Moodiness in teens could herald depression
2004-04-13
JEN HORSEY, CP

TORONTO -- While teens -- and their parents -- often shrug off persistent feelings of angst or irritability as every adolescent's moody rite of passage, experts caution sometimes these should be treated as early warning signs for depression. But years of government belt-tightening across Canada have left health-care systems stretched thin, and mental-health advocates say many of the estimated one in seven kids who suffer from depression don't know where to go to get the help they need.

"There's extremely poor funding for mental health in adolescents," said Dr. Bonnie Leadbeater, a psychology professor at the University of Victoria.

Although some family doctors in Canada perform counselling for patients, there are provinces in which few doctors offer the service and it isn't covered by medicare.

Private psychologists can charge more than $100 an hour and waiting lists for publicly funded psychiatrists can be months long. That leaves mentally ill kids and their parents with few choices.

Many young people with depression aren't the type who attract attention by having outbursts in public. Rather, they whine and mope a little at home, sleeping too much or finding their grades suffer. These, Leadbeater said, are kids who may not get diagnosed and may go on suffering in silence -- perhaps unaware they're ill at all.

"You have to get pretty sick before we're willing to respond to depression in this country," she said.

In a study published in the International Journal for Behavioural Development, Leadbeater found a link between smoking and depression in teens. She said depressed youngsters sometimes resort to drugs, alcohol or tobacco in an attempt to seek relief for their symptoms.

Depressed teens sometimes end up on the wrong side of the law. "There's a fairly high correlation between conduct problems and depression," Leadbeater said.

In Ontario, a judge stayed charges against a 13-year-old Ottawa girl because the province's justice and health systems failed to provide timely forensic psychiatric assessment.

The girl was back in custody within days after a violent outburst at a group home. Medical reports suggested she may suffer from bipolar disorder.

Sarnia social worker Deb Gordon said cases like this demonstrate how the children's mental-health system is "a house of cards ready to collapse."

Gordon said it's up to provincial governments to provide more stable funding.

The average wait time for children in crisis is 21 weeks and growing longer, Gordon said, adding that even in emergencies, kids don't always get the treatment they need.

Kids needing mental health treatment aren't admitted often enough and when they're let out of the hospital, they don't get good discharge planning, Gordon said.

"Prevention is a real priority more and more in children's mental health," said Charlotte Waddell, a child psychiatrist at the University of British Columbia.

She said talking to a professional is a very effective therapy -- more so than medication -- but access is a problem.

Waddell urges children to ask for help from teachers, guidance counsellors, parents or any other trusted adult. The system may be damaged, she said, but it still works.