After working as a social worker in the public sector for 15 years, Jessica Diamond saw a need to offer timely services to children struggling with mental illness. Depression, anxiety and behavioural disorders skyrocketed in children under 12 during the pandemic, and the public health system didn’t have the resources to help them all. In 2021, Diamond opened a private social work clinic for children in Toronto. Diamond now works with 25 kids struggling with mental illness brought on by years of pandemic-restricted social contact.
You worked in children’s mental health for more than a decade before opening your private practice. Why did you make the switch?
In 2018, my then-eight-year-old child was having mental health difficulties, and I thought I knew how to help: I had spent more than a decade as a policymaker in the child welfare sector. But even if you know where to look, mental health services are hard to come by. Parents can wait as long as two years to get off Ontario’s free wait list and see a children’s social worker or psychotherapist—that’s a long time in a kid’s life. So, in 2018, I got my master’s in social work, and in 2021 I opened The Help Hub. We offer therapy for children, youth and families, as well as parent coaching. My opening coincided with an especially tough two years for kids during the pandemic, and my roster of patients grew very quickly. I hired three associates—a social worker, clinical psychologist and an early-childhood family and support specialist—to keep up with the demand.
Who are your patients?
I work with children under 12 and their parents for family counselling. I also have a colleague who works solely with teenagers. For kids under 12, appointments are a mixture of talking and playing: cognitive behavioural therapy with a jar of play-doh.
How has the pandemic impacted children’s mental health?
During the pandemic, these kids’ worlds shrank considerably, and with fewer opportunities to socialize or play outdoors, their screen time rose exponentially. This led to lifestyle changes impacting children’s development, and resulted in social anxiety, depression, weight gain and interrupted sleep. It didn’t help that parents were (understandably) not at their best: their work lives were shifting and they lost relationships of their own. Many experienced burnout, which meant they had less compassion and energy for their kids at home.
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Are there groups of kids with specific conditions who have been disproportionately affected by the pandemic?
Kids or teenagers with neurodevelopmental disorders like autism or ADHD suffered because of limited in-person services like therapy and social skills groups that are essential for their socialization and development. Some of those kids are now years behind in their development. One of my patients with a neurodevelopmental disorder now finds it hard to make friends and play with others during recess, despite being able to do so pre-pandemic—they’re out of practice.
Kids from low socioeconomic backgrounds are also disproportionately affected, because they were more likely to lose relatives during the pandemic and likely had limited professional support to cope.
We’re no longer in lockdown. How are kids still feeling the effects of the pandemic?
Children are experiencing an epidemic of anxiety, depression and low self-esteem unseen before the pandemic. I see more and more kids as young as eight in my practice who self-harm or are experiencing suicidal thoughts. Anxiety has peaked as kids have re-entered the world: they’re thrown into social situations without knowing how to play with others, or even read facial expressions because we’ve been masking for so long. We think humans are just born with those skills, but that’s not true. When a kid realizes they aren’t good at socializing or making friends, it can lead to frustration, which can contribute to depression. It’s a vicious cycle that needs to be treated in childhood: the faster we can help these kids, the more downstream issues we can prevent as they age. But we don’t have the resources to help all these kids in the public system, and things are getting worse.
Parents of a five-year-old told me their child began self-harming while they were waiting for an assessment on Ontario’s public wait list. I saw another seven-year-old who’s been on the wait list for seven months, despite a worsening mental health condition. Initially, the child was struggling with some anxiety but was still able to go to school and socialize with others. By the time they contacted me, the child had become disruptive in class and at home, avoiding school altogether some days.
Is our health care system equipped to offer mental health services to kids?
Mental health services are woefully underfunded, and it’s worse for children’s mental health. In Toronto, only two hospitals serve kids under 12 in their mental health units. That’s roughly 20 beds for a city with approximately 450,000 kids. It leads to outlandish wait times: in 2022, Children’s Mental Health Ontario noted that wait times for public mental health services for children range from nine months to two and a half years depending on where you live. Children and families are suffering as a result. Schools are no better. The Toronto District School Board has one social worker per five schools—that’s barely enough to handle the most extreme cases. Other kids fall through the cracks.
Just before the pandemic, I encountered a child who was younger than 12 who needed immediate mental health care. His family doctor didn’t have the training to address mental health issues in children, and his only option—other than a one-off conversation with a stranger on a helpline—was the emergency room. He waited eight hours before seeing a mental health specialist, and then had to wait another five weeks for a follow-up appointment with a child psychiatrist. That’s a common case: family doctors are rarely equipped to help children with mental health issues, meaning kids face long wait times to see professionals in the public care system. It’s a bit of a circus.
What needs to change?
We have to fund the public sector, where wages are so low that they can’t attract and retain mental health professionals. Starting salaries for social workers in Toronto hover around $30 an hour. That’s not a livable wage. Coupled with a demanding workload due to staffing shortages, it leads to burnout. That was part of the reason I started a private practice. While my services are more expensive because it’s a private clinic, I offer a reduced fee to families who can’t afford them.
What can parents who can’t afford therapy do?
We’re recovering from years of depleted social contact. I recommend parents spend five to 10 minutes every day connecting with their kid: have a conversation with them, read with them, play outside together. After-school activities or clubs are also a good opportunity for kids to socialize.
Parents should also prioritize their own mental health. It can be as simple as picking up that book you stopped reading or going for that walk after dinner. These small actions will improve your mood and are a good start toward reclaiming a normal family life.