Elizabeth HowellThe Ottawa Citizen
Date Published: Wednesday, September 26, 2012
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Patient backlog presents huge challenge as youth transitions into adult system
Gina’s 17-year-old son spends many of his days in bed, alternately crying and worrying about the world outside. He has obsessive-compulsive disorder and generalized anxiety.
Gina, a Kanata mother of three, has spent the past decade of her son’s life moving him to different doctors and schools. She’s helped him deal with powerful prescribed medications. She’s brought him to the Children’s Hospital of Eastern Ontario for years of treatment, particularly when he spoke about suicide.
But with her son turning 18 soon, Gina — who didn’t want her last name or son’s name published, to protect him from further anxiety — is worried for his future.
As an adult, he will no longer qualify for CHEO’s services. She says there’s a waiting list of months, at the least, to get into any psychiatrist’s office in the Ottawa area.
After Gina’s family doctor could not find a psychiatrist, she took out the phone book and “literally started with the As and the Bs,” working her way through the list. With every call, she was told there was no room for new patients. Talk therapy with the psychologist her son uses has not been helpful, she adds.
Her son hasn’t been able to attend high school regularly since March.
“How he’s feeling (now) is he can’t foresee his future,” Gina says. “He cannot foresee even making it to 18. He’s just so depressed. Nothing gives him joy.”
Earlier this year, the Mental Health Commission of Canada released a strategy report saying the country must do more to help mentally ill Canadians. Only one out of three people with a mental health condition report receiving treatment, say two studies cited in the report.
The commission calls for increasing federal and provincial spending in mental health, as a proportion of overall health spending, to nine per cent in the next 10 years.
That increase from the current seven per cent would cost taxpayers $4 billion, commission officials estimated in media reports.
While the strategy does not break down services by city, mental health doctors in Ottawa are reporting a surge in patients.
Doctors say that’s partly due to awareness from local initiatives, including Do It For Daron. The mental health campaign is named after Daron Richardson, a daughter of then-Ottawa Senators’ assistant coach Luke Richardson. At age 14, in 2010, she took her own life.
While more people are seeking treatment, physicians say the provincial and federal funds to treat these patients have remained stagnant for several years.
“Frankly, (treatment) doesn’t occur very well in Ottawa,” says Hazen Gandy, the division chief of hospital-based mental health services at CHEO.
The hospital does not speak to individual patient situations for privacy reasons, but Gandy said the teen’s plight in finding treatment is something he has heard many times before.
The 19-bed in-patient unit for youth mental health is usually more than full, he says, and other services are stretched. For example, mental health-related emergency visits increased nearly 50 per cent to about 2,650 in 2011—12. The year before, it was fewer than 1,800.
The transition to adult treatment is “not a good model,” he acknowledges.
“In many situations ... these patients terminate (treatment) with us, but because there aren’t adult services to pick these up, they go into crises.” If patients in a crisis situation go to an emergency room, they will receive treatment, he says.
CHEO and other local hospitals have implemented a pilot project for young patients making the transition to adult services, he adds.
Through the Champlain Local Health Integration Network, a full-time “transition co-ordinator” oversees the files of more than 100 young patients. Among other services, that person works to get the youth on waiting lists as soon as it is clear they will require treatment as adults. Wait times can be measured in months or years.
“We only have our focus on probably the five to 10 per cent of the most severely ill,” Gandy says. “There are other youth and families with perhaps less severe illness, that still require care, that this pilot project doesn’t address.”
Gina also tried talking to the Royal Ottawa Foundation for Mental Health, which has both youth and adult mental health services. The hospital has long waiting lists of its own, though. In the youth unit alone, there was a surge in demand in September, just as school began.
“I have to say this is challenging, because it’s not just a youth problem that is increasing in demand. The increase for mental services is across the board,” says Smita Thatte, clinical director of the Royal’s youth psychiatry program.
“It is clearly a bottleneck ... there are no new resources. (We are) using the existing resources, and sometimes that is not adequate to address the demand.”
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