How Markham Stouffville Hospital is improving access to child and adolescent mental health care

Everyone has done something, unintentionally or not, to hurt another person and later felt guilty about it. When Luther Wood felt as if he’d wronged someone, his guilt took on a life of its own, dominating his thoughts as he replayed the incident over and over. “I was just terrified that I was causing hurt to somebody else,” says Wood, now 18. “I would feel an overwhelming sense of guilt in my life as a little kid.”

These types of intrusive, seemingly never-ending thought cycles are a hallmark of obsessive-compulsive disorder (OCD), which, in hindsight, Wood can see traces of all the way back to his early childhood. It became much worse as a teenager. Whether it was a rough-and-tumble session with his brother or an untoward thought about a friend, he couldn’t stop himself from dwelling on it, mentally punishing himself for what would be innocuous to anyone else. “These thoughts would come up, and then I would sit on it for as long as I could before I would kind of just explode,” he says. “I’d have to admit everything to my parents, which was kind of a compulsion in itself.”

OCD is typically portrayed in pop culture as compulsive organizing or handwashing. In reality, the worst part is those unprovoked thoughts, which often drive the sufferer to perform repetitive behaviours to stop them.

“I just thought that was kind of who he was,” explains Luther’s mom, Julia Wood. “I didn’t at all understand the deeper level of the emotional and mental burden, or how it grows and takes over every aspect of your life.”

Our most valuable resource

Wood is far from alone in his mental health struggles. The Canadian Institute for Health Information estimates that approximately 20 per cent of Canadian children and youth (ages three to 17) have a mental health disorder, while an estimated 400,000 Canadians have been diagnosed with obsessive-compulsive disorder, according to the Canadian Psychological Association. More broadly, a Canadian study indicated that child and adolescent visits to hospital emergency departments for attempted suicide or self-harm rose throughout the pandemic, continuing an overall upward trend over the past decade.

Right now, Ontario’s health system is unable to keep up with the demands of this growing population. The only way to do so is to ensure more hospitals have both outpatient and inpatient units. That’s something Oak Valley Health’s Markham Stouffville Hospital (MSH) has committed to recently with its announcement to build a six-bed youth mental health inpatient unit to accommodate more patients requiring intensive, long-term treatment.

Dr. Rustom Sethna, Oak Valley Health’s Chief of Psychiatry, has witnessed this youth mental health crisis first-hand during his 33-year tenure, and it has made him the hospital’s fiercest advocate for the inpatient unit.

“There’s a critical shortage of inpatient beds dedicated to this demographic, which leads to long wait times, increased emergency department visits and just inadequate care,” says Sethna.

Untenable wait times

Luther managed his undiagnosed OCD for most of his childhood, until he hit his teens—which coincided with the first pandemic lockdowns—when things took a turn for the worse. Soon, his compulsions impacted his ability to complete schoolwork and function normally in his daily life.

“I was in a constant state of really severe anxiety,” he says. “Feeling like a terrible person all the time and being unable to fix it by myself, no matter how hard I tried.”

His parents, after realizing that something serious was happening with their child, took Luther to their family doctor who immediately identified his symptoms as OCD. While anxiety-reducing medication gave him some relief, it didn’t work for long.

That began his arduous journey of finding an effective treatment plan—an all-too-common problem, according to Children’s Mental Health Ontario. The organization reports that as of 2020, 28,000 children and youth were on wait lists for mental health treatment across the province, with wait times extending as long as 2.5 years in York Region. Both private counsellors in the Woods’s town of Uxbridge had a two-year waitlist. “We needed something sooner than that,” says Julia.

A light at the end of the tunnel

Luther’s OCD turned out to be too complex for the community adolescent counsellor he tried, so his family doctor referred him to MSH. There, a psychiatrist could oversee his medication treatment while he attended weekly appointments with a social worker.

The outpatient program was the perfect fit for Luther and his parents, offering a combination of therapy and education for the entire family. For those who arrive at MSH’s emergency department in crisis and need admission for more intensive treatment and observation, however, it’s an entirely different journey.

“If we determine the child cannot return to their home or community, we place them in a hold in our ED in one of our mental health suites,” explains Dr. Sethna. “They’re held there, usually supervised by security guards, until we find a suitable child and adolescent treatment facility in the GTA that’s willing and able to take them.”

The new Child and Adolescent Mental Health Inpatient Unit at MSH will provide a specialized environment and individualized treatment plans designed for today’s youth. Offering care for children and adolescents within their community will keep families closer, making recovery and reintegration into everyday life easier. With generous community support through the Markham Stouffville Hospital Foundation and a $500,000 donation from Hyundai Canada to kick-start a $3.1-million fundraising project, the hospital plans to break ground for the new unit in a few years, pending government approval. “Every child needs to have access to high quality, affordable and culturally competent mental health care in our diverse community,” Dr. Sethna adds.

As for Luther, after two years of treatment, he’s progressed to the point where his medical team felt he had all the tools he needed to manage his symptoms and live a full life. He’s now in his first year of linguistics at Wilfrid Laurier University and can’t believe how far he’s come: “I feel like a completely different person.”