Canada’s mental health system is failing children in crisis

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Very sick children in need of mental health treatment are ending up in adult psychiatric units because there’s nowhere for them to go when they are in crisis, says a Waterloo researcher.

“It’s a huge systemic problem,” said Professor John Hirdes, co-author of a new study looking at the mental health symptoms of children and youth in residential and inpatient care settings. “Most hospitals in Canada do not have sufficient resources for child-specific beds in their mental health units.”

Hirdes points out that children with a mental illness have very different needs than adult patients. The recent collaborative study by interRAI Canada researchers at Waterloo and Western University found that children are at a higher risk for self-injury and suicidal ideation than adults. They are also more physically and verbally abusive, and display more extreme behavior than adult counterparts.

“Early intervention in childhood is key to reducing the likelihood of future social and emotional impairment, adult unemployment and the need for more intensive treatment later on,” said Shannon Stewart, an associate professor at Western University and an adjunct professor at Waterloo who lead the study. “Children’s mental health has been labeled the orphan’s orphan of Canada’s heath care system.”

While 20 per cent of children experience mental health issues such as depression, anxiety and attention deficit disorder, only one quarter of those who require treatment actually receive it.

No choice but the ER

“The number of facilities designed to meet the developmental needs of children and their families are incredibly limited, but the need has never been greater,” said Stewart. “When a child is in crisis, and the wait-list for a child-centered facility is months, parents essentially have no choice but to take their children to the local hospital.”

Seventy per cent of all adult mental health disorders begin in childhood and the repercussions from a lack of appropriate care can last a lifetime. Care in child-specific units focus on the family and often deal with the child’s first episode of major mental health problems.

“If we want to give these children the best shot in life, and avoid more intensive treatment later on, the first step is to make easier, quicker access to child-centred services a priority, including specialized beds for children and youth,” said Stewart.

If you are concerned your child is having mental health issues, Stewart advises:

• Visit your general practitioner to obtain a physical exam and rule out any physical ailments that may be mimicking a mental health problem and get an appropriate referral;
• Educate yourself about mental health issues in children;
• Connect with your child’s school to see if there are any issues that may be impacting your child’s socio-emotional functioning. For example, children who are bullied are up to 5 times more likely to engage in self-harm behaviour;
• Get a strong standardized assessment done, like the integrated interRAI Child and Youth Mental Health (ChYMH) assessment instruments for early identification of mental health issues to support coordinated service plans and more seamless transitions across service sectors,
• If your child is expressing thoughts of suicide, go to the emergency room at the local hospital.  Inquire about child-focused crisis programs and timely follow-up services to support the needs of your child and family.