CHEO sets up special mental health unit in its emergency deparment

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Just to the side of CHEO’s busy emergency department, the newly opened mental health transition unit feels like it is a world away. The four-bed unit, complete with beanbag chairs and soft lighting, is designed to divert children and youth experiencing mental health crises away from the emergency department to a calmer space where they can be seen by specialists and, in many cases, safely discharged back home with a treatment plan after a short stay.

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It is potentially life-saving for children and youth in the kind of situation she has experienced, said former patient Abby.

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Abby, whose last name we have agreed not to use to protect her identity, remembers sitting in CHEO’s emergency department when she was 16. Her obsessive-compulsive behaviours were spiralling out of control and she had a plan to end her life, she says.

She remembers the experience as “noisy, chaotic and overwhelming”. While the doctor she eventually saw tried to help, she specialized in physical, not mental, illness. Abby was sent home early the next morning, exhausted, dehydrated and still in crisis. She returned the following night after a suicide attempt.

It was one of many nights she spent in CHEO’s emergency department. She was also treated on the hospital’s mental health floor, which, she says “kept me safe”.

Abby says the new unit, the first of its kind at a pediatric hospital in Ontario, offers a new path for patients and their families who might not need to be admitted to hospital, but do need immediate help, a chance to calm down and a plan for further out-patient treatment.

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“I am very grateful for the care that I got, but the emergency department is not a space that is easy to come down from in a crisis. This unit seems much calmer. I think that it would have been amazing and it will be amazing.”

The transitional unit was officially opened Monday by Ontario Health Minister Sylvia Jones. It is part of a $330 million annual increase in pediatric funding announced by the provincial government last year, recognizing that support of children’s hospitals and health services had not kept up with population growth and increasing demands. CHEO’s portion of that increase is $40 million a year.

In addition to the transitional mental health unit, the funding is enabling CHEO to operate more beds, run more clinics, perform more surgeries and offer mental health help to children and youth in Eastern Ontario and the North, served by the regional hospital, said president and CEO Alex Munter.

David Murphy, director of mental health programs at CHEO, said the hospital has one of the highest volumes of pediatric mental health patients coming to emergency in the country.

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“We have been having a really difficult time trying to keep up with that demand.”

The new transition unit, unique to CHEO, offers up to 72 hours of specialized treatment and stabilization for children and youth coming to emergency in need of mental health support.

Often that is what patients need, he said, but many are admitted into the hospital’s in-patient unit for intensive treatment because there is no other option.

“It is about transitioning from the emergency department into a program that can do short-term diagnostic clarification, safety planning and engage with patients and families to be able to safely transition back into the community,” he said.

Dr. Kelley Zwicker, a community pediatrician and part of the Kids Come First health team, said children and youth with complex mental health needs access services repeatedly because they are not getting the kinds of treatment they need.

She said pediatricians are among those welcoming the new services for their patients.

“I don’t think there is one community pediatrician in the region who hasn’t gone to bed worrying about their patients.”

Abby, at 19, is now treated in the adult health system and is studying nursing. She commended CHEO for identifying the gap in their care and developing a program to help.

“I hope that other hospitals, whether pediatric or not, will follow CHEO’s lead.”

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