Mental Health Issues at Camp: A Growing Challenge

Depression, anxiety, ADD, ADHD, anorexia, bulimia – statistically it is likely that someone at camp will be struggling with one of these mental health issues. Are you prepared?

Mental Health professionals are encouraged that society is becoming more aware, informed and accepting of mental conditions, but we are still years away from being as open and knowledgeable about mental health as we are about physical health. Cheryl Bernknopf, RN, BScN, Professor of Nursing at Seneca College (Toronto) and a camp nurse with thirty years of experience, offers some practical advice for camp leaders:

First, the camp must determine if it has adequate personnel resources to serve campers and staff with mental health issues. Some camps are contracting with mental health experts to provide this service.

If the camp accepts campers with these special needs, preparations are necessary.

1. Gather complete information on the camper’s condition with adequate lead time for the health care staff to communicate with the parents if there are questions about the condition, the triggers or the treatment. Share this information with staff on a need to know basis.
2. Inform the family on the realities of a typical camp day. Will their child be able to cope? Together discuss strategies that will enable the camper to enjoy the experience.
3. Insist that the campers have been on the same medication at the same dosage for at least three months prior to camp. Reactions to new medications can be unpredictable, thereby posing an increased, unknown risk.
4. Advise the parents that it is NOT advisable to take a holiday from medication. Campers need to be at their best initially to settle into camp and establish relationships.
5. Educate your staff on mental health conditions. Train them to acknowledge campers’ feelings; to recognize signs of distress; to be sensitive and tolerant and to have strategies to handle specific situations. Stress the importance of close supervision.
6. Proactively, identify a safe person (e.g. counselor, camp nurse) whom the camper can talk to at any time if they need help and a safe place to go (within sight of supervising staff) if they need time out. Establish a private signal for the camper to indicate without drawing attention to himself that he is taking time away from the activity.
7. A safe counselor must clearly understand that their role is to listen attentively and stay calm. They are not trained therapists. They do not offer advice. If the camper becomes agitated the counselor should accompany the camper to medical help. The camper needs to know that the counselor will be documenting the conversation and sharing the information with someone else who can keep them safe.
8. If a camper has trouble talking about their feelings and problems, suggest that they may prefer to write them down.
9. Enlist the help of sensitive cabin mates.
10. Be clear about what is unacceptable e.g. refusal to take medications. Be discreet in the method of dispensing medications so as not to draw attention to the camper.
11. Check in with the camper regularly. Be proactive to avoid social problems.

Camps should be aware that:

1. There are parents who do not divulge a child’s mental health condition for fear that the camp will not accept them. Camps must communicate clearly with parents that to withhold vital medical information could put their child at risk. For the safety of the child and the camp, full disclosure is necessary.
2. Staff may withhold medical information for fear of not being hired or being ostracized by peers. They may be more willing to make full disclosure if they know that only the health care staff will be privy to their medical information. Their privacy will be respected unless their job performance forces the medical staff to inform the director.

Establish a procedure to enable staff to take an unscheduled break if one is needed.

Experts identify four factors for good mental and physical health

• Regular exercise
• Healthy balanced diet
• Meal times with family
• Face to face time with friends

Does this sound like camp?