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Monday, July 14, 2014

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Teenage health unit deals with more demand

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The Goldman-Herzl Family Practice Centre’s Dr. Michael Malus, right, and psychologist Perry Adler.

MONTREAL — The Teenage Health Unit at Jewish General Hospital’s (JGH) Goldman-Herzl Family Practice Centre is striving to cope with increasing demand for its services amid budgetary challenges.

Herzl administrators worry that this situation could eventually affect the unit’s level of care.

Established in the mid-1980s by Herzl director Dr. Michael Malus, the unit provides free medical and psychological support – in strictest confidence if desired – to teens aged 13 to 19.

Services range from basic medical care and reproductive health to issues they say are being presented on a more frequent basis: bullying, depression, stress, anxiety, substance abuse, eating disorders, and even cutting and serious thoughts of suicide.

“There are so many kids in need now,” Carmelina Ricciuto, Herzl’s chief administrator, told The CJN at a recent fundraiser for the unit co-ordinated by the JGH Auxiliary and held at Au Vieux Duluth restaurant in St. Laurent, which donated to the unit all contributions related to the event.

 “There is a triage process, but I would say we are seeing more than 1,000 [teens] each month,” said Cindy Pessah, a psychology co-ordinator at Herzl.

The fundraising event came only days after 15-year-old Amanda Todd killed herself in Port Coquitlam, B.C., following months of bullying and harassment online and at school.

The event also came as the unit was searching for innovative ways to meet its $300,000 annual budgetary requirements.  This has become a more pressing issue since one benefactor discontinued support more than a year ago (the unit uses private funding because cognitive psychological therapy – the primary one used at the unit – is not covered by medicare).

In 2011, the JGH Auxiliary donated $100,000 to the unit.

 “Funding is becoming a huge problem,” said Ricciuto, who described it as a crisis situation. “The cheques are coming slower now.”

Thought has even been given to “capping” the number of sessions for teens to meet with psychologists, Ricciuto indicated – something never considered previously because it is virtually impossible to predict how much therapy teens in crisis might need.

For Malus and unit clinical psychologist Perry Adler, the rise in the number of cases is attributable to several factors, among them unprecedented social and school pressures that did not exist to the same extent years ago.

In the case of bullying, “you used to be able to go home and find refuge from it,” Malus said. But now, bullying and harassment follow you home on Facebook and Twitter, “and there’s no escaping it.”

The Teenage Health Unit’s roots date back to 1983, said Malus, who also heads the JGH’s department of family medicine, to when he visited a residence for pregnant teens as part of a research project.

In 1985, after visiting a number of high schools, Malus saw that teens face common issues regardless of family income or ethnic background – a realization that led to the creation of the unit.

“That was the beginning of our relationship [with high schools],” Malus said, adding that the unit continues to visit schools every year as part of its outreach program and to hand out wallet-sized cards with contact information on them – something teens take full advantage of.

“Our interventions are up 47 per cent,” Malus said.” We’ve become victims of our own success.”

The Teenage Health Unit is only one aspect of the Herzl centre, whose roots go back to 1912 as a dispensary. At the time, it served both as the organizational model for the Jewish federation and as a precursor of the JGH, which was established in 1935.

The Family Practice Centre, used for the clinical training of resident physicians in family medicine office practice, is described as “state-of-the-art,” divided between a Family Medicine Clinic and a CRIU Walk-In Centre located inside the JGH’s Pavilion H on Cote des Neiges Road.

The centre uses primary care staff physicians, as well as teams of residents, psychologists, nurses, nurse-practitioners and co-ordinators.

As part of the centre’s post-graduate training program, residents are involved in its adolescent medicine program dealing at a medical level with “common adolescent problems,” as well as other issues, including maternal child health, drug rehabilitation, geriatrics, pediatrics, breastfeeding, mental health, women’s health and in-patient care.

The teen unit itself has more than 20 psychologists who meet with teens on a continuing basis, “all free to the patient,” Pessah said.

 

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