No end in sight to kids' mental health crisis, Calgary doctors warn

Alberta Children's Hospital is facing a growing wave of children with complex mental health needs, leaving some families waiting for days in the emergency department.

According to Alberta Health Services (AHS), while overall ER visits for mental health care dropped slightly between 2018 and 2022, the number of kids requiring hospital admission jumped by 36 per cent.

There was a 20 per cent increase in the number of children needing specialist mental health care while in the emergency department during the same period.

"We continue to see incredibly high numbers of incredibly complex young people in desperate need of help," said Dr. Sterling Sparshu, a Calgary-based child and adolescent psychiatrist and clinical assistant professor at the University of Calgary.

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According to Sparshu, the hospital was already experiencing a surge of children in need of mental health care prior to the pandemic.

That accelerated when COVID-19 hit, he said, and it hasn't waned.

"The system's still in a state of crisis. Even if we had fewer kids presenting, the ones who are presenting need so much more from us that we still need more resources."

Long ER waits

Sparshu treats children for a wide range of serious issues, including depression, severe anxiety disorders, eating disorders and trauma.

Some are as young as four years old.

"We are seeing very sick kids and sadly younger and younger kids with more and more severe challenges."

In a best case scenario, he said, kids wait in the ER for several hours to be admitted to a mental health bed.

But some wait for days.

"It's heartbreaking that when we have families in crisis, they have to wait days until they can get from the ER up to a mental health unit and get the care that they need and deserve," said Sparshu.

"It's incredibly demoralizing for families."

Self-harm on the rise

There's also been a dramatic increase in children under 18 presenting to the emergency room due to self-harm

According to AHS, the number of visits to the Alberta Children's Hospital ER for this reason jumped by 86.5 per cent between 2018 and 2022.

"You've got more youth who are coming that actually need more intensive intervention, more specialist mental health care, rather than being seen by just the emergency department team," said Dr. Paul Arnold, director of the University of Calgary's Mathison Centre for Mental Health Research and Education.

"[There are ] also more that require admissions. At the same time, we haven't had a corresponding increase in capacity to manage that complexity and severity."

He points to Calgary-based research showing a global increase in the number of ER visits for suicidal ideation and attempts since the start of the pandemic.

But Arnold, who is also a child and adolescent psychiatrist, said the exact causes of this ongoing mental health surge among kids and youth are unclear.

"I don't think we know for sure. Could this be some kind of perfect storm that's leading to this worsening in terms of mental health? It's hard to say."

Some potential factors, according to Arnold, include increased social media exposure, pandemic-related isolation and economic stressors.

More help needed

AHS said the increasing complexity of cases means it takes longer to safely diagnose and treat children.

"AHS acknowledges the concerns of parents whose children may face long wait-times," spokesperson Kerry Williamson said in an email.

"We are working hard to bring wait-times down and improve access the health-care system."

Patients who are in crisis are monitored and cared for in a treatment space within the emergency department, he said.

AHS points to the recently opened $39-million mental health facility, The Summit: Marian & Jim Sinneave Centre for Youth Resilience, as one way it's working to address the need.

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The centre is expected to help about 8,000 patients and families every year, through early intervention and treatment.

Both doctors agree, while The Summit is not designed to replace the emergency room, it will help.

"I think we need more accessible, equitable and effective care across the board," said Arnold.

The new centre is one piece in a broad spectrum of services needed, ranging from more school supports and more intensive preventative programming to more mental health beds, according to both doctors.

"Undeniably, we need more hospital beds for acutely ill children, and we need people to staff them. Just like the ICU needed more beds in a time of crisis," said Sparshu.

But he wants families to know, despite the system pressures, help is there when they need it.

"There is hope for recovery. And we see successes every day."