Both CHEO and The Royal saw a continued trend towards higher numbers of inpatient days and outpatient referrals. Outpatient referrals to CHEO declined over the previous year but were still 42% higher than the baseline in 2009/10.
Fiscal Year 09/10 10/11 11/12 12/13 13/14 14/15
1773 2237 2637 2900 3162 3073
Total % change
+75 % CHEO Emergency
Visits
In-Patient Days –
CHEO (19 beds)
4541 5433 5697 5525 5626 4669 +3%
Outpatient referrals received at CHEO
1039 1689 1929 1828 1619 1471 +42%
Outpatient visits at
CHEO
In-Patient Days –
The Royal (8 beds)
(16-18 year olds)
5600
2302
7015
2566
7556
2375
7462
2489
7198
2693
8309
2810
+48%
+22%
Outpatient referrals received at The
Royal (16-18 year olds)
229 288
315 254 261 251 +10%
The Royal has seen significant changes in the reasons that 15- to 18-year-olds need care. In the past year, The Royal has seen a 167% increase in youth presenting with thought disorders, a 19% increase in youth with suicidality and emotional dysregulation, and a 30% increase in moderate to severe substance use disorders. Patients admitted to The Royal’s Youth Program are facing very complex mental health issues, many of them presenting with more than one complaint.
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October 29, 2015

At CHEO, a review of the children and youth seen by crisis intervention workers in the CHEO
Emergency Department in 2014/15 confirmed that many were at high risk.
• 79% of children/youth presented to CHEO Emergency with a current level of suicidal ideation or behavior; more than one third of those had a specific suicidal plan or made a suicidal gesture/attempt.
• The majority of youth (64%) had at least one area in which they were experiencing a severe difficulty requiring urgent or intensive intervention.
• 68% of youth had no or insufficient mental health resources at the time they came to
Emergency.
Among inpatients, 91% of young people admitted to CHEO’s 19 mental health beds are admitted because of a significant risk of self-harm. Serious suicidal thoughts or behaviours are seen for 81% of young people, while 34% are admitted with moderate to severe self-injury.
Since 2009, the proportion of inpatients with suicide risk has increased 23%, and the proportion with self-injury has increased 79%.
Symptoms of moderate to severe depression are seen for 73% of admitted young people, while almost half (44%) have moderate to severe anxiety. These rates of depression and anxiety symptoms are also up by 12% and 33% since 2009, respectively. Young people often present with more than one of these mental health needs.
There are currently 905 children and youth waiting for mental health outpatient and outreach services from CHEO and The Royal, down from 1,195 a year ago. Expected wait times for outpatient services are 6 to 9 months at CHEO, down slightly, and 6 months at The Royal. Both
CHEO and The Royal attempt to see urgent referrals within two to three weeks.
October 29, 2015