Purple’s Path to Progress: Integrating Care for Dual Diagnosed Youth 

March 1, 2024 – We’d like to introduce you to Purple.  

Purple doesn’t want to be here anymore. Purple doesn’t want to go to school or leave their house. A once creative and engaged child, Purple is now suffering.   

Purple is a 15-year-old, non-binary youth who was diagnosed with autism and Attention-Deficit Hyperactivity Disorder (ADHD). Purple is a second-generation immigrant who lives with their mom in a basement apartment and has limited time with their dad. The relationship between each parent and the child is strained. Purple is suffering.  

After displaying high-risk behaviours of suicidal ideation and violent thinking, Purple was referred to the Ontario Autism Program’s (OAP) Urgent Response Services (URS) team at Kinark.  

The OAP’s URS program offers short-term services (up to 12-weeks) in response to a specific, high-risk need that requires rapid attention, and is available to children and youth who are registered with the OAP and that display any one of ten high-risk behaviours that began or escalated within the previous 14 days. Tthis could include suicidal ideation or behaviours, violent thinking, risk of exploitation, self-injurious behaviour, aggression, inappropriate sexual behaviour, destruction of property, flight risk and other such harmful behaviours. The children admitted to this critical program are some of the most at-risk youth in Ontario.   

The URS program is rooted in client and family-centred care. What differentiates this program from other supports is that these services are coordinated and collaborative between specialties. This inter-disciplinary approach provides high-quality, evidence-based service while remaining accessible and responsive to the client and their families. These interdisciplinary team members may include a URS Coordinator, an ABA team and respite services, as well as a Physician, Speech Language Pathologist, Occupational Therapist, Psychologist, Mental Health Consultant, and Registered Dietician. Eventually these teams support with the client’s transition to collaborative partners such as child-care providers, schools or other children’s services.   

When Purple entered care, their treatment plan focused on safety planning and risk mitigation. It focused on parental validation and emotion coaching, as well as skills development in effective communication, accurate expression of emotions, and appropriate asks for support. Repairing the relationship between Purple and their mother was paramount to the treatment plan, and improving communication was at the core of the family’s behaviour therapy sessions. Eventually, discharge planning took place and included working with Purple’s school to ease transition, coordinating gender affirming services, as well as ensuring that Purple had access to ongoing mental health supports.   

As the team readied Purple for discharge from the URS program, the clinical team was pleased to report that Purple had a decrease in suicidal ideation and violent thoughts. Purple gained confidence in using the prepared safety plan and coping strategies, and developed a newfound trust in seeking mental health supports. Purple now feels optimistic and has a positive view of therapy, they are eager to continue with treatment.   

Purple’s mother has noticed a significant difference in Purple’s behaviour and a substantial improvement in their communication, “When we started the program, we were really in crisis…this year last time, I was an exhausted mother, I didn’t think it would get better, but it did…The whole [URS] program was a bridge between me and [Purple] that connected us together, I feel that connection.”   

Purple feels like themselves again; reading anime, spending time with family, and embracing their artistic side. They have now moved forward in their path to recovery and no longer require urgent response services. We’re pleased to share Purple’s progress and proud to support this critically important program, providing urgent mental health supports to the children that need it most.   

In Simcoe County and York Region, URS services are provided by the York Simcoe Autism Network (YSAN), a network of 11 service providers. In its first year of implementation, the YSAN team served a total of 323 URS clients. Of those 323 URS clients, 34 per cent had a mental health need and 48 per cent of clients that were referred for a second round of services required a mental health consultation. This program allows for the development of an urgent treatment plan that combines both ABA services and Mental Health services in order to offer clients, like Purple, the care they need, when they need it.  

Kids and youth like Purple need help. Their needs are complex, and their lives are often fraught with difficulty that, unless you or someone you know has been impacted by these conditions, many cannot understand. Purple’s story is truly inspiring and encourages us to continue to instill hope in our clients and families for a better future.  

Purple is no longer suffering, but many other young people across Ontario are. If you resonated with Purple or their mother’s situation, we want you to know that there is always hope and we are here to help.  

Based on the CMHO presentation – Integrating Care for Dual-Diagnosed Youth: Learnings from Urgent Response Services