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Youth Psychiatric Youth Psychiatric Inpatient Services

Kind of like an umbrella

Judy Y. Smith

Reprinted from "Treatment for Young People" issue of Visions Journal, 2006, 3 (1), p. 26-27

The bad news is, this summer Abbotsford was dubbed Canada’s theft capital. The good news: a new adolescent psychiatric unit is under construction in this BC city, and medical experts say one will likely help the other.

“Kids with mental health problems who don’t get proper treatment are much more likely as adults to have problems with substance abuse, being unemployable, dropping out of school and becoming delinquent,” says Dr. Derryck Smith, head of the Department of Psychiatry and medical director of mental health programs at BC Children’s Hospital, and head of the Division of Child and Adolescent Psychiatry at UBC.

Roughly 150,000 children and youth in BC experience significant distress that affects their functioning at home, school, with peers or in the community, according to government statistics.2 These distresses cover a wide range: anxiety, conduct, attention-deficit and depressive disorders; obsessive-compulsive and eating disorders; schizophrenia and psychosis. And while treating ill children and youth before they act out is important, treating them differently than adults is critical.

Tanis Evans, unit team leader of Kelowna’s two year-old adolescent psychiatric unit, says youth with serious mental health issues do better in a space developed specifically for them. And even with the best resources, these illnesses—especially in their acute phase—are hard to diagnose unless the patient is viewed 24 hours a day over a period of time. “Unless you’re very accurate in your diagnosis,” says Evans, “you’re not going to have a treatment plan that matches what the youth requires.”

Before the unit opened in Kelowna, the problem of teen suicide, including a high profile case involving a promising young local hockey player, became impossible to ignore in the region. But Evans is proud to say there have been no suicides since. “We get positive feedback from families; kids leave here feeling positive; families feel empowered. They still have a young person with severe problems, but hopefully with some strategies and direction.”

Evans worked at Surrey Memorial Hospital in the ‘bad old days’ when sick teens were housed in the adult psychiatric ward. It was during that time that Surrey mom Donna Murphy had her suicidal son Kelly admitted—not realizing their problems would be far from over.

“Just as I was wheeling him there, an older woman in a very zombie-like state walked out of her room. Kelly became very frightened,” says Murphy. “Older people are just really sick. And they [the adolescents] get on the older peoples’ nerves. I mean, they’re kids. They’re bouncing all over the place and they drink all the milk and they make too much noise and it’s very scary for the adults. So it’s much better for them to be in units for adolescents.”

Kelly spent two months in the adult psychiatric unit—a terrifying experience for him and his family. After his release, he vowed never to go back. Without community services to rely upon—and still feeling hopeless—Kelly took his own life at age 18.

“He was in the hospital for so long, and if he’d had people trained to work with youth, I think it could have been different. I will never know,” Murphy reflects.

Murphy’s anger and pain motivated her to fight for a Surrey adolescent psychiatric unit. She was on its planning committee. Her own experience, plus extensive research, led her to believe shorter hospital stays, as a way to stabilize the kids, are better. “If they stay too long they can either become more depressed or institutionalized.”

Frank Fung, Fraser Health’s director of mental health and addictions services for Abbotsford, Mission and Chilliwack, agrees.

“Hospital is kind of like an umbrella. You don’t walk around every day with an umbrella—well, unless you’re Michael Jackson,” says Fung. “You use it when it rains, and it keeps you dry—and you use the same principle in looking at inpatient service: when you need it, you use it, and then when it quits raining, you close it up. I like to use the same approach [for youth mental health delivery]. We’re going to use the Surrey model, except a shorter length of stay, maybe two weeks.” Abbotsford’s new hospital, to be completed in 2008, will include a six bed adolescent psychiatric unit—the first in the Fraser Valley. Fung is currently fi ne-tuning program content, talking to his counterparts in Surrey, and consulting with the grass roots on how the program should be integrated with community services.

“It is complex, because it’s new to our area. We haven’t had an adolescent psychiatric unit in our existing hospital, so this is new territory for us. The unit must also be supported by community services, and must work with the families—that’s most important. Abbotsford’s hospital is already integrated with the community, but with the new unit, the link will be even stronger.”

Adolescent unit leaders seek to give children and youth more coping and emotional skills and ensure they are plugged into existing community supports. Evans says her unit’s credo is that “children will do well if they can.” After all, a hospital stay may be short— but it can affect the rest of a child’s life.

Some mental illness precursors in youth

  • changes in behaviour, such as an active child becoming withdrawn

  • changes in feelings, such as becoming worried, guilty, anxious or angry

  • changes in thoughts, like lowering self-esteem, self-blame or even suicidal thoughts

  • difficulty coping with day-to-day life

  • lack of sleep or appetite, or low energy

  • intense fear of becoming fat

  • odd or repetitive movements, such as spinning or hand-flapping

  • unusual ways of speaking or a private language

Any of these symptoms can morph into self medication by abusing drugs and alcohol, or can escalate into hurting others by violence, thefts and vandalism.

About the Author

Judy is a freelance writer living in Vancouver

  1. Skelton, C. (2006, July 21). Abbotsford is Canada’s theft capital. The Vancouver Sun

  2. Waddell, C. & Shepherd, C. (2002). Prevalence of mental disorders in children and youth (a research update prepared for the Ministry of Children and Family Development). Vancouver, BC: University of British Columbia.

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