A Newmarket mental health expert fears that children traumatized by the COVID-19 pandemic will fall through the cracks if she is not permitted to build a proposed addition to her Prospect Street clinic that would allow for physically distanced play therapy areas.
Kristin Greco, a social worker, psychotherapist and clinical director at the Newmarket Psychotherapy Team clinic, said she and her colleagues are seeing a surge in the number of elementary school-aged children, some as young as seven, who are experiencing grief, anxiety and depression during the coronavirus crisis.
And while the team has taken its services virtual during the pandemic, therapy doesn’t work for most children that way, said Greco. When you are not in the room with young children, they are difficult to engage, lose interest and find the virtual environment upsetting, she added.
“It’s keeping me up at night,” said Greco, who has hundreds of local families on her roster, including members of York Regional Police, the OPP and frontline health-care workers.
“There are a lot of depressive symptoms with kids, and the difficulty with elementary school-aged children is they don’t have the language to explain or talk about it,” Greco said. “So it’s the behaviour that we see, like tantrums, not listening, tearfulness, inability to sleep and their appetites are affected.”
“And the most distressing thing is there's been a lot of reports from my clients and my colleagues where children are expressing suicidal ideation,” she said.
A May 2020 Ipsos survey, conducted on behalf of Children’s Mental Health Ontario (CMHO) and Addictions and Mental Health Ontario (AMHO), for the first time, included children and youth in its annual mental health index.
The study examined mental health and mental illness in 2019 and since the COVID-19 pandemic began in mid-March. In 2019, it found half of Ontario’s children and youth are at risk for mental health issues, with 30 per cent being at high risk and 19 per cent at moderate risk of mental health issues.
Since COVID-19, more than half of parents, or 59 per cent, noted behavioural changes in their child, ranging from outbursts or extreme irritability to drastic changes in mood, behaviour or personality, difficulty sleeping and altered sleeping patterns, as well as persistent sadness.
In 2019, one-quarter of parents, or 25 per cent, reported that their child felt sad or hopeless almost every day for a couple of weeks or more and, since the start of the pandemic, 14 per cent report that this is happening more often.
“Significant changes such as these can be signs of a mental illness,” the report stated. “Previous research shows that almost 12 per cent of children and youth will have a serious mental illness before the age of 18 that requires treatment from a mental health professional.”
The findings also show that COVID-19 is greatly impacting the mental well-being of families in Ontario, with 42 per cent of Ontario’s adults having increased their substance or gambling use since the pandemic started, and more than a quarter, or 28 per cent, are experiencing increased tension in the household.
Greco said she is seeing the impact of the pandemic on her own three children, twin boys aged nine, and a seven-year-old daughter.
“My kids are struggling and they don’t have pre-existing issues, but they’re having days when they are breaking down because of the social isolation they are going through,” she said. “For example, they thought going outside meant they would have to be running from these little green blobs, the virus, and so we figured out that’s what they were envisioning, so we corrected that.”
The longtime mental health clinician said, from her experience, the pandemic is forcing many parents to work from home and, unintentionally, some are neglecting the children’s needs as they try to juggle parenting with work.
“They are trying to do an impossible thing that normally takes a village,” she said. “And some of the kids are at home, unfortunately, in environments where there are issues such as domestic violence, or maybe they were being seen by children’s aid before, but those visits have decreased or stopped.”
In the early days of COVID-19, there was a lull in clients seeking therapy as parents tried to navigate the unprecedented disruption brought about by the public health crisis, Greco said.
“But now, we’re getting a huge influx in referrals in terms of children needing to be seen,” she said. “We don’t want to have a waiting list at our clinic. If we can’t see someone in need of mental health support promptly, we want to be able to send them to one of our community partners who can see them.”
The issue is critical, Greco said.
Child and youth waitlists can be three to six months long for private therapy, and York Region is tops in the province for publicly provided care with the longest average wait of 919 days, according to a January 2020 CMHO report.
The current clinic is housed on the main floor of a century home at 130 Prospect St., with a residential unit on the second floor. The proposed addition would expand the main floor space to include two rooms where physical distancing during in-person therapy is possible.
“We need bigger offices to see these children safely because of COVID,” Greco said. “For physical distancing, we can’t do that in our current clinic space.”
“The addition would give us a couple of large rooms for children to do play therapy, so a parent can sit there if needed, the child can play, and the clinician can do the work they need to do,” she said. “They can’t wear a mask for therapy, it takes away the whole purpose of it.”
Greco hired an engineer and in May they approached the Town of Newmarket to discuss the plan. After meeting with town officials, Greco was disheartened to learn that the property’s 2005 zoning bylaw doesn’t permit such an expansion to happen quickly.
“I’m asking for anything, I’m begging for someone to allow us to do what needs to be done to help these children,” she said. “Right now, we don’t know how we’re going to do it safely.”
“I love Newmarket, and I value our community partners here, council and the planning department have been open to talking with me, but there’s not much more I can do. What can council do to help mental health resource clinics expand their resources to support the community?” said Greco.
“I’m asking for somebody to do something, to say this community has clinicians that have the resources to see people and the only thing that’s stopping us right now is the red tape,” she said.
Councillor Bob Kwapis said he and the town’s planning department have been “bending over backwards” to explore ways to accommodate Greco’s need for space. Another meeting is scheduled for next week with Greco and her engineer to brainstorm ideas that can be put in place fast.
“We all know how important the service is that she is providing, not just to the town but to the province and all the children,” Kwapis said. “We’re fully aware of how critical this is, I can’t stress that enough.”
But Greco’s addition proposal triggers potential amendments to the area’s zoning bylaw, as well as compliance with Ontario’s Planning Act. That means a usually long process that involves public meetings and feedback on the proposal, and town staff reflecting all that in a report to council for consideration that includes a recommendation to deny or approve it.
“The Planning Act and the rezoning process is a very onerous and lengthy process, and she needs the space urgently, so we said let’s see if there are any alternatives,” Kwapis said.
One idea that was explored involved Greco and her team holding a temporary pop-up clinic to see young clients, but for reasons of confidentiality and safety, that was rejected.
“This is important, and we’re encouraging her to go through the process if she needs this long-term, but we are focused on that short-term immediate need that she requires, and that’s the challenge that we’re having,” said Kwapis. “We can’t circumvent the Planning Act, our hands are tied.”
Meanwhile, the town plans to review and update its official plan in the near future, acting manager of planning services Adrian Cammaert said.
"This review may include the re-examination of uses, heights and densities along some of the town’s primary collector roads, such as Prospect Street," said Cammaert. "This study will include a significant public engagement component."
Greco feels the 15-year-old zoning for the property, which permits a one-practitioner office and one residential unit, is out of date with the evolution of the area. Its proximity to Southlake Regional Health Centre has seen medical clinics proliferate on the street, where more than one health-care professional practises out of the same space.
At Newmarket Psychotherapy Team, up to 10 clinicians rotate among the clinic’s four small offices to serve clients. Also, the team offers a wide variety of free workshops and parenting support groups that require them to rent space elsewhere.
“We want to be able to help the community through this pandemic with a safe physical space here at our office,” said Greco. “There’s going to be kids that are hospitalized, on medication, taking their own lives, and I’m sure we can prevent some of that if we have space.”
“There needs to be an exception in certain cases, especially during a pandemic,” she said.