Excerpt from the chroinicleherald.ca published August 23, 2013
Family sent troubled daughter to Ontario treatment camp despite financial burden.
The man, whose name can’t be published because it would identify his 14-year-old daughter, said she is making progress at Venture Academy in Barrie, but the province won’t help with the fee … because he didn’t follow its guidelines to get funding for out-of-province treatment.
“It’s a pretty scary thing to see your kid, your daughter, your first-born, morph from a happy-go-lucky kid into this person you just don’t recognize,” he said in a recent phone interview.
He said the family did not know the proper procedures or how to find out about them when they decided, on their psychiatrist’s advice, to send the girl away after a series of serious incidents late last year.
In addition to breaking things in the home, getting into fights and routinely running away, she pulled a knife on a family friend, was charged with stealing a car and possession of bear spray and had started to hang out with criminals.
Her father said she was always a high-strung kid, “but not in an out-of-control kind of way.”
That energy began to show negative signs when she was about 11 and started having issues at school.
“By the time she was 12, we realized that there was more under the hood,” he said.
She began to show more indifference to people in authority and was diagnosed with attention deficit hyperactivity disorder. The diagnosis quickly escalated to one of oppositional defiance disorder, then conduct disorder, which the psychiatrist said was severe.
The family faced delays getting her into treatment and scheduled appointments. Also at about that time, her father began leaving home for extended periods because of his work in the military, which seemed to compound the girl’s bad behaviour.
The family sought an assessment for her at the IWK Health Centre in Halifax but were informed they couldn’t get an appointment for six months, he said. But they were told to bring her in for an emergency assessment if she had a serious episode.
Sometime after that, the daughter went out of control and started smashing things in the house, so her mother and grandmother took her to the children’s hospital for an emergency assessment. The father said they were told it would be a four-hour wait.
After the assessment, he said, his wife and her mother were told to bring the girl to a shelter if they couldn’t handle her and she could find her way home later.
“It left my wife and my mother-in-law stunned because that was the professional opinion,” he said, adding that the response shook their confidence in local treatment options.
When the girl’s actions took a quick turn for the worse, the exasperated family applied to Venture Academy on their psychiatrist’s advice. According to a letter written by the psychiatrist, and provided to The Chronicle Herald by the father, they had no other choice and risked a complete breakdown of their family unit.
Afterwards, the family went to the provincial government seeking financial aid. The timing of their application, after they had already decided to send the girl to Ontario, appears to be the main reason their request was rejected.
That rejection angered the father, who is supported by the psychiatrist in his fight for funding.
“Throughout this entire process, nobody ever pointed us to any of these guidelines,” the father said. “We were scouring for all this stuff and nobody could tell us.”
He said he was later sent a one-page guideline that he found vague.
The guideline says the province will consider out-of-province treatment when it can be shown the patient has significant problems that don’t respond to reasonable attempts at treatment in Nova Scotia. It says prior approval is necessary before payment will be considered, the patient must be referred by a Nova Scotia specialist and only accredited facilities are eligible for payment.
Furthermore, the guideline says applications for out-of-province mental health treatment require up-to-date psychiatric assessments, a history of previous attempts at treatment and an indication of why they fell short, why the out-of-province facility was selected and what the treatment would cost.
The province also wants to know how the treatment would continue when the patient is returned to Nova Scotia. That is an issue for this family because they now live in Ontario.
Health and Wellness Minister David Wilson would not say how many Nova Scotia children are funded to go to Venture Academy, but he did say out-of-province treatment is rare.
“We receive, typically, less than five out-of-province treatment requests in any given year.”
Although Wilson said he appreciates the stress that families are under, the government has to have a process for investing in out-of-province treatment.
“I know at times it may not be as quick as people would want, but we really take each individual case seriously,” he said. “The turnaround is approximately about a month.
“These are often very complex situations. We try to expedite that process as quickly as we can.”
Wilson said the guidelines are well-known in the medical community.
Without getting into particulars about this specific case, Marika Warren, an assistant professor of bioethics at Dalhousie University, said it’s vital that people know as much as possible about treatment and funding opportunities.
“Ensuring that patients and families know what options are available to them, and the various costs that might be associated with them, is important for anyone in making treatment choices,” she said.
“It’s important for informed consent. That would apply the same to, for example, care for cancer where there might be a treatment available elsewhere that isn’t here.”
Although the inability to secure funding is crippling the family financially, the father said the investment in the school has been worth the money.
He said Venture Academy focuses on communication, self-confidence, self-image and a lot of physical activity.
After a few months at the school, the girl was able to spend some time with her parents, who saw a huge, positive difference. Although they still feel the Nova Scotia government should help them pay, they will never regret sending their daughter to the Ontario school.
“It’s my kid again,” the father said. “You make sacrifices for your kids. It’s going to be worth it.”