Treatment Options in Canada

[Tiatt]

So SDBPD14 is a about 10 days away from being discharged from the psych hospital and they have formally dx her with BPD (no surprise there). As such they have no programs in place that they can put her in.

Is there really no treatment options in Canada?  That is what we were told.  Basically that because she is under 18 we are SOL.  I can't believe this, the team doing the assessment recommends a group home so that bio mom and my SO don't go nuts themselves as she is decompensating quite rapidly and they expect it to get worse.  Of course mom and dad don't want to put her in because they feel guilty but it may be the only way to keep her safe.  Even if they decide to go down that path SD14 has to volunteer (like that is going to happen).

If anyone is from Canada and is aware of any treatment centres please let me know.  We are in Ontario

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[americanbelle]

Tiatt, I am also in Ontario and sad to say we are very limited as far as mental health goes both here and in Western NY. There is a doctor east of Toronto who does provide DPT.  I don't know where you live but Hamilton has a program at St. Joseph's and there is always CAMH in Toronto.  We found a psychiatric nurse who is trained in DPT by the grace of God because I was ready to move down to North Carolina with my daughter.  Duke University has an awesome program there.  Google Paul Links MD.  He is at Chedoke/McMaster in Hamilton and he actually answered my email years ago when I was totally lost.  Best of luck to you.

[Lost In Space]

Hi Tiatt, I don't know if this is any help at all but in searching for resources for my wife I found just one listing.

Nova Scotia Hospital, Halifax/Dartmouth, 902-464-3111. Unbelievably I live about 30mins from the hospital & my wife is due to start therapy there soon. Apparently Canada has been slow in taking up DBT but that is supposed to be changing relatively rapidly. Hope this helps a little...

[Gingerb]

Tiatt,

Yes, I'm also in Canada. There seems to be about one DBT group per major city. Try calling your youth psych ward and ask them what groups are available.

Also, if you have a good counsellour they may be approachable. Our counsellour has done reading and is implementing some techniques.

Yes, we found out when our gd16 turned 14 that we basically could not compel her to participate in any programs. It's such a frustrating system. We have this huge responsibility and no way to enforce anything. EVERYTHING is voluntary once they turn 14 and privacy is duly observed, so half the time you don't get to know what is happening in terms of treatment.

We are looking into a place called Pine River Institute. It's outside TO. Look at their website. It came highly recommended to us, BUT the waiting period is about 6 months, so apply now and then if you need it, you got it! It is subsidized, so you only pay $500 a month the government pays the rest and it is extremely intensive and very successful. It seems to be geared more toward kids with rehab issues, but when I downloaded the application, it became obvious to me that most of their students have other issues, mental health wise. We are planning to apply.

Our gd16 was in a group home for 3 months when she was 15. It was technically voluntary, but I don't think she got that at the time because of the way they phrased it and she was pretty distracted by the turmoil anyway. I would say that experience was not even remotely therapeutic for her, in fact things really took a turn for the worse, but it was a much needed break for us (we don't have respite care) and we were able to sleep through the night because somebody else was staying up all night long waiting for her to come in. I also believe she would have taken a turn for the worse at that stage regardeless of who she was living with. I think the group home was really a much needed break for us.

Ginger

[pennifree]

Hi Tiatt,

West coast here and there is DBT available here too, but like everyone else, it is limited to just a few offices and only one hospital program. The hospital program is good but has an average 12 month wait list.   The private practice program is very good with little wait list but costs a fortune and in our situation is not covered under any health insurance.   All is voluntary and confidentiality trumps parental concern after the age of 14.

There are no supports for family or loved ones as far as I have been able to find.

Our mental health care system really drops the ball for our kids as far as I am concerned. 

Wish I could be more help.

pennifree

[Tiatt]

Thanks folks... .Ginger I am looking:)

[Reality]

Pine River Institute helps 13 to 19 year olds and they have a wait list of 140 young people.  That being said, they have a close connection to Montana Academy in the States, which the province should fund as there are few good facilities here.  What is interesting about Pine River Institute is that 100% of the kids have substance abuse problems and after a stay of 12 to 14 months, the success rate is 80%.  This RTF is researched by a global expert on bullying, Debra Peplar, also a professor at York University.  The co-founder was a professor at York University and her husband is a medical doctor and adjunct professor at the University of Toronto.  I add these details so you understand that the research and results are not pie-in-the-sky.  

I would contact Montana Academy.  As well, I highly recommend the books written by John McKinnon, a co-founder of Montana Academy,  An Unchanged Mind:The Problem of Immaturity in Adolescence and To Change A Mind.  Both are available on Kindle.  

My son had very late dxBPD, nine months before dying.  I diagnosed him myself and 4 months later, he was able to access an assessment at CAMH.  

Reality

[jellibeans]

Does anyone know the name of the RTC in Ontario Canada. It was something Pines in the name. If you know of this place can you tell me if it was covered by Ontario Health Insurance Plan (OHIP)?  And how you got your child admitted.

[griz]

Hi jellibeans:  I know Reality know a tremendous amount about this place... I believe it is Pine River. You should try to pm her.  She is a wealth of information.

Griz

[Skip]

This may help:

PineRiver: When we discovered that the waitlist for a bed funded by OHIP was about 6 – 9 months we were somewhat discouraged and we knew that our son could not wait.  Then we looked into the bursary program as an option.  We were accepted and our son left for the woods within a matter of weeks.

www.pineriverinstitute.com/

https://bpdfamily.com/message_board/index.php?topic=196049.msg12212899#msg12212899

[jellibeans]

Thank you all

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Reality]

jellibeans,

Pine River Institute services youth from the ages of 13 to 19.  It has 5 beds that are privately funded, otherwise the treatment is funded by OHIP.  There is a waiting list of about nine months to one year, from my understanding, nonetheless, I would encourage initial contact with Pine River to explore options.  I also think the Ontario Ministry of Health could be contacted to start a process to access funding on a case by case basis.  The facility is relatively new, so I am not sure if this has been done before, but I think it may be a possibility.   Typically, young people in Ontario go to Residential Treatment Facilities in the US and parents apply for out of province funding from OHIP or pay themselves.

No doctor, social worker, crisis worker, Mental Heath helpline, hospital told us about Pine River Institute when we sought help for Will.  When I visited this place after he died, I knew within minutes, it was the place we had needed to find.  I had never heard of it until I read an article iin the Globe and Mail I think in his last year when he was already 23 and I was too exhausted and traumatized myself to make the connection that it might be a source of information.

I visited Pine River Institute with some friends from Will's Way (our small mental health advocacy group).  All three of us agreed that it was a place we would feel comfortable endorsing to others.  The people who work there are kind, intelligent and highly skilled.  There is an integrated two-month wilderness program in Algonquin Park followed by a stay at Pine  River Institute itself, where the youth are enrolled in an on-site school program integrated with therapy, life skills and exercise in the outdoors.  There is a strong emphasis on nutrition, as well.  The food is delicious and very healthy.  Everyone working at Pine River is part of the community in an authentic way.  So, for example, a young person overwhelmed for a time helps the nutritionist with meal preparation.  Pine River is a true community and relationships are honoured.  My personal opinion is that the work at Pine River Institute is revolutionary in the field of youth mental health in Canada and beyond.  

There is a small outpatient BPD clinic at CAMH in Toronto.  The wait list is usually closed and interested people are asked to phone back monthly to find out when the wait list is open.  To access the comprehensive DBT orogram, there is a long wait again once assessed, usually many months.  There is a partial DBT program consisting only of the skills training, which is slightly more accessible; however, it does not offer the complete DBT program, as the phone option in times of crisis is not available and the patient has to have a therapist outside of the program, meaning that the weekly meeting of therapists doesn't happen either.  The partial DBT is a research model.

I hope this information is helpful.  If I can be of any help, do let me know.  

Reality

[mary93]

Hi Tiatt im also from Canada, from Quebec. Im off to work now, so ill try and remember to get back to this when     I get home tonight

[co.jo]

I think it reveals something about our mental health system when this thread has been read over 2500 times, and there are so few posts- because there are so few treatment options in Canada.

[mary93]

Yup, not many options in Canada. But a major part of the problem is they refuse to diagnose a BPD under 18. they send them to "mental health places" etc but will not put the "label" on them as they say they moods etc are always changing in adolescence (I guess it might not be a bad thing for some, imagine having a label put on you which could turn out to not be a proper diagnosis) I have seen it with my own 2 eyes, a young girl of 17 they refused to diagnose her BPD, hence no specialized treatment, the day, and I do say the day she turned 18, oh now shes a BPD and was told she has to leave the youth facility and was sent to a crisis center and now can move on with BPD treatment! It is not ok that this goes down like that, as the quicker treatment is started the better I would imagine. I imagine that things will bew changing as it appears that they are realizing that there are more and more BPD, so they will eventually have to do something (I hope)

[sadi]

Hi tiatt, I am also from ontario not sure how far you are from london. There is a psych hospital there, they have children's wards there for 13 to 18 long term treatment can stay for months.

[Reality]

I think it reveals something about our mental health system when this thread has been read over 2500 times, and there are so few posts- because there are so few treatment options in Canada.

Co.jo:

A very good point.  Dr Joel Paris, a psychiatrist in Montreal and a highly-respected global expert on BPD, states that he sees patients with BPD who have been misdiagnosed and sometimes medicated with up to 5 different medications.

I think that the iconic CAMH, which is very heavily pharma-funded and has close academic and research links to the University of Toronto, creates an illusion of Canadian mental health care, which is not always as service-oriented as it positions itself to be, unfortunately.  The BPD clinic there is very small and although highly-respected research is conducted at CAMH at that clinic, the wait list itself speaks volumes.  It seems that the access point there, is, in fact, the CAMH Emergency, if one needs care urgently.

It makes sense that early diagnosis and intervention of BPD are not practised widely, as there is very little treatment even if one is diagnosed here in Canada, even for adults.  The NEA-BPD website states that the prevalence of BPD is 5.9%, the same rate as bipolar or schizophrenia.  Even though our population is relatively small, that means that there are well over a million people suffering from Borderline Personality Disorder in Canada. 

At the recent ISSPD CONFERENCE, an international conference for Personality Disorders, in the lecture on early intervention, BPD is described as not just an individual, but also a social problem.  CBC recently held a broadcasted Town Hall meeting on the mental health crisis in Canada and three young women spoke of their suicide attempts.  Not one word was mentioned about BPD.  Most people with whom I have spoken here in Toronto during the last year had  never heard of Borderline Personality Disorder, although that is changing now.  Yet, my impression is that self-harming behavior amongst adolescents and young adults is becoming increasingly common in middle schools and high schools. 

There was a walk this year in Toronto in May to heighten awareness of BPD, sponsored by the Sasha Menu Courey Fund.  Hopefully, there will be another event in the coming year.  As well, Sasha's parents visit high schools with a highly informative presentation on BPD, which has been well-received. 

Sadi:

I have never heard of the treatment facility in London.  What is the name of the hospital?

This thread is very important.  The more information the better. 

Reality

[co.jo]

I am in British Columbia, and my BPDd is in Montreal. I know of nothing out here, definitely not on Vancouver Island where I am. She pretty much diagnosed herself after it was mentioned as a possibility by a psychiatrist.Although now she says it is PTSD caused by her abusive childhood, and it is ALL MY FAULT.

Anyway, there is sure a lack of info out there, most people have never heard of bPD , and until it becomes more "popular" there is probably not a lot of funding for it. We need a celebrity to come forward and say they have it, and create a foundation, etc... .

[hopeangel]

Hi Co.jo!

My BPDd was also convinced she had been abused by me and  family and it was 'all my fault' but there again the vast majority of people she has been friendly with or in relationship with she now deems 'abusers'.

My point is that this used to hurt me so much and yet it is just part of the disorder, just driven by their pain and distorted world view it isn't personal, in fact they accuse the ones they care for most almost as a test of love, which you do NEED to pass, it isn't manipulative or malicious, although it sure feels that way, its just something they need to do.

There IS potential for improvement I know that but this is a long battle and I pray you get the help you need and deserve! My dd hasn't had therapy yet and she is getting better on her own after 4 years in total since her first breakdown, we live in the uk btw!

I am hoping you can get some support asap!

[allibaba]

DBT group therapy in Ottawa as well.  I believe that its free of charge and requires a referral from a psychologist.  No idea on the age requirements of the group though... .