It was three years ago this Valentine’s Day when Prince Charles Secondary School’s (PCSS) medical clinic, The HUB, opened its doors to students for the first time.
Reserved specifically for PCSS students in Grades 8 to 12, as well as for those in the school’s Wildflower program, the HUB came to be after the town joined the Child and Youth Mental Health and Substance Use (CYMHSU) Collaborative in 2014, a province-wide initiative designed to better support B.C. youth.
“Every month, everybody involved in child and youth services in Creston would meet,” said Dr. Nerine Kleinhans, one of the HUB’s physicians and the chief of staff of the Creston Valley Hospital.
“This was doctors, public health, the police, Valley Community Services, East Kootenay Addiction Services, the Lower Kootenay Band — anybody that worked with children would meet every month.”
Despite having these monthly meetings, Kleinhans said that it wasn’t enough to help Creston youth and their struggles. So in October, 2018, PCSS and School District 8 arranged for a meeting with member groups to figure out how to better support local youth in gaining access to mental health services.
“Every single group just came together for the greater good. Nobody had alternative motives. The only goal was to help these youth,” said Kleinhans. “At the end of the meeting, we decided that we want to have a clinic in the high school that offers medical services, counselling for mental health, substance use, public health.”
Three years later, the HUB initiative is still going strong — Kleinhans said that 38 per cent of high school students are registered in the program.
“It’s this incredibly safe, friendly space where the youth can just come in and see us. It’s very important to me because from the beginning, we didn’t want it to be just a mental health clinic,” she said.
She estimates that around 30 per cent of visits are actually mental health-based.
“There’s a lot of contraception advice as well. But we see everything,” she said. “We see headaches, we see musculoskeletal problems. We put in stitches. We see anything and everything.”
The clinic shares a space with the school’s counsellors, although the physicians have their own medical office. It operates twice a week: Wednesday and Thursday mornings.
On Wednesdays, Dr. Carrie Armstrong is in at the HUB, and she is joined by a mental health counsellor from Valley Community Services. On Thursdays, Kleinhans is joined by a substance abuse counsellor from East Kootenay Addiction Services.
Students don’t need permission from their parents to frequent the clinic. No matter the topic, Kleinhans said that she always affirms with students that their conversations are kept confidential.
“Sometimes they come in with one thing, and they sometimes use that as an excuse. We kind of have to make our way to why they’re actually there, which is very interesting,” she said. “It’s really about building good relationships with the teens.”
The HUB averages about 10 visits from students each morning, according to Kleinhans. She added that the majority of students who stop by the clinic are in grades 11 and 12.
“It really gives the kids a sense of [independance]. They can make their own appointments. I think it’s just empowering for them to access medical advice,” she said. “Sometimes it’s something small … then I’ll start asking them some other questions. We would talk about dating, safe sex, eating healthy.”
In 2019, the HUB and the team behind it received an Interior Health Quality award. For Kleinhans, she said that Thursdays have become her favourite day of the week.
“These kids are so honest. There’s so much room for helping them. I can see the good work that we’re doing,” she said.
The HUB during COVID-19
After nearly a year into the COVID-19 pandemic, one of the growing trends that Kleinhans has noticed among the visits from students has revolved around anxiety.
“They are really struggling. What we’ve seen is more mental health visits since we started in September than the year before,” she said. “They really rely on their friends and where they fit in in their groups. The fact that they can’t visit each other’s homes and all of that, and everything that goes on in social media, it’s very hard for them.”
Students struggling with their mental health are first congratulated for their bravery in seeking out help. From there, a mental health counsellor enters the scene, and more discussions are held to see how students can be better supported and if further action is required.
“They need support and understanding, and that’s what we give them. We give them a soft place to land, basically,” said Kleinhans.
Another alarming trend on her radar is a noticeable increase in students stopping by the clinic and inquiring about eating disorders.
“We’re seeing a lot more questions about eating disorders now than I’ve ever seen in the last three years. Just questions though,” she said.
Although she isn’t exactly sure what the correlation is between the pandemic and eating disorders, she said that she thinks it has to do with the feeling of being in control.
“We are in this state where things are out of control. But this is a very small aspect of their lives,” she said. “They can’t control what’s going to happen to the world, but they can control their weight and what they’re eating. That’s how I understand it.”
Whatever the situation may be, the HUB can connect students with their family doctor if necessary.
“We ask the kids if they mind if we share the encounter with their family doctor. I will just send a copy of the consultation with the student’s family doctor to keep them in the loop,” said Kleinhans.
Working with the students, she continued, has been a humbling experience for both her and Armstrong.
“Sometimes, I think I learn more than what I give. There’s still so much that I don’t know. We’re so privileged that these kids trust us enough to talk to us,” she said.
She added that she always learns something new with every visit.
“They tell me everything, because we trust each other,” she said. “All you need to do is trust us. We can’t fix everything, but we’re going to show up and help you. It doesn’t matter what your problem is, we’re going to be there for you.”
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