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Covenant House

By the time Nicole reached Grade 11, she was “completely out of control.” There was the drinking and the drugs; there was the binging and purging; and there was her dysfunctional family who put padlocks on the fridge in a misguided attempt to save her from herself.

By the time she was 18, she was drunk “almost 24-7,” and had made multiple trips to hospital psych wards. Quoted in a CBC radio interview last year, she said: “I was never really given any – I won’t say any – but I really wasn’t given a lot of help. I would briefly talk to a psychiatrist, usually while I was still drunk.” And then they’d send her on her way.

In January 2009, after her worst month ever, she sobered up at the age of 20 with the help of the Covenant House Mental Health Program, a partnership between the downtown youth shelter and the InnerCity Youth Mental Health team at St. Paul’s Hospital.

The premise of the program is simple: a team of eight psychiatrists goes to where the kids are, instead of expecting the kids to come to them. Participants have weekly psychiatric appointments, meetings with youth workers, support to find housing, and a variety of life skills courses and other activities they can join. The emphasis is on building relationships so they regain a sense of trust in the world.

Thanks to the program, Nicole was able to put a name to her erratic behaviour – bipolar disorder. Because she was sober and had a place to stay at Covenant House, she was able to follow the required regimen for her mood stabilizer. “It was definitely a bit of a relief because something like bipolar is an actual diagnosable condition and that means there’s help for it. I wasn’t just crazy,” she says.

Nicole is one of 80 at-risk and homeless youth aged 19 to 24 being supported by this innovative program, which has an impressive appointment attendance rate of 80 per cent.

“When I first started working here, there was no psychiatric help like this available. There was nowhere to go,” says Tracy Brown, who co-ordinates the program at Covenant House. Youth workers could only watch powerlessly as their clients struggled to deal with undiagnosed and untreated mental health problems, even psychosis. A psychiatrist came once a week to help those on the verge of harming themselves or others. “We were just firefighting,” recalls Brown.

The psychiatrists at St. Paul’s realized there had to be a better way, and launched this project with Covenant House in 2007. In 2009, Vancouver Foundation’s Youth Homelessness Initiative stepped in with a $200,000 grant to help cover two more years of the project, which has already won awards from St. Paul’s Hospital, the City of Vancouver and Eva’s Initiatives, a non-profit based in Toronto.

Covenant House sees 2,000 homeless youth a year, and an estimated 40 to 60 per cent have moderate to severe mental illness. About 70 per cent come from foster homes. “At 19, these youth have no family,” says Brown, adding, “A lot of people think drugs and alcohol are the problems with these youth. I always thought that was just a Band-Aid.”

The program’s lead psychiatrist, Dr. Steve Mathias, or “Dr. Steve,” as the youth call him, has a small office in a single room occupancy building where 10 of the program participants live. He speaks softly, with a faraway look in his green eyes. “We’ve helped youth who [literally] thought they were fish swimming on the sidewalk. We have some kids who believe they are being monitored or followed or persecuted and they have to keep on the run. We have kids who have self-harmed to the extent that they have cuts upon cuts on their arms.”

On a tour of the building, Mathias enthusiastically and genuinely greets each young person he sees, asking them how they’re doing and chatting for a few minutes.

On Wednesdays, members of the mental health team prepare a drop-in breakfast. On Thursdays, they do lunch. More than just a free meal for hungry young people, it’s a chance to build relationships, and reinforce the knowledge that someone will be there for them no matter what. “It’s that one meal that is cooked in their home just for them,” says Brown.

They’re an incredibly traumatized population, adds Mathias. “The kids we see are kids whose parents were strung out on crack, kids who were physically beaten, kids whose mothers walked out on them when they were eight years old, never to see them again.” And that kind of damage doesn’t get reversed overnight. “The human brain actually develops differently when a person is raised in that kind of environment,” says Mathias. “Attachment is from cradle to grave; it can happen all through life, depending on the influences that come into your life,” says Brown. The good news is that it’s possible, over time, to help them.

On his way out the door, Mathias asks a brown-haired young man how he is doing; “Good enough,” comes the answer. These young people have their entire lives in front of them, but many have been so traumatized that respect is new for them, says Mathias. Some are incredibly bright or have amazing talents; they are painters, computer geeks, soccer players. But they haven’t been able to live out their potential. “We’ve become a society where we just expect people to find their way. With these youth, that’s just unreasonable because they need a lot of help. They need years of help, but they get there.”

Progress can be measured in the tiniest details – it could be as simple as someone lifting his or her head up to make eye contact for the first time, or sleeping through the night.

As for Nicole, she was eventually able to enrol in university and hold down a part-time job at a restaurant. She says when she’s sober and happy, the possibilities are endless: “But really I just want to feel like a member of the world and a person among people. That’s my biggest dream. And it’s starting to happen.”

To find out more about the Covenant House Mental Health Program, email or call 604-638-4438.
If you would like to help young people like Nicole realize their dreams, contact Vancouver Foundation’s Donor Services at 604-688-2204 and ask about our Youth Homelessness Initiative.


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