The Children's Hospital of Eastern Ontario is struggling with a spike in the number of children and teens needing urgent care for depression, anxiety, suicidal thoughts and other mental-health crises.

The hospital's emergency department has been overwhelmed since September, but the situation got worse in November, following the suicide of 14-year-old Daron Richardson, the youngest daughter of Ottawa Senators assistant coach Luke Richardson.

At least 500,000 Ontario children -- up to one in five under the age of 18 -- have difficulties that are diagnosed as a serious mental illness.

"There was a surge before this tragic death, but it intensified after," said Dr. Simon Davidson, CHEO's chief psychiatrist.Demand for the hospital's 19 psychiatric beds (15 for teens, four for children under age 12) has been so high that the children's unit remains closed to voluntary admissions and additional beds in the medical wards have been reallocated for psychiatric patients. The Royal Ottawa Mental Health Centre has eight beds that are reserved mainly for 16-to-18-year-olds, but in recent weeks, those beds have also been full.

"We're running out of places where we can put these patients," said Davidson, who's also chief of the Royal Ottawa's specialized services for children and youth.He pointed to the bed shortage as a symptom of the province's chronically underfunded mental-health services, which quickly come under strain when demand surges."When we experience an increased demand like we're having now, we are very close to having serious difficulties coping," said Davidson.

Under Ontario's mental-health regulations, only individuals who are considered an "imminent" danger to themselves or others are hospitalized on an urgent basis.

For children and teens, however, physicians consider additional factors, such as the level of family and community support available, whether bullying is involved and the severity of symptoms such as crying, sleeplessness, anxiety and substance abuse."We're doing careful risk assessments and admitting the ones that have to be admitted," said Davidson.

Staff from CHEO's outpatient mental-health clinic have been reassigned to provide crisis intervention, and an extra psychiatrist has been pressed into on-call service, bringing to two the number of specialists available to ER physicians for round-the-clock medical advice.

With more staff focused on urgent care, children and teens waiting for outpatient mental-health services will inevitably face longer delays, Davidson warned. For non-urgent cases, the average wait for CHEO's mental-health services currently sits at two to five months.

Davidson said it's too soon to say how much longer non-urgent patients could be expected to wait. "It all depends on how long the surge continues."

CHEO officials are nervously eyeing the months ahead out of fear the winter flu season could add to the crush of children and teens showing up at the emergency room, creating additional pressures on beds and staff.

In November alone, 39 children and teens were admitted for mental-health crises, nearly double the number compared to the same period last year.

Likewise, the number of crisis visits to CHEO's ER nearly doubled last month, to 232 from 148 in November 2009. If the trend continues, the hospital could exceed the total number of ER visits (1,773) made by children and teens suffering from mental-health crises last year.

Officials are at a loss to explain the sudden surge, but Davidson suggested the economic downturn could be putting extra stress on families, causing children to experience increased anxiety, depression and panic attacks.

He also wondered if the outpouring of public support for the Richardsons, following the death of their daughter, has made more children and teens feel comfortable about seeking help instead of suffering in silence.

The problem is that Ontario's mental-health services are already stretched to the limit, and the strain isn't simply confined to hospitals, said Davidson.

He noted that in the weeks following Richardson's death, YouthNet, which offers in-school counselling services, and the Youth Services Bureau, which offers suicide-prevention services, also struggled to meet demand, suggesting those agencies are "dramatically under-resourced."

Davidson said the growing gap between supply and demand means the province must step up funding for mental health.

At least 500,000 Ontario children -- up to one in five under the age of 18 -- have difficulties that are diagnosed as a serious mental illness.

Resources

- . The Youth Services Bureau's 24-7 crisis line for Eastern Ontario. Teams of professionals answer calls about mental-health issues among youth, make house calls if needed, and connect youth and their families to professional help. The YSB also has a temporary residence where troubled youth can stay while being assessed. The crisis line number is 613-260-2360 or 1-877-377-7775.

- . www.youthnet.on.caoffers interventions and resources by youth for youth
- . www.ementalhealth.caoffers a complete list of mental-health resources in the community
- . www.newmentality.cais a program of Children's Mental Health Ontario that helps youth break the stigma of mental illness and works with them to get youth involved within mental-health centres

- . The Children's Hospital of Eastern Ontario's website, www.cheo.on.ca,currently features an illuminating YouTube video of psychologist Ian Manion talking to teens about suicide prevention. Also included is a list of warning signs of suicidal behaviour.