Dr. Cory D. Saunders, C.Psych.Developmental Neuropsychology

Windsor Regional Children’s Centre

Depression

Muscular Dystrophy: 1/6000

Cystic Fibrosis 1/4000

Childhood Cancers 1/500

Diabetes Mellitus 3/100

Autistic Disorder 2-3/5001/88 1/50

113.54 FTE Social Workers Child & Youth Workers Psychologists Psychometrists Medical Consultants & Child Psychiatrists

Number of Children Seen 2011/12: 2725

Number of Visits 2011/12: 10,145

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2008-09

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2012-13*

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675

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589545

786849 844

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2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13*

Referrals

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What are the most common mental health issues in school aged children?

Where do they come from?

Is there a common denominator?

What is the purpose of the student’s behavior?

5 or more symptoms for at least 2 weeks: 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

Family history An imbalance of chemicals in the brain Difficult life events Traumatic events in childhood

abuse neglect divorce family violence

Gender Increased stress Chronic illness

Four different categories: emotional signs, cognitive signs, physical complaints, and behavioral changes

Not every child who is depressed experiences every symptom

Typical moods or emotions experienced: Sadness Loss of pleasure or interest Anxiety Anger or Irritability

A depressive mood can bring on negative, self-defeating thoughts

The signs to look for are: Difficulty organizing thoughts Negative view Worthlessness and guilt Helplessness and hopelessness Feelings of isolation Suicidal Thoughts

Depression is not just an illness of the mind - it also causes physical changes

Changes in appetite or weight Sleep disturbances Sluggishness Agitation

These signs will be the most obvious and easy for your detect

Avoidance and withdrawal Clinging and demanding Activities in excess Restlessness Self-Harm

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

These symptoms may indicate depression: 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

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

Four out of five teens who attempt suicide have given clear warnings:

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

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ER Visits

Admissions

Children Young children –medication with some simple

cognitive behavior therapy if appropriate Older children – Cognitive behavior therapy and

medication (SSRI)

Adolescents Cognitive behavior therapy Medication (SSRI) If SSRI used an initial period of monitoring

Immediate Risk: Proceed to the ED at WRH Met campus

Urgent Care: Walk In Clinic: Monday, Tuesday, Thursday 12-6pm.

Referrals for Service Windsor Regional Children’s Centre (aged 6-18) Maryvale Adolescent and Family Services (aged 13-

18)

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