Division of Child & Adolescent Psychiatry | Psychiatry | School of Medicine

Division Chair: Dr. Johanne Roberge, MD, FRCPC
Administrative Support: Allie Singers

Introduction

This small subspecialty Division delivers full academic and clinical services within a tertiary care centre based at the Hotel Dieu hospital in downtown Kingston. Our catchment area extends over five counties; according to a recent census there are 85,000 children and adolescents less than 18 years of age in this area.

The Division provides comprehensive psychiatric services to children and adolescents suffering from psychiatric disorders up to 18 years of age. The morale is high amongst divisional members who share a sense of cohesion, allegiance and a commitment to academic, clinical and research goals of our tripartite mission. We provide a full spectrum of services necessary for comprehensive care of our patient population. The clinical services serve as a rich resource for the educational needs of our undergraduate from the school of medicine and post graduates from the Departments of Psychiatry, Paediatrics, Family medicine, Psychology. We are frequently chosen for observership and elective placement, not only, by our own undergraduate students but also those from other Canadian and overseas universities.

For more information on our Child & Adolescent Subspeciality Program

Our goal is a timely response in an efficient and effective manner to provide seamless service for the mental health needs of our community. Our wait lists are closely monitored to ensure prioritizing by acuity and severity in an effort to reduce wait times to the shortest possible. This has been made possible by very close interagency collaboration and support.

Outpatients
Mood and Anxiety Clinic: We were fortunate to recruit the team leader of this clinic in 2008 from the University of Pennsylvania where she had trained as a resident and then specialized and worked in mood disorders for 10 years. Apart from being an experienced clinician and researcher she is an excellent educator. This clinic has a full team of multidisciplinary members and provides assessments and multimodal treatment for mood and anxiety disorders.

Neurodevelopmental Clinic: This clinic provides assessment and intervention within a multidisciplinary team for disruptive disorders, Neurocognitive/neuropsychiatric disorders including PDD, Psychosis, ADD/LD. These disorders constitute more than 50 percent of our referrals.

Urgent Consult Clinic: This clinic provides urgent consultation and brief intervention to children and adolescents at risk for harm to self or others due to underlying psychiatric disorders. It is staffed by a full time Social worker and Registered Nurse and a psychiatrist/senior residents in Psychiatry. The clinic runs Monday to Friday 9 am to 5 pm (excluding bank holidays).

Eating Disorders Clinic: This clinic provides outpatient assessment and treatment for Eating disorders for children and adolescents. The team is made up of a part time psychiatrist, a part time Pediatrician, full time Social worker and BST and half time nutritionist. The main intervention is based on the Maudsley family based treatment model.

In some cases, admission may become necessary to the pediatric ward for medical complications or to the psychiatry ward for symptom control.

Family Court Clinic: This clinic is dedicated to court referred cases only.

Inpatients
This is a locked 8-bed ward with a highly structured milieu for observation assessment and treatment of all psychiatric disorders. Majority of admissions are from our OP clinics including at times from the urgent clinic. The front line staff are nurses experienced in child and adolescent psychiatry and CYW’s, a full MDT supports them.

Consultation to Paediatric
Almost 30% of our referrals come from our paediatric colleagues most are for the OP clinics. In addition we provide in house consultation to the paediatric ward. We have joint grand rounds with paediatrics and conduct seminars for their core teaching on child and adolescent psychiatry.

Outreach
We provide onsite consultation to CMHA in town and in other towns in our region. Each psyciatrist dedicates an afternoon or a full day (in case of regional sites) once a month at these sites.

Telepsychiatry
We are committed to providing Telepsychiatry consults and follow-up for remote regions within our catchment area.

Shared/Collaborative Care
This division subscribes to shared care and actively engages Family physicians, Paediatricians and CMHA in service provision to our population.

4 GFT psychiatrists; appointment is in process for a 5th Psychiatrist with expertise in Eating Disorders and Family Therapy. The multidisciplinary staffing consists of Psychologists, Psychological Associate, Psychometrists, Social Workers, OTs, Nurses, CYW’s, BST, Teacher and Pastoral Care Workers.

One of our major mandates, as part of an academic department of the faculty of health sciences, is the education of undergraduates and postgraduates in child and adolescent psychiatry. We have a strong commitment to this role. Members of our Division have held the post of PGE training director of psychiatry and the Directorship of Undergraduate psychiatry education is held by a child and adolescent psychiatrist. One of our faculty (Dr. John Leverette) is amongst the authors of new RCPSC subspecialty requirement guidelines for child and adolescent psychiatry. We have been the recipients of National education awards from RSPSC, CACAP, Excellence in Education (faculty of Health Sciences Queens University) and the yearly department of psychiatry residents award for excellence in teaching.

For more information on our Child & Adolescent Subspeciality program.

The predominant model we have espoused is that of clinician-scholar. This implies that scientific and research evidence informs clinical practice and that questions arising from clinical practise form the basis of our research. We have ongoing collaborative research projects in Mood Disorders, ADD, PDD and mental health screening with the Faculty of Psychology at Queens University.

Training in Research Design, Methodology, and Statistics are available through the departments of psychiatry, psychology and Community Health and Epidemiology and specific mentors are available for residents interested in pursuing a research career. Research electives have been encouraged and arranged for these residents at other national and international universities.