A shortage of emergency services for children and youth with serious mental illness in Greater Victoria is putting vulnerable kids at risk, families say.
In two recent cases, parents allege their daughters were sent home from the emergency department at Victoria General Hospital despite being in obvious mental distress.
The families say both girls ended up on long wait lists to get into Ledger House, which has 13 acute- care beds for children and youth with complex mental- health issues from across Vancouver Island.
“It’s just a huge gap in mental-health services for children,” said Kelly Bradley, whose 11-year-old adopted daughter suffers from bipolar disorder. “The community resources aren’t there that people refer you to. “The crisis line will help if your child is having a bad day, but not the kind of days where you have to hospitalize your child [because] they need acute care.”
The Vancouver Island Health Authority denies that anyone in crisis gets turned away. If an emergency-room physician decides that a child requires immediate help, they will be admitted to the pediatrics unit, the authority said in a prepared statement.
But health officials acknowledge that a rise in child and youth psychiatric cases is putting a strain on the system.
“We do recognize that there is a need for additional support for children with mental-health issues and certainly we’re working on improving things for this population,” said Dr. Richard Crow, executive medical director of mental health and addiction services.
Kelly and Owen Bradley, who asked that their daughter’s name be withheld, have started an online petition at change.org calling for a specialized hospital unit to treat children experiencing a mental-health crisis.
Kelly Bradley says her family called the mental-health crisis line three times in recent weeks to get help for their daughter. Each time, crisis workers could hear the distressed girl in the background and advised the family to go to the emergency department.
The situation was so serious that the Bradleys had to get police to assist in transporting their daughter safely.
On the first visit, the hospital kept their daughter in a safe room for four days, before sending her home, Kelly Bradley said.
Within 20 hours, the young girl was back in emergency, only to be released after a few hours.
Two days later, the same thing — only this time, she was discharged before her parents could even get to the hospital, Bradley said.
“She’s hurting herself, she’s hurting her family, she’s begging them to keep her, and she still was sent home.”
The Bradleys, who have adopted six children out of the child-welfare system, said the situation has put unbearable stress on their entire family. “You have a child who’s violent towards themselves, or toward their family, and it’s up to the parents to stay up all night and make sure they stay in their room and make sure the other kids are safe and make sure that they’re safe.”
Bradley said it took nearly three weeks after the first emergency-room visit to get their daughter admitted to Ledger House, which offers stabilization and assessments but no long-term treatment.
A second family, who wish to remain anonymous to protect their child’s privacy, is still waiting to get their teenage daughter admitted to Ledger House despite a series of mental-health crises.
The teenager first sought help in late December for depression and anxiety. She was told to take a bit more medication and sent home from emergency a few hours later, her mother said.
But she ended up in emergency again a few days later, and was kept on the pediatric unit for two weeks.
“It’s very unusual for them to hold them that long, but she was refusing to leave,” her mother said.
Still, the family feels she has yet to get the help she needs. “Up at VGH, they have very little support for these children,” the girl’s mother said. She said the mental-health workers are run off their feet trying to deal with five to eight children with serious mental-health issues as well as those that come into emergency.
“What I found at the hospital is that they’re doing the best that they can with the very little resources that they have, but this isn’t the appropriate unit for these kids. They really need a specialized mental-health unit for them.”
Victoria child and adolescent psychiatrist Dr. Clare Wood said the region needs an acute crisis program for children and youth with serious mental illness.
In busy periods, there can be up to eight children with acute mental illness on the pediatric unit at Victoria General Hospital without sufficient mental-health staff to properly care for them, she said.
“It’s under-resourced and under-staffed.”
The conditions, however, can be life-threatening. Wood noted that suicide is still the second-leading killer of young people in Canada and that depression is the major precursor.
“These kids are at high risk,” she said.
Wood said studies show the benefits of early intervention in improving the development of children and youth with mental illness and their ability to function later in life.
But community mental-health services are fragmented and difficult for parents to navigate, she said. The Ministry of Health delivers some programs, while the Ministry of Children and Family Development provides others, and the two ministries often take different approaches.
“I think the families are very brave to come forward,” Wood said. “It’s very difficult. They face tremendous stigma and judgment in the community based on the child’s behaviour.”