Transcript Children`s Mental Health Presentation on Depression

Depression
Dr. Cory D. Saunders, C.Psych.
Developmental Neuropsychology
Windsor Regional Children’s Centre
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Muscular Dystrophy:
1/6000
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Cystic Fibrosis
1/4000
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Childhood Cancers
1/500
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Diabetes Mellitus
3/100
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Autistic Disorder
2-3/500
1/88
1/50
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113.54 FTE
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Social Workers
Child & Youth Workers
Psychologists
Psychometrists
Medical Consultants & Child Psychiatrists
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Number of Children Seen 2011/12: 2725
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Number of Visits 2011/12: 10,145
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200607
200708
200809
200910
201011
201112
201213*
980
876
589
827
841
786
849
Referrals
855
844
Closed
675
645
545
192
181
2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13*
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What are the most common mental health
issues in school aged children?
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Where do they come from?
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Is there a common denominator?
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What is the purpose of the student’s
behavior?
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5 or more symptoms for at least 2 weeks:
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Depressed mood
Markedly diminished interest or pleasure
Significant weight loss or gain
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or inappropriate guilt
Diminished concentration or indecisiveness
Recurrent thoughts of death or suicide
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Family history
An imbalance of chemicals in the brain
Difficult life events
Traumatic events in childhood
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abuse
neglect
divorce
family violence
Gender
Increased stress
Chronic illness
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Four different categories: emotional signs,
cognitive signs, physical complaints, and
behavioral changes
Not every child who is depressed
experiences every symptom
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Typical moods or emotions experienced:
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Sadness
Loss of pleasure or interest
Anxiety
Anger or Irritability
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A depressive mood can bring on negative,
self-defeating thoughts
The signs to look for are:
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Difficulty organizing thoughts
Negative view
Worthlessness and guilt
Helplessness and hopelessness
Feelings of isolation
Suicidal Thoughts
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Depression is not just an illness of the mind
- it also causes physical changes
 Changes in appetite or weight
 Sleep disturbances
 Sluggishness
 Agitation
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These signs will be the most obvious and
easy for your detect
 Avoidance and withdrawal
 Clinging and demanding
 Activities in excess
 Restlessness
 Self-Harm
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Most symptoms are similar to those in adulthood
Depression can be difficult to diagnose in teens
because adults may expect teens to act moody
Adolescents do not always understand or express
their feelings well - they may not be aware of the
symptoms and may not seek help
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These symptoms may indicate depression:
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Poor performance in school
Withdrawal from friends and activities
Sadness and hopelessness
Lack of enthusiasm, energy or motivation
Anger and rage
Overreaction to criticism
Feelings of being unable to satisfy ideals
Poor self-esteem or guilt
Indecision, lack of concentration or forgetfulness
Restlessness and agitation
Changes in eating or sleeping patterns
Substance abuse
Problems with authority
Suicidal thoughts or actions
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Teens may experiment with drugs or alcohol or
become sexually promiscuous to avoid feelings of
depression
Teens also may express their depression through
hostile, aggressive, and/or risk-taking behavior
Such behaviors often lead to new problems, deeper
levels of depression, and destroyed relationships
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Four out of five teens who attempt suicide
have given clear warnings:
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Suicide threats, direct and indirect
Obsession with death
Poems, essays, and drawings that refer to death
Giving away belongings
Dramatic change in personality or appearance
Irrational, bizarre behavior
Overwhelming sense of guilt, shame or rejection
Changed eating or sleeping patterns
Severe drop in school performance
ER Visits
444
388
Admissions
409
337
285
280
151
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116
300
139
146
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181
195
91
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Children
 Young children –medication with some simple
cognitive behavior therapy if appropriate
 Older children – Cognitive behavior therapy and
medication (SSRI)
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Adolescents
 Cognitive behavior therapy
 Medication (SSRI)
 If SSRI used an initial period of monitoring
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Immediate Risk:
 Proceed to the ED at WRH Met campus
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Urgent Care:
 Walk In Clinic: Monday, Tuesday, Thursday 12-6pm.
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Referrals for Service
 Windsor Regional Children’s Centre (aged 6-18)
 Maryvale Adolescent and Family Services (aged 13-18)
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Coordinated Access
 HelpLink, Intake, Service Coordination
Children’s Crisis Services
 Walk In Clinic, ERCR
Children's Treatment Services
 Clinic Services
Youth Justice Services
 Probation Diversion, Adolescent Sex Offender, Youth Mental Health
Court Worker (pre-charge diversion)
Intensive Family Services
 Milieu Continuum (Residential through Day Treatment)
Assessment and Consultation Services
 Developmental Services, Psychological Assessment, Medical Services
Child and Adolescent Mental Health Beds
Sexual Assault Domestic Violence Treatment/SAFE Kids