Savannah Saieva says she felt so abandoned by the city-run children\u2019s mental-health clinic she relied on, she attempted to take her own life.<\/p>\n
As a vulnerable teenager, Saieva spent two years with Child and Adolescent Services, building a trusting relationship with a clinical therapist who was successfully treating her anxiety, depression, low self-esteem and effects of bullying.<\/p>\n
\u201cWe had a bond that pretty much saved my life,\u201d Saieva, now 21, says about the therapist she saw at the clinic regularly from 2018 to 2020.<\/p>\n
But that lifeline was \u201cripped away\u201d when the therapist suddenly left the public health clinic with little warning, Saieva says.<\/p>\n
\u201cNo one explained what was going to happen with my treatment,\u201d Saieva said. \u201cI was just expected to start with someone new, someone I didn\u2019t know and didn\u2019t trust at all.\u201d<\/p>\n
But within weeks, that new therapist was also gone. The next one didn\u2019t last either, leaving Saieva feeling utterly alone.<\/p>\n
\u201cI was bounced around,\u201d Saieva said. \u201cMental-health facilities need to be reliable for the people who depend on them. People\u2019s lives do depend on these services.\u201d<\/p>\n
Without consistent care, her mental health deteriorated to the point that she says she was self-harming and developed an eating disorder. In 2021, at 16, she attempted to take her own life.<\/p>\n
Saieva\u2019s suicide attempt came during a period of dramatic turnover at Child and Adolescent Services, with roughly 11 of the 14 therapists left between 2019 and 2022.<\/p>\n
Former staff describe an upheaval triggered by changes to how the clinic was managed and a shift toward brief, higher-volume therapy \u2014 changes they say disrupted long-standing therapeutic relationships at a time when youth mental-health needs were surging during the COVID-19 pandemic. Even years later, many say they remain deeply concerned about the children who they fear were left without stable care.<\/p>\n
\u201cI try to make sense of the psychological distress I continue to experience in relation to my former workplace,\u201d said Joanne Robinson, who was a clinical therapist at Child and Adolescent Services from 2011 to 2021. \u201cEven several years later, so many of us still feel motivated to speak out about our experience.\u201d<\/p>\n
The questions come as Hamilton Public Health Services has identified child and youth mental health as a priority through 2029.<\/p>\n
Public health says the clinic\u2019s overhaul led to \u201csignificant quality and service improvements,\u201d including shorter wait times and more children served \u2014 but the loss of experienced clinicians has raised questions about whether expanding access came at the cost of continuity and high-quality care for vulnerable youth.<\/p>\n
Losing a trusted therapist \u2014 especially suddenly \u2014 can disrupt a child\u2019s sense of safety and stability, said Andrew Sofin, president of the Canadian Association for Couple and Family Therapy.<\/p>\n
Transfers to new therapists, he said speaking generally, should be carefully planned, clearly communicated and timed to support the client.<\/p>\n
\u201cThe therapeutic relationship is the absolute foundation of good clinical work,\u201d Sofin said. \u201cHaving somebody the child or teenager trusts, and feels like they have the expertise and the knowledge to help them, that\u2019s what makes all the difference.\u201d<\/p>\n
Dream job<\/p>\n
Hamilton\u2019s Child and Adolescent Services was described as a dream job for clinical therapists by former staff.<\/p>\n
\u201cIt was high calibre, the staff were phenomenal, the services were bar none,\u201d said Tammy Dunn, who was a clinical therapist there from 2010 to 2022.<\/p>\n
<\/p>\n
Hamilton\u2019s Child and Adolescent Services was described as a dream job for clinical therapists by former staff.<\/p>\n
Cathie Coward\/The Hamilton Spectator<\/p>\n
Positions were hard to come by at the clinic because those who got hired rarely left. It took Dunn three years to get a job there.<\/p>\n
\u201cThe turnover was very slow,\u201d said Louise Oke, who was a clinical therapist at Child and Adolescent Services from 2001 to 2020. \u201cThere were really experienced, dedicated clinicians who worked there for their entire careers.\u201d<\/p>\n
Sofin said it\u2019s unusual for a publicly funded mental-health clinic to attract experienced clinicians.<\/p>\n
\u201cMost of the time, you\u2019re only getting people straight out of grad school,\u201d Sofin said.<\/p>\n
Generally, therapists eventually move on to better-paying jobs \u2014 mostly in the private sector. Sofin said a public clinic would have to be \u201cfantastic\u201d to retain experienced staff for years.<\/p>\n
\u201cIt was a dream come true,\u201d Dunn said about working there. \u201cI felt like I was always learning. I was being challenged to be better, to learn more and it was just a really invigorating, colourful place.\u201d<\/p>\n
Former staff say the job started changing in 2018, when new management took over and began to substantially shift the direction of the clinic.<\/p>\n
Hamilton Public Health Services declined a request for an interview, but said in a statement that the clinic underwent a program review and changed its approach in 2018 to align with Ontario\u2019s child and youth mental-health action plan. The service is funded by the provincial government.<\/p>\n
\u201cConcrete and positive outcomes from the program review include a significant increase in clients served, decreased wait times and an increase in clients who reported a positive experience,\u201d stated public health.<\/p>\n
The clinic had 1,000 referrals last fiscal year, which ended March 31, 2025. Of those, 868 kids received counselling and therapy \u2014 an increase of about 125 children compared to the fiscal year that ended March 31, 2023. Over that time, the waiting list went down to about three months from five months.<\/p>\n
However, the former staff say the changes focused too much on the numbers and not enough on the vital counselling services provided to children, youth and their families.<\/p>\n
\u201cIt was about quantity over quality \u2014 \u2018Let\u2019s get our numbers up,\u2019\u201d Dunn said. \u201cIt wasn\u2019t about concern for the quality of therapy \u2026 It wasn\u2019t about relationships, which is the No. 1 factor in success in therapy. It wasn\u2019t evidence-based.\u201d<\/p>\n
It\u2019s an all-too-familiar conflict to Sofin, who says ensuring timely access and good quality care with limited funding has become a difficult balancing act in the country\u2019s strained mental-health system.<\/p>\n
\u201cThis is endemic across all of Canada,\u201d Sofin said. \u201cThe waiting lists have ballooned, especially since COVID. What\u2019s happening is we\u2019re getting a real push and pull of, \u2018How many sessions do you need to really help somebody?\u2019 versus, \u2018How long is the wait list?\u2019\u201d<\/p>\n
Unstable budgets<\/p>\n
Public health said in its statement that financial considerations were not part of the program review.<\/p>\n
But Child and Adolescent Services has had an unsteady budget for years \u2014 as is the case with many provincially funded public-health programs.<\/p>\n
In June 2024, public health had to ask the city to make up a $103,931 funding shortfall to avoid cuts to the service. Its report on the clinic at that time showed it had previously balanced the budget by reducing staff in three other fiscal years going back to 2016.<\/p>\n
However, at other times, the clinic was given budget increases by the province that allowed staff to be added, or got just enough funding to keep what it had.<\/p>\n
Controversial changes<\/p>\n
Public health and former staff tell very different accounts about the changes that started in 2018.<\/p>\n
The public health statement said the review was \u201caimed at improving service delivery.\u201d<\/p>\n
\u201cImprovements included the review and reinforcement of practice standards, validated assessment and treatment protocols, and an increase in evidence-based interventions,\u201d the statement said.<\/p>\n
Hours of work became more standard and the clinic was open more often, including an increase in evening appointments.<\/p>\n
A rapid-access service in community-based agencies was introduced to extend the clinic\u2019s reach and remove barriers. However, public health did not answer questions about how it works.<\/p>\n
The former staff say despite having years of experience in the field, they weren\u2019t consulted on the changes.<\/p>\n
\u201cThere are very little resources for mental-health services for kids,\u201d Oke said about the importance of getting it right.<\/p>\n
One of the biggest concerns of former staff was a new emphasis on solution-focused brief therapy with the goal of clearing wait lists and seeing as many kids as possible.<\/p>\n
\u201cThey just wanted us to see clients for short periods of time to get through the wait list,\u201d Oke said. \u201cWhether or not clients needed more than a brief service, they were only going to get a brief service.\u201d<\/p>\n
Brief therapy is done in a small number of sessions \u2014 roughly three to 10.<\/p>\n
It can give a child with anxiety about going to school a specific plan and tools to help keep them in the classroom, for example. But former staff say it doesn\u2019t necessarily address or treat the underlying anxiety.<\/p>\n
\u201cBrief is useful, it can be helpful,\u201d Oke said. \u201cIt works for some people. But it\u2019s not the only thing.\u201d<\/p>\n
Another change that troubled former staff was a push to get rid of the specialization that had formerly been one of the points of pride in the clinic.<\/p>\n
It meant clinicians had to take on cases outside of their areas of expertise.<\/p>\n
\u201cThere is specialized training to do that work,\u201d Robinson said. \u201cWhat we\u2019re seeing is very little faith in, or respect for, our expertise. Morale plummeted.\u201d<\/p>\n
Robinson, for example, spent 20 years working at the John Sopinka Courthouse before joining the clinic\u2019s forensic team that did assessments for courts, worked with youth convicted of crimes and provided therapy to victims.<\/p>\n
Dunn described her distress at being expected to do forensic work when her specialty was brief therapy.<\/p>\n
\u201cWe were going to do these specialized assessments for folks who started fires and sexually offending youth,\u201d Dunn said. \u201cYou can\u2019t learn that in a one-day workshop.\u201d<\/p>\n
The former staff also say there didn\u2019t seem to be an understanding of the importance of relationships in therapy.<\/p>\n
\u201cRelationship is the key,\u201d Robinson said. \u201cYou don\u2019t want some random person who works at the clinic to phone you up.\u201d<\/p>\n
For example, when COVID hit, they say the initial plan did not keep kids with their therapists. Anyone requiring therapy would be cared for by a smaller team instead. They say the plan was changed amid widespread backlash from therapists.<\/p>\n
\u201cIt\u2019s unethical because you could be retraumatizing the client,\u201d Dunn said. \u201cThey\u2019re retelling their story, reliving the trauma over and over again with a new person.\u201d<\/p>\n
One of the most alarming changes was that staff say they were discouraged from consulting colleagues on cases. This common practice strengthens clinical outcomes and, in certain situations, is a requirement of regulatory colleges.<\/p>\n
\u201cThat can make or break the clinical outcomes,\u201d Sofin said. \u201cYou need to be able to have that back and forth to really be able to be the best clinician you can be.\u201d<\/p>\n
<\/p>\n
Hamilton Public Health Services operates the city\u2019s Child and Adolescent Services clinic.<\/p>\n
The Hamilton Spectator file photo<\/p>\n
Pressure cooker<\/p>\n
The new approach at the clinic also came with increased amounts of documentation, the former staff said, and tighter restrictions on their ability to work extra time to get it done.<\/p>\n
The hours were so rigid and inflexible that Robinson says she wasn\u2019t allowed to change her shift by 30 minutes one day to accommodate an appointment for one of the kids in her care.<\/p>\n
\u201cIt just became a pressure cooker,\u201d Robinson said.<\/p>\n
While all these changes were taking place, the former staff describe their workplace becoming \u201coppressive\u201d and \u201ctoxic.\u201d<\/p>\n
Staff who had worked for years with no disciplinary issues and good performance evaluations said they were increasingly in trouble at work and feeling targeted for speaking out. Two of them say they were called into meetings with management that left them highly distressed right before they were supposed to provide therapy to kids.<\/p>\n
\u201cI don\u2019t throw around the word trauma lightly \u2026 but I would say that this experience at the city was traumatic for me,\u201d Robinson said. \u201cTo be treated the way that I, and so many of my colleagues, were treated in the context of a mental-health clinic, is still hard to fathom.\u201d<\/p>\n
Raising alarm<\/p>\n
At first, staff started taking leaves \u2014 Dunn alone took four separate medical leaves, all for stress.<\/p>\n
But ultimately, the majority of the therapists left a career many described as a deeply loved calling.<\/p>\n
\u201cI was fighting to save my emotional and mental well-being while facing an extremely painful and insufferable situation,\u201d Dunn said. \u201cI was left with no choice but to walk away.\u201d<\/p>\n
Oke also took a stress leave before she says she decided to \u201cjump ship\u201d and leave the clinic.<\/p>\n
\u201cPeople worked there under enormous stress,\u201d Oke said. \u201cYou couldn\u2019t come in to work and do your job every day when you were crying or just not OK emotionally.\u201d<\/p>\n
Some former staff pinned their hopes on a questionnaire circulated by the Canadian Union of Public Employees (CUPE) in 2021 that they say showed so much discord, a workplace review was requested.<\/p>\n
\u201cManagement said no,\u201d said Dunn, who was the union representative for the clinic, fielding concerns from almost every staff member. \u201cOnce they said no, the union just kind of walked away and that was it. I was a strong supporter of the union, and I was profoundly let down.\u201d<\/p>\n
CUPE did not respond to a request for comment regarding what representation Local 5167 provided to the clinic workers.<\/p>\n
Others said they tried to flag what was going on in exit interviews and Robinson wrote a letter to city leadership when she left.<\/p>\n
\u201cWhile I appreciate your belief that the culture is toxic, we don\u2019t have the information to support that allegation,\u201d Matthew Sutcliffe, who was director of employee health and labour relations at the time, responded to Robinson\u2019s letter in November 2021.<\/p>\n
Public health said that it can\u2019t speak to personnel matters.<\/p>\n
\u201cHowever, we can confirm the City of Hamilton has robust policies and procedures in place to investigate and address issues in the workplace,\u201d said the statement.<\/p>\n
Public health said the clinic meets all the mandatory standards of the Canadian Centre for Accreditation, which looks at governance, leadership, management and program areas of community-based health and social services.<\/p>\n
Effect on kids<\/p>\n
What really weighs on the former staff is how their departures potentially affected the kids in their care, especially during the pandemic.<\/p>\n
\u201cI think there was a lot of trickle-down impact on clients,\u201d Oke said.<\/p>\n
Saieva was one of Oke\u2019s clients at the clinic and never did find another match with a therapist there.<\/p>\n
<\/p>\n
Savannah Saieva, left, and her mother, Shirley Saieva, say the loss of therapists at a city-run children\u2019s mental-health clinic between 2019 and 2022 caused lasting harm.<\/p>\n
Cathie Coward\/The Hamilton Spectator<\/p>\n
\u201cIt was one of the worst years of my life,\u201d Saieva said. \u201cThis was in COVID times \u2026 It was a pretty serious time for me to have support and that\u2019s just something I didn\u2019t have.\u201d<\/p>\n
Saieva left Child and Adolescent Services in 2021 for a different community mental-health clinic, but eventually gave up on public care and sought out Oke in private practice in 2023.<\/p>\n
\u201cI walked in with the biggest smile on my face just to have that person that I created that bond with,\u201d Saieva said about finding Oke again.<\/p>\n
Saieva is now studying sociology at McMaster University and doing well in Oke\u2019s care.<\/p>\n
\u201cI can genuinely say, without her, I would not be where I am right now,\u201d Saieva said. \u201cShe taught me a lot of the coping skills I have.\u201d<\/p>\n
It took a lot of work for Saieva to get to this point. She initially came to the public health clinic following a suicide attempt in Grade 8 at age 13. Oke was the second therapist Saieva saw, and they clicked.<\/p>\n
\u201cShe got to know how I worked,\u201d Saieva said. \u201cWhen I go into her office, I just yap, which is so uncharacteristic of me.\u201d<\/p>\n
She can remember in excruciating detail when Oke told her she was suddenly leaving the clinic.<\/p>\n
\u201cI felt my heart drop and I started sobbing,\u201d Saieva said. \u201cI felt like I was back in eighth grade, just alone.\u201d<\/p>\n
Saieva said the loss of her therapist caused a lot of harm.<\/p>\n
\u201cI was basically at ground zero again,\u201d Saieva said. \u201cTherapy is something that\u2019s supposed to help you. It\u2019s supposed to be supportive, reliable, convenient and it was just none of that.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Savannah Saieva says she felt so abandoned by the city-run children\u2019s mental-health clinic she relied on, she attempted…\n","protected":false},"author":2,"featured_media":329906,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[134,554,555,111,139,69],"class_list":["post-329905","post","type-post","status-publish","format-standard","has-post-thumbnail","category-mental-health","tag-health","tag-mental-health","tag-mentalhealth","tag-new-zealand","tag-newzealand","tag-nz"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/329905","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=329905"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/329905\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/329906"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=329905"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=329905"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=329905"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}