Dr. Alice Leung has always had a soft spot for the underdog. She knows what it's like to grow up as an outsider in an economically disadvantaged area.
"I was born in Hong Kong and we moved to the Norwood neighbourhood in Edmonton when I was five," she says. "I actually had to repeat kindergarten because we arrived in March, and my English wasn't good enough to start grade one by September," she recalls, with a rueful laugh.
Leung's father, a butcher, landed a job at Gainers, a meatpacking company then owned by Peter Pocklington. Her mother, a kindergarten teacher in Hong Kong, found menial work as a hotel housekeeper.
"I didn't know we lived in a poorer neighbourhood," she says. "They'd feed us snacks at school. Only later did I realize: 'They're feeding us because we live in an underprivileged area. It was a very grounding experience. I guess that's why I feel very connected, not just to the immigrant population, but to the underprivileged."
Despite the challenges, Leung's family worked hard and prospered in their adopted homeland. Leung, a talented student, went on to earn a medical degree from the U of A in 1995, and she completed her residency in psychiatry in 2000.
A year later she completed a fellowship in child and adolescent psychiatry, with a focus on assessment and psychotherapies for children, adolescents and their families, at the University of Toronto's Hincks-Dellcrest Institute & Centre (now the SickKids Centre for Community Mental Health).
"By then I had met my husband. We didn't have kids, so we could have uprooted and moved to Toronto. When you're young you think you want to live in a place that's cosmopolitan and exciting," she says.
"But once I was there I looked at Edmonton as a very comfortable place to live. There's lot of opportunity here, it's friendly and not too big. So we returned in 2001 and I started working at CASA, both with outpatients at CASA Downtown, then later, at CASA Ford Road, and with inpatients at CASA House."
She found CASA's work with troubled children, adolescents and families stimulating, rewarding and challenging, offering plenty of scope for professional growth.
"At CASA House, in addition to providing psychiatric consultation I could do family therapy, group therapy, multi-family therapy, parent support groups, some individual therapy and of course my outpatient practice, which is assessment and follow-up - currently at CASA Ford Road and the Morinville Mental Health Clinic - but also for many years telepsychiatry to remote families in northern Alberta."
Leung was appointed Medical Lead at CASA House in 2009 - a position she continues to hold - and in 2016, Chair of CASA's medical staff. Leung resigned as Chair after starting her new AHS and Division roles.
"The interesting thing about working at CASA House is you find at the end of the day that yes, medications are significant. But there are a lot of family dynamics behind why kids end up in residential care, including inter-generational trauma."
Challenges at school are another big factor. "For kids, school is akin to adults' work. If you spend six hours a day at school and it's in an unpleasant environment, where you feel bullied or socially anxious, that's going to affect how you function."
In 2013, after working as a psychiatrist for a dozen years, Leung went back to study for the new subspecialty child and adolescent psychiatry exam from the Royal College of Physicians and Surgeons, becoming one of just half a dozen practitioners in Edmonton and 27 in Alberta to earn a subspecialty certificate in child and adolescent psychiatry.
On Sept. 1st, Leung was named Alberta Health Services' Clinical Section Chief of Child and Adolescent Mental Health and Addictions for the Edmonton Zone. She is also Division Director of Child and Adolescent Psychiatry at the U of A, which just graduated its first subspecialty resident in child and adolescent psychiatry this year.
"It's actually quite a big portfolio because it's both academic and clinical," says Leung.
"Part of my role is to help ensure we work together and communicate better, and we've already begun meeting to discuss this. My goal is to make all parts of childrens' mental health and addictions work together in a more seamless, collaborative and effective way."
That means ensuring there is better differentiation and movement between primary, secondary and tertiary levels of care, she says. "It's a hierarchy of care, so we want people to start in primary care and as needed, to flow up or flow down through these levels of care, depending on their needs. Right now, people just plug into the system wherever they can because they're so desperate."
Although it has been just a few weeks since Leung assumed her new role as AHS Clinical Section Chief of Child and Adolescent Mental Health and Addictions for the Edmonton Zone, she is quick to cite her top immediate priorities.
"Number one, would be for the patient, with their family, to receive the right service at the right time in the right place," she says. "Part of that is to ensure better understanding and collaboration between services, but we also have to help families navigate the system better."
Priority two, she says, is to increase system capacity. "That's where I think the role of the Division of Child and Adolescent Psychiatry is really important. Yes, we can recruit from abroad or the rest of Canada, but realistically we aren't going to get many people via those routes, so we need to train more medical students and residents, and increase consultation and training for physicians working in Primary Care Networks. That's where I think the Division can play a significant role."
Her third key priority, she says, is to make sure child and adolescent psychiatrists don't feel isolated or unsupported, but part of a bigger team. "These people are often really swamped, so it's really about how I can help them do the good work they want to do. I want them to feel engaged, part of the team and part of a larger vision."