Quebec must prioritize mental health of adolescents, pediatricians say


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Eating disorders have quadrupled since the start of the pandemic and emergency rooms are overwhelmed with young patients who have suicidal thoughts.

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Katherine Wilton  •  Montreal Gazette “Everything must be put in place for a return to school as normal as possible next fall, including attendance five days out of five,” says the director of pediatrics at Sainte-Justine Hospital. Photo by John Kenney /Montreal Gazette

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School closures, distance learning and a lack of sports and opportunities to socialize have damaged the mental health of many adolescents, Quebec’s senior pediatricians say.

About 40 per cent of beds in pediatric hospitals are filled with youth suffering from eating disorders, anxiety and depression — more than double the numbers seen in previous years, the physicians wrote in a letter to Premier François Legault, Education Minister Jean-François Roberge and public health director Horacio Arruda.

Cases of eating disorders in hospital clinics have quadrupled since the start of the pandemic in March 2020 and emergency room pediatricians are overwhelmed with teenagers suffering acute anxiety and suicidal ideation.

With the number of COVID-19 cases declining and vaccinations increasing, Quebec must prioritize the mental health of adolescents until the end of the school year, wrote Dr. Anne Monique Nuyt, director of pediatrics at Sainte-Justine Hospital.

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Students should be in class as much as possible and they need opportunities to participate in extracurricular activities and sports, she wrote.

“There are two months left and we need to act to limit the consequences of the pandemic on a generation of adolescents who are the workers and parents of tomorrow,” Nuyt wrote.

“Everything must be put in place for a return to school as normal as possible next fall, including attendance five days out of five.”

At the Montreal Children’s Hospital, emergency room doctors have seen a major increase in teenagers suffering from a variety of mental health issues, including severe eating disorders, anxiety and suicidal thoughts in children as young as nine.

“It’s related to social isolation, having no sports or extracurricular activities and an overuse of screens,” said Dr. Suzanne Vaillancourt, a pediatrician at the Children’s. “Adolescents are calling their parents at work saying they don’t feel safe at home.”

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Some parents have reported that their children rarely leave their room.

“They have been online for months and don’t have a lot of social interaction,” Vaillancourt said. “Adolescence is an important developmental stage and they have given up a lot over the last year.”

Physicians say there are not enough resources available to support the young patients and their families.

“When a young person is not doing well … parents can’t work and absenteeism increases, along with family stress,” Nuyt said.

Physicians fear they’re only seeing the “tip of the iceberg” because fears over contracting COVID-19 could be discouraging some parents from seeking help for their children.

While some high school students in red zones have been able to attend in-person classes every second day, thousands of first-year CEGEP and university students have been at stuck at home for more than a year.

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Over the past few months, the psychiatric department’s eight-patient unit at the Children’s has often been over capacity, which means teenagers with acute suicidal ideation are admitted to surgical or medical units, where they require 24-hour supervision, said Dr. Martin Gignac, the hospital’s Chief of Child and Adolescent Psychiatry.

“We have seen a significant increase in the number of consultations, especially for suicidal crisis and intentional medication ingestion,” he said in an interview on Friday.

Although the psychiatric unit has been full in the past, especially during stressful periods of the school year, it has been occurring more frequently during the pandemic’s second wave.

On some nights, the hospital has 12 or 14 adolescents who are hospitalized.

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“The usual activities that they were using to manage the stress in their lives have been cancelled,” Gignac said. “Some (patients) were part of elite soccer team, who used to train every day, but they’re not playing games and there are no tournaments or socialization.”

If parents notice major changes in their child’s mood, academic performance or sleeping and eating habits, they should talk to their child and consider consulting a mental health professional.

“When they start talking about disappearing or (saying) there’s a solution — these are red flags,” he noted.

Over time, Gignac would like to see crisis intervention units in the community, where teenagers could have quick access to mental health workers. Day programs, where families could avail of intensive psychotherapy, would also be an effective way of keeping adolescents out of the hospital.

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“We need to have alternatives to the hospital, but there’s not much else to offer,” he said. “The private services are available, but the demand has been quite high these last few months.”

kwilton@postmedia.com

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