Isolation rooms used every day

Supposed to remain “exceptional measures”, the isolation and restraint of young people housed in rehabilitation centers and group homes are on the rise in most regions of Quebec.

Centers and group homes in Montreal, Montérégie, Laval, Mauricie, Estrie, Abitibi, Outaouais, Quebec and the North Shore, among others, have experienced increases since 2020, according to a compilation of The Press carried out with data transmitted under the Access to Information Act.

In some cases, only isolation measures are increased. In others, it is restraint measures or even out-of-service withdrawals that are exploding. And sometimes, as in Mauricie, Estrie and Montreal, it is all three that are increasing.

Children housed in rehabilitation centers are the most vulnerable in society. The center is “the last line” for young people with mortgages, often from dysfunctional families.

The CISSS and CIUSSS – which oversee youth centers and group homes – explain the significant increase in control measures, in particular, by the increase in the number of children placed in Quebec since the pandemic.

In several regions, overflow units had to be opened. In this context, units supposed to serve to calm young people in crisis have sometimes been transformed into living units, thereby depriving those involved of valuable tools.

Consequence: these same stakeholders resort more to restraint and isolation. This is what we observe in Laval and Montreal.

It remains that the increase in control measures in certain regions is much greater – in proportion – than the increase in the number of young people accommodated.

The cases are also more complex than before, and the distress is greater, indicate those responsible for the youth program of the CISSS and CIUSSS where the increases are felt.

“The customer base is growing,” confirms Mélany Rivard, coordinator of the Dominique-Savio site, in Montreal, where the measures exploded. We are seeing more diagnoses of mental disorders and multiple traumas – physical and sexual – sometimes in the same young person, she says.

Here, the isolation rooms are used every day.

Many are sent there for “their own safety”, explains the head of duty at this site, Jean-Frédérick Beaulieu. We are talking about children who mutilate themselves, hit their heads on walls, attack other young people or attack the workers, for example.

Locked, certainly, but large and bright, the isolation rooms at Dominique-Savio have nothing to do with those resembling “cells” where “tannants” of only 9 years old were sent to the Cartier center in Laval – until The Press revealed this practice earlier this year.

Here, windows let in daylight. Stuffed animals, heavy blankets and other sensory objects are available to children. Calm music plays there. The lighting is subdued in the evening.

The case of “heavy users”

In Dominique-Savio, “large users” of control measures drastically increase the statistics. 9% of young people in accommodation are affected by 86% of the measures.

Like little Maya* who ended up here after spending the first eight years of her life in a cage. She only came out to be used as a sex toy.

Or this other little girl in accommodation, 11 years old, with whom the mother cut ties overnight. The child is convinced that “something happened” to him, unable to imagine that his mother – his only family – could have abandoned him. Since then, the little one has had crisis after crisis.

This type of child “with multiple traumas” can become “disorganized” seven or eight times a day to make it clear to adults “to keep their distance”, illustrates Jean-Frédérick Beaulieu.

Same story elsewhere in Quebec. “The 6-year-old who arrives to us in 2024 has nothing to do with the one who arrived to us in 2000. It’s two worlds,” says the deputy director of youth accommodation, rehabilitation and delinquency at the CIUSSS de la Mauricie-et-Centre-du-Québec, Mathieu Bédard.

Representative of the category of paratechnical personnel, auxiliary services and trades at the Federation of Health and Social Services (FSSS-CSN), Guillaume Clavette notes that young people in accommodation are “much more medicated today”.

In interview with The Press at the end of April, the Minister responsible for Social Services, Lionel Carmant, explained that the increasingly marked presence of children with intellectual disabilities or an autism spectrum disorder (ID-ASD) in youth centers has an impact on restraint measures. The minister said he wanted to “take these children out of youth centers to put them in more suitable environments” and offer more respite to families.

In the eyes of the minister, the solution involves “good training of educators”, that is to say ARC training (attachment, regulation and competence). “Where they have had this training, we see that the rate of restraint and isolation decreases. We want all educators [la] follow,” he said.

Educators manage to create a bond of trust with children, “but it takes time, a lot of patience, consistency and stability,” underlines Mr. Bédard, of the CIUSSS de la Mauricie.

Critical shortage of educators

In the metropolis, the shortage of educators is such that overflow units have been opened “many with agency staff”, admits the director of the youth program at the CIUSSS du Centre-Sud-de-l’Île-de- Montreal, Jason Champagne.

Its CIUSSS cannot do without this independent workforce, but it tries by all means to recruit it and thus offer stability to the children, says Mr. Champagne.

“How can a young person feel safe and calm if they see new faces passing by so often? People who don’t know it, who decode it poorly, continues Delphine Collin-Vezina. So are it the young people who are more complex or the environments which are less reassuring for them? »

Let us avoid placing “the blame” on the children in care or on “the stakeholders who are carrying at arm’s length a system that is experiencing an incomparable crisis,” concludes M.^me Collin-Vezina.

* Fictitious first name since the law does not allow us to identify it