into university, I help with that.  Um, schools in general universities, we have quite a few new initiatives and one being we have ah a chair in adolescent mental health, Dr. Stan Cutcher who’s doing a lot of….

Tova: Great.

Andy: …working in schools.

Tova: Great, that’s great, so it’s getting in different places and you’ve been really in that core piece of folks that are making that happen and that again is pretty exciting.  So now let’s go to the point where there is a young person who, who requires the services of of you potentially, they’re not even sure if it is you and they’re first steps, what would they be if we really wanted to get started on the road to health.

Andy: Right, right.  So, getting the help is what I mentioned the centre…??? Getting into the system.  Finding me, any youth can give me a call if they feel like they’re not getting appropriate service or not getting timely service, any issues at all, I’m…

Tova: As long as it’s under the mental health and they’re under 19 umbrella you’re pretty good to go.

Andy: That’s right, they don’t have to go through the clearing house to see me.

Tova: Understood.  We’ll that’s good to know how assessable you are, you better be careful but that’s good.  I know you’re busy (laugh) but we’ve just opened that right up.

Andy: Yeah (laughs).

Tova: But that’s wonderful.  Now for you yourself too, what’s interesting to me is you did develop this idea of a mental health advocate and take it to addictions and IWK and department of health and they really thought it was a worth while project and said “go for it”.  Why, what brought you to the place, cause I mean we all want to make changes in the world but we don’t always do what we need to do to make those changes and one of the things I’m really interested about is you become a hero in the sense that people who say we need to change this and then there’s people who say we need to change this and this is what I’m going to do.

Andy: Right.

Tova: You’re one of those.

Andy: Um.

Tova: And that fascinates me greatly.  So, where, how did you get from mental health youth aren’t really getting what they need, which I certainly felt a long time, but I’m not sure I’ve done, certainly I know I haven’t done what you’ve done in terms of hands on directly.

Andy: Right.

Tova: So let me ask you, what got you to that point that the rest of us are sitting around saying “somethings gotta be done” but we’re not doing it.

Andy: Yeah, ah, real true passion for mental health, couple of reasons, was working in the community, working with youth in mental health, realized how the system is you know is behind.  Red Cross Canada and Mental Health Admissions, but a big thing, myself, I live with Bi-Polar disorder, so I know what it’s like to go through a mental illness, the stigma and accessing services so that’s what drove me to write the proposal and go with it.

Tova: And you know, I want to give you a lot of credit because I know you and I both know in the business to have two people sitting on television and discussing their own mental health is unusual and it’s really that exact stigma we both want to bust and I think there’s no better way to bust the stigma then say “hey, you know, that’s me too and I’m a working, functioning, I’m a guy who’s changing the world Andy Cox and yet we all live with our disabilities, we embrace them, we don’t pretend they’re not there we don’t hide them and we certainly don’t let the shame that people give us be carried on by ourselves, that’s my big thing.

Andy: Right.

Tova: So I really think disclosure is incredibly important so first of all I want to congratuglate for really both of us for saying we know that that’s important but now that’s why you did it.  It must be an incredible support to the youth you work with to know you get it on that level as well.

Andy: It is, it is.

Tova: I know that would mean a lot to me to be honest.

Andy: Yup, yup.  Peer support is huge, ah, going through something that somebody else had gone through period but also mental illness because it’s such a hard journey, the stigma and accessing the system.

Tova: Right so it’s, it’s, just really nice then there’s people who go “I get it, let’s talk about it” and that would make you so much more assessable on so many more levels and that’s why you are definitely the right guy in the right place as far as I’m concerned.  I want to talk a little bit more about what happens when someone does get connected with you and some of the many ways you can support them, I mean we’ve talked generally about advocacy but I’m not sure that everybody quite gets what that means so what I would like to do is give you a chance to think about some of those specific things you do while we’re going to take a break but I also wants to make sure that everybody knows that, and um, I’ve said it right that you are in mental health advocate in the mental health and addictions program at the IWK and it’s a role you developed in ’04 and now you’re in there making a difference to a lot of peoples lives, so when we come back on Inclusion Revolution here on Eastlink TV, we’re going to hear more from Andy about the specifics of accessing Andy and the many supports he can help you access and in order to do that I’m going to ask him some pretty probing questions about some of the things he does without of course getting into any confidential but I’m really interested if you can take us through a process perhaps of someone anonymous, like myself, (laugh), or not so anonymous and what some of the ways you could support us could be.  So we’ll be right back after a very short break with Andy Cox from the IWK, he’s a mental health advocate, very rare to see, but someone we all want to get to know a little bit better.  We’ll be right back.

Tova: Welcome back to Inclusion Revolution, here on Eastlink TV, and I’m joined by Andy Cox, a mental health advocate for youth and Andy when we broke I was asking you a little bit about the process but before we got there, I really want to talk about when we should be calling you or our Doctors or any of that because one of the things I’ve experienced in my time with family and youth with mental health is that often times there are signs but we don’t necessarily know what those signs are or what to look for and we often write it off to teenage angst or you know, oh, he’s just going through a phase, you know we all love to hope that and because of the stigma of mental health, we often avoid some of the clearer signs.  I’m wondering if you can share with me and of course our audience a little bit about some of the things that if you saw in your child or friend that might make you want to think it’s more than just a little teen angst.

Andy: Sure.  Um, not a clinician but…

Tova: From your experience.

Andy: My experience and also working with youth and clinicians I’ll ah give some signs and you’re right, there’s a difference between you know, teen, different teen behaviours and mental health problems as opposed to a mental health illness but some things um you know a youth may be isolating and feeling worthless and useless, their sleep maybe um messed up, their eating patterns ah, they may even feel ah suicidal and ah that’s not the person, that’s the illness, that’s a symptom of an illness so those things may lean towards something like depression but then there’s mania, or um things like pressure speech or kind of abnormal ideas um and a very, very, very happy above normal, um…

Tova: Extreme behaviours in a sense.

Andy: Yeah, quite extreme yeah.  And then there’s um, ah, some maybe suffer from psychosis or eating disorders, yeah, there’s so many, ah, yeah, so those are some of the signs when they would ah, hopefully would ah go to their Mom, teacher, GP and then hopefully come to us.

Tova: And even if often they don’t go to that person, it’s that person seeing it and looking for those signs and saying this is more than just that sort of called teen angst and some of the things I heard you say just to kind of have a little bit of a check list going, and that was number one, obviously if they become really depressed and almost suicidal that’s kind of like a heads up obviously but also when they, when there’s like you start to see eating disorders and really dramatic changes in behaviour that are just like you know for instance, I was in drama club and I was the star of all the plays and then one day I decided I wanted no part of it and wouldn’t be touching stuff like that and it use to be my passion so a parent might say “oh she’s just growing out of drama” but sometimes that’s also I know a sign, well in my case it was a sign of ah, ah sinking into a depression and some of the other resulting mental health challenges that I faced but it’s really important because I think so many people want so badly for it not to be true which is where the stigma comes in that they’ll often avoid those signs and hope it’s just, hope it’s the teen angst.  So, what if anything do we do there, I mean I guess what we do is we keep doing what we’re doing which is educating on these issues and trying to provide people with real points to look at and say if that’s happening, we need to talk to someone.  So, let’s say it is happening and the parent has acknowledged these are signs that I recognize in my own child, what, what happens next?  What should they do next?  Cause one of the things that happens is I may identify because but I don’t know where to go or what to do and where do you even start?  Especially with a child.

Andy: Yeah, number one would be to, to a GP and mental health is rampid and GP’s see a lot of mental illness and ah hopefully the GP, maybe the GP if they’re not able to help with medication or what, hopefully they can ah, refer to, to our services that clearing house and then we all have, have all these sub specially programs.

Tova: So, you can help determine what they need if they can just sort of get to you essentially and I say you, I mean your thorough services within mental health and addictions IWK piece right?

Andy: Yes.

Tova: And we’re going to make sure you give that number and any website information as well because I think that’s really important.  So, OK, Mom has called, let me ask you this, because this happens a lot in my experience, the youth themselves is going why did you call?  I’m not interested and as far as I’m concerned, I’m not the one with the problem and I mean frankly I’ve heard that enough to know it gets said.  Does a parent then, do we recommend that the parent go I hear you but I’m calling the Doctor, I mean this is a lot where it stops, is the parent going “fine, how much do I want to fight with you”.  And, do you have any advice or even information and I’m not saying so much as a clinician it’s just a person who’s experience these kinds of challenges from families, how do we get to the point where we can be compliant, the youth can join in to this process rather than be dragged in or do we have to accept that sometimes we are dragging people in, in order to support them which is challenging but often necessary?

Andy: Yeah, that’s a huge issue, um….

Tova: I like the huge issues, go for it Andy. (laugh)

Andy: Yeah, yeah, no, I…

Tova: Just your thoughts.

Andy: When I come in with you know rights issues there and getting help….

Tova: That’s right.

Andy: Yeah, um, you know getting, having the parent get as much education as possible, finding somebody who’s gone through the system like myself, can kind of offer some guidance and you know, it’s not that bad you know, this can happen and you can come through with it but it is hard, you know the one or five or the one in four people have the mental illness, one in five youth don’t get, one in five youth with mental illness don’t get the service be it ah, ah…

Tova: So 20% of all youth that have mental health are not going near services and it’s primarily in your opinion and frankly mine the stigma.

Andy: Stigma…

Tova: And, you know, as much as we do, and that’s why you’re in systemic as well as I know advocacy…

Andy: Yeah.

Tova: Because you’re trying to change it from the top but meanwhile supporting from the ground level and I think that’s what’s so fascinating about your role in the community and you’re sort of an invisible role but it’s so far reaching and so important I wanted people in our community to know about what you’re doing and about IWK and health and addictions is doing but also the fact that you’re this indivual who understands mental health, who understands the challenges around it as we all do but again we don’t come with instructions so you and I have very different experiences and we don’t get to be just two of the same…

Andy: Yes.

Tova: Cause that doesn’t happen, but for you personally, can you take me through the process of where perhaps a youth would be reached out to you or GP calls and says I have this youth and I want to ah, ah, work with you cause he’s not gonna just go here or go there, he’s a little resistant.  Where do you fit in or can you tell me how you can help in that environment.

Andy: Um, hum, sure.  So, for, with, with for the GP to go right to the services, once again it’s the clearing house, but ah sometimes I can be kind of in between and educated them around our services and ah, ah, talk about myself as going through ah the illness and accessing services.  I also have a great relationship with the programs ah so there for ah, you know, ah, maybe a youth is, is um needing services even more, than maybe we can look at getting him or her in a little quicker.

Tova: I understand, I understand.  So, you really are the guy that could probably do a lot more than most, simply because you have your hand in frankly so many pots and that’s a good thing by the way, not a bad thing (laugh), in this case it’s a good thing, but it’s what we need, we need a navigator, so I guess you’re really a navigator for the youth.

Andy: Um, hum.

Tova: Now here’s my next question, it’s a little tougher.  I’m 19 tomorrow and you’ve been my guy and you’ve supported me in ways myself and my family could never imagine, now what?

Andy: Yeah, we ah, our program, we don’t kick the youth into the adult system.  We, we and myself have good relationship with adults system, Capital Health here in Halifax and we make sure it’s not a one night thing, it’s a, a you know a process of getting into ah the, the next system.

Tova: The good news is you’re not dropped like a, a something on the door step in a sense cause ah, I’ve always been concerned about after the IWK experience because it is 19 and we all know that’s not all resolved by 19 and we’d like it to be but it often isn’t.

Andy: Yes.

Tova: So, you’re involved in that transition phase so that person sort of has that peer advocate as they go through it, I think that’s really important.  We’re gonna take a quite break because I have too (laugh) and when we come back we’re going to wrap up a little bit of the discussion of some of the other things you are doing in our community and I find it again fascinating.  For Inclusion Revolution this is Tova and Eastlink TV saying come back in just a moment cause we’re gonna go for a quick break and when we come back my good friend Andy Cox is gonna tell us a little bit more on how to support mental health youth in this community.  Great.

Tova: Welcome back to Inclusion Revolution, I’m your host Tova and again Andy Cox has been kind enough to stick around a little longer because I have some more questions and I’m sure you have a lot of questions to and Andy’s gonna be the guy you’re gonna wanna follow up with.  We’ll make sure the number and his email is on his website as well, on Inclusion Revolution.com for you.  So Andy, before we wrap up today, one of the things we haven’t really touched on is we’ve touched on the way you work and connect with family, you connect with of course the programs within the IWK addictions and mental health services and you’re connecting with schools.  What about the community of agencies with disabilities?  I’m, I’m, for instance, you know I’m associated with Reachablitiy and I know that there’s great agencies in the community like Lake City and Lang House and these are all supports for mental health consumer’s specifically with Lang I know it’s youth, so can you tell me some of the relationships if any you have in the community agencies and how you’re utilizing their services or perhaps their utilizing yours in maximizing supports for mental health you.

Andy: I really try to get keep tabs on, on some of these organizations, I find that non-profit organizations, they have so much passion, so um, an example would be um, a great organization that we are a great partner, Lang House.

Tova: Yeah, I enjoy their work as well.

Andy: Yeah, great centre down on Barrington Street, very friendly, non clinical, um, sort of, um, youth from 16-30, so they help with the transition as well.

Tova: Yeah, a very peak transition time, for sure.

Andy: Yeah, but they offer ah, ah, a youth would have a kind of informal case worker, they offer help with getting back into schools, stigma, ah, employment, housing, peer support, which we’ve talked about.

Tova: So you could see your clients transitioning, your not just transitioning them, you’re transitioning them to environments that offer them the kinds of supports you would like to continue to offer them but of course your role is up until that age, so you do have the next step essentially in place and um, how difficult to sort of get connected to these agencies or are you just sort of saying here you are and there going let’s do it?  Sometimes I know there’s different challenges around working with different agencies, and I’m wondering for you, how seamless it is and maybe some of the other agencies that you maybe have worked with or recommend that if people who are watching today, that perhaps they have a adult children ah, with mental health or siblings or friends you know, some of the different places they might go as they get a little older and I know that one of them you mentioned is Lang, what I really like about the Lang House model is as you said, it’s really holistic in terms of the things they do and of course they’re able to take youth as young as 16 which provides you a fantastic transition environment.  Something about community agencies that we should know, other agencies that maybe you recommend people call if a child again, the person involved is over 19, again, Lang being a great opportunity, you just have to google that everybody, Lang Health, Laing.

Andy: Yeah, there’s um, some, some housing organizations, I just find the non profit, they really do a balk of the mental health work.

Tova: Understood.

Andy: And they don’t get recognized ah for that, ah, so ah, yeah, Reachability, um, some of the housing, you know, homeless, a lot of homeless.

Tova: Homeless initiative is also very, right now I know the department of community services has a very large homeless system initiative in place and I again, people don’t always think about the fact that with mental health, often comes poverty and homelessness, I mean they are very connected for some very obvious reasons if we’re not managing our mental health, the likely hood is that we’re not functioning very well in that community and our work and ultimately making money is going to be more challenging.  What is your commitment to you’re the employment piece?  Do you have any involvement in that, other than the referral to Laing how I know does great work with employment and mental health youth.

Andy: I don’t do so much, I can link them up to organizations ah, we do in our programs, we have occupational therapist who do quite a good job with that, that or getting….

Tova: Right, for back to school or back to work that’s not necessarily your specialty but again, because you’re a navigator, you’re like the captain of the ship, you’re taking the ship and the different supports that everybody needs and I think that that’s a very powerful role in a positive way, not powerful as in power but as in power for what you are providing, and I think that that, once again, I wish every type of disability had its advocate because I have so many calls for so many advocacy challenges and of course we don’t have anyone to really send them to and we try always to every agency, I know tries to do what we can in the constructs, I think a navigator like yourself whose also you know, obviously a mental health advocate, a navigator of the community, is something that I would like to see as growing, I think that you should start a navigation school, where you could actually communicate and support other people who would like to become supportive navigators and advocates in the community, I don’t know if you’re ready to write another proposal (laugh) but keep that in your pocket, it’s yours OK?

Andy: Laugh.

Tova: But I think that really what we want, the big message that I want everyone who’s viewing today and to tell all their friends is there are people navigating the community for mental health in the community, Andy Cox is a great example of that and not only is Andy Cox a great example of that but he stepped up to the plate, wrote his proposal, sold his idea and made it work.  And I think that that is an incredibly powerful message that we can just sit back and let the water wash over us, those of us who live with mental health or just are interested in supporting and you know changing that stigma, changing that way of thinking because we both know how it affected us individually and that’s why we’re both probably in the business we’re in, which is we want to make a difference for those who didn’t have the supports that you and I can now provide.  And for that reason I want to congratulate you and thank you, and we don’t do a maritime of the week and if we did, it would be you Andy, ok?  You’d be my maritmer of the week.

Andy: Laugh.

Tova: So what I would like to do is just skip to our pole and our news of the week which I think you are going to find interesting cause I tried very hard to make sure we reflect today’s discussion and I’m not sure if you know this but parents for children’s mental health, which is our source for this, they have a health fact sheet that states, it’s estimated 70% of childhood mental health issues can be solved with early intervention and therapy and boy are you they guy to talk to about that.  And our pole today, do you think children are too young to be taking prescription medication for mental health issues. If we’d have time, I would ask you, I’ll ask you afterwards about that.  If you’re interested in answering those questions, just come to Inclusion Revolution.com and for this week, I’m Tova Sherman the host of Inclusion Revolution, I hope you’ll join us every Sunday night at 8:30 and Monday –Friday at 3:00 for Inclusion Revolution here on Eastlink TV.  We’ll see you soon.