Youth mental health

Sunnybrook: Canada’s leading site for youth mental health

Dr. David Kreindler head of the division of youth psychiatry at Sunnybrook

Dr. David Kreindler, head of the division of youth psychiatry

Text. Instagram. Snapchat. It’s the language of teens.

Adolescents with mental illness can use simple and colourful touch options on their smartphones to tell their doctors how they feel. The new software is being tested at Sunnybrook’s Centre for Mobile Computing in Mental Health. Call it state-of-the-art mood journaling.

For psychiatrists at the receiving end, this mood information gets charted and becomes an important piece of the clinical picture. “Mood journals certainly can help to clarify diagnosis and determine whether treatment is working,” says psychiatrist Dr. David Kreindler, head of the division of youth psychiatry at Sunnybrook.

Previous studies have found that teens do like texting their doctors this way. “Tests of the software reveal that reporting rates are approximately 75 per cent, which are considered very high,” says Dr. Kreindler. “For teens, the reporting rate with a pen and paper would be zero.”

“We engage in research and offer care that integrates brain, mind and body,” says Dr. Ari Zaretsky, psychiatrist-in-chief, SunnybrookThe new study, called PATH-MOD, is exploring whether this high-tech form of communication results in fewer rehospitalizations for those with recurrent mood disorders.

PATH-MOD is but one of many projects at Sunnybrook aiming to improve the lives of young people suffering from mental illness. Sunnybrook is Canada’s leading site for youth mental health, housing the country’s largest youth psychiatry division and overseeing North America’s largest mood and anxiety disorders clinic.

“One of the ways that we distinguish and differentiate ourselves at Sunnybrook is that we focus on complex mood and anxiety disorders across the lifespan and we work closely with neurology and neuroimaging colleagues in the larger Brain Sciences Program. We engage in research and offer care that integrates brain, mind and body,” says Dr. Ari Zaretsky, psychiatrist-in-chief at Sunnybrook.

Here are some of the ways the team at Sunnybrook is helping teens onto a smoother, brighter path.

Natural Therapies for Youth Bipolar Disorder

“Bipolar disorder is the fourth most disabling medical condition among adolescents worldwide,” says Dr. Ben Goldstein, director of the Centre for Youth Bipolar Disorder. “When it strikes in teens, it hits pretty hard.” Dr. Goldstein’s research is changing how physicians around the world view and treat the disorder. He has found, for instance, that bipolar disorder is linked with cardiovascular disease. Both disorders are associated with high amounts of inflammation and oxidative stress in the bloodstream. Dr. Goldstein calls it the “heart-mood interface.”

He is testing whether exercise and natural remedies such as curcumin can reduce symptoms of depression, as well as a correlating drop in inflammation and oxidative stress.

“In treating bipolar disorder, we tend to layer on mood-stabilizing medications when one alone is not adequate, but there can be side effects,” he says. “We are looking for solutions that produce benefits with fewer side-effects.”

Helping to Screen Youth for Depression

Because of the stigma surrounding mental illness, a teenager who is depressed may suffer in silence for a year or longer and only go to the doctor when he or she feels physical symptoms. “Research suggests that 30 per cent of teens in the primary care waiting room have symptoms of depression,” says Sunnybrook psychiatrist Dr. Amy Cheung, who holds the Bell Canada Chair in Adolescent Mood & Anxiety Disorders. “But they may not be there for depression, but rather for a stomach ache or headache.”

Dr. Cheung is teaching primary care physicians to ask teens about their mental health as a regular part of a check-up. “We are trying to make it a standard part of health care,” she says.

She is also leading national efforts to improve mental health literacy among adolescents, parents and teachers, and to improve mental health care services for teens who do come forward.

Treating Anxiety Disorders

The Frederick W. Thompson Anxiety Disorders Centre is dedicated to the treatment and research of anxiety disorders, with a focus on obsessive-compulsive and related disorders. It is an epicentre for OCD research across Canada.

Preventing Suicide Through Science

Suicide is the second leading cause of death among 15- to 24-year olds, and Sunnybrook psychiatrist Dr. Mark Sinyor aims to find ways to prevent it.

Dr. Sinyor is one of the founding members of PROGRESS (Program of Research and Education to Stop Suicide) at Sunnybrook. He is using coroners’ records and other data sources to examine thousands of suicides that have occurred in Toronto and Ontario. From this will come a deeper understanding of suicide, which will inform efforts to prevent it.

Making a Fresh Start

Fresh Start is a co-operative program by Sunnybrook’s division of youth psychiatry and the Toronto District School Board to help transition kids back to school. At Fresh Start, teenagers who are in recovery from a mood, anxiety or psychotic disorder are seen by youth counsellors, social workers, nurses, teachers and physicians. They are medically monitored while developing skills to re-enter the school system.

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