Silverstone Hoping EMPATHY Might be Reborn in Fort McMurray As Students Struggle to Cope in Aftermath of 2016 Fire

The record-breaking wildfire that tore through Fort McMurray in the summer of 2016 left Alberta's oilsands capital looking like a scorched war zone.

1 March 2018

The record-breaking wildfire that tore through Fort McMurray in the summer of 2016 left Alberta's oilsands capital looking like a scorched war zone.

Roughly 2,400 homes and buildings were destroyed, thousands of vehicles were torched and personal property losses reached $2.4 billion.

With production from nearby oilsands facilities halted or curtailed for weeks, the unprecedented disaster also cost the oil industry and the Alberta government billions of dollars in lost revenues.

Those were just the visible scars, however. The raging inferno - nicknamed The Beast - also left plenty of unseen devastation in its wake, as residents battled with lingering issues like depression, anxiety and Post-Traumatic Stress Disorder (PTSD).

Over the past year and a half, a team including the University of Alberta Department of Psychiatry's Dr. Peter Silverstone and Dr. Vincent Agyapong has studied how the disaster affected the mental health of Fort McMurray's residents, particularly the city's school children.

With $500,000 in funding from a partnership including the Canadian Institutes of Health Research, the Canadian Red Cross and Alberta Innovates, Silverstone and Agyapong have studied the physical, emotional and psychological after-effects of the wildfire on 3,200 students, aged 5 to 18.

Their goal? To use the assembled data to generate a detailed portrait of the mental health issues and related needs of children and youth in Fort McMurray, and beyond that, to use the findings to advocate for more mental health resources to support them.

(Silverstone previously applied that approach in Red Deer, by implementing the EMPATHY program. The results were impressive, as outlined below.)

In the weeks after the fire, Agyapong found that roughly 80 per cent of all Fort McMurray residents faced some type of mental health issue. Even six months later, a third continued to grapple with mental health issues, and the rate of PTSD among adults reached 12.8 per cent, up from less than half of one per cent previously.

In particular, Agyapong and Silverstone have been studying PTSD rates among Fort McMurray's children and adolescents.

"We're working with both the Fort McMurray Public Schools and Fort McMurray Catholic Schools, and they have both been tremendously supportive," says Silverstone.

"We hope to have first data from this study fairly soon. We're hoping everything we've learned will translate into some positive outcomes for students. My strong suspicion is that there will be significant increases in the number of mental health problems for children and youth in Fort McMurray."

It's a subject Silverstone knows a lot about.

The EMPATHY program, which he spearheaded in Red Deer Public Schools over a 15-month period between 2013 and 2014, involved more than 6,200 students from Grades 6 through 12. It was created with the support of the then-superintendent of public schools in response to a rash of teen suicides.

EMPATHY employed a novel, multi-pronged approach to screening students for mental health issues, using both universal and targeted surveys to identify kids who were struggling with anxiety and depression, or abusing alcohol and drugs.

"There are pros and cons to each approach, so we used both. The universal approach has not been shown in the literature to be very effective. The percentage of kids who need it is very small. To measure a change in 100 kids when only 10 have problems is hard," says Silverstone.

"With the targeted approach, whatever your threshold is, you're always going to miss kids. And as it turned out, several of the youth in Red Deer who had committed suicide weren't on anybody's radar. So we used both approaches."

The results were disturbing. "From Grade 6 up to Grade 12, it was really striking how many children and youth felt awful. About 10 per cent of them suffered from depression, and about 25 to 30 percent had anxiety issues, so it was really worrying."

The key to the EMPATHY program's success, as it turned out, was something quite unexpected.

"We hired a series of wonderful individuals we called Resiliency Coaches. None were highly trained, they weren't teachers or psychologists, but they were good at being empathic with children and youth. That was the real strategy," says Silverstone.

Junior high students were offered mental health training courses, while secondary school students struggling with depression or suicidal thoughts had quick access to trained support, and professional help as needed. Students were also offered online interventions with therapists after their parents were notified.

A follow-up study was done in 2015, 15 months after the program ended. Silverstone's findings? The percentage of students who were suicidal dropped from 4.4 per cent to 2.8 per cent, and reported rates of depression, anxiety, and self-harming all fell sharply. In addition, drug and alcohol use as well as the rate of bullying incidents declined.

"Our ongoing analysis shows that this program doesn't only help with depression, anxiety and suicidality, but also reduces drug and alcohol use. That's exciting," says Silverstone.

"In the end, Red Deer went from half a dozen student suicides in these schools over 15 months to none over the past three years that I am aware of. So EMPATHY made a big difference to suicidality, to anxiety, to depression, to drug and alcohol use, and bullying. That's pretty comprehensive."

The cost of the program per student: about $150 per year. Funding for the EMPATHY program ended following the 2015 provincial election.

"We've been using some of these same screening tools in Fort McMurray and the results I expect to show will include high rates of depression and PTSD. So there are likely to be major problems there in the wake of the fire," he says.

"We hope to report first data from the Fort McMurray study fairly soon, which we hope will ultimately translate into some beneficial outcomes for students. Prevention is the way forward, we should be spending more money on prevention, and EMPATHY is a program that works. There's nothing like it anywhere else in the world."