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SickKids

Psychiatry

3 pairs of child feet with toddler shoes on

The Department of Psychiatry at SickKids is made up of a group of clinicians, educators and researchers who are committed to providing exemplary clinical psychiatric care to children and adolescents, which incorporates evidence-based and best clinical practices in child and adolescent mental health.

Teaching the next generation

We are fully affiliated with the University of Toronto and are a major teaching and training site for pediatric psychiatric assessment and treatment for trainees across a wide range of interprofessional disciplines and across all training levels. In addition, as a department, we are actively engaged in conducting innovative and relevant research to improve mental health outcomes in children and adolescents.

Multidisciplinary

Our department works collaboratively with all areas of the hospital to integrate psychiatric care into the physical health care of children and adolescent in the hospital, as well, we work in partnership with other hospitals in the Greater Toronto Area and with the various community mental health agencies and organizations. 

What we do

The Department of Psychiatry provides specialized psychiatric consultation, short-term treatment and follow-up to children and adolescents with complex mental health needs alone and in the context of physical health disorders. We work collaboratively with clinics and units across the hospital and in partnership with hospitals and mental health agencies across the Greater Toronto Area.

4 teens hanging out

Our clinical work ranges from the treatment of acute psychiatric emergencies, to the treatment of chronic psychiatric disorders, as well as the provision of specialized and integrated psychiatric care to physically ill children and adolescents, through our consultation liaison services. We strive to support evidence-based approaches and best clinical practice guidelines, to ensure children and adolescents receive the best possible care. 

We offer unique educational opportunities for different interprofessional groups of trainees at all levels of training. Our department leads and collaborates with partners around the world on innovative research to improve mental health outcomes in child and adolescent mental health.    

The SickKids Department of Psychiatry strives to: 

  • Assess and treat children and adolescents with primary psychiatric disorders and their caregivers
  • Support through assessment and treatment, children and adolescents with physical health and mental health concerns and their caregivers
  • Address mental health stigma
  • Integrate mental, physical and behavioural health care for all children and adolescents
  • Promote holistic and collaborative care for all patients
  • Educate patients, caregivers/families and health care professionals
  • Engage in innovative research to improve the lives of children with physical and mental health concerns. 

Programs and services

All referrals to the Department of Psychiatry must be made by a family physician or pediatrician and go through our centralized intake program, Mental Health Access Program (MHAP).

Community health-care providers can refer patients using a secure web portal called EpicCare Link.  Learn more about how to refer a patient to SickKids.

Our intake team reviews all referrals and determines if our services are appropriate for the patient to be seen within our department or elsewhere.

Upon acceptance of a referral:

  • Families/caregivers will receive an electronic questionnaire through a secure email link which will need to be completed prior to an assessment being booked.
  • Families/caregivers without access to a computer or internet have the option to receive the questionnaire through the mail.
  • If a referral is not an appropriate fit for our services, the referring physician will be provided with more appropriate recommendations about local community mental health service agencies and providers.
  • At times, our intake team may determine that a telephone consultation with one of our consultants and the referring doctor may be the most appropriate option before an appointment is booked – this typically may take place when it is felt that the telephone appointment may be enough to answer the referring physician questions and meet the families needs.
  • Please note that we do not provide parenting capacity assessments or reports for legal purposes.

The Urgent Care interprofessional team of Psychiatrists, Nurse Practitioners, and Therapists, provides psychiatric support in collaboration with the SickKids Emergency Department to rapidly evaluate and triage children and adolescents presenting in acute crisis to the most appropriate course of management which may include inpatient admission, brief crisis stabilization, or provision of the most appropriate resources for follow-up upon discharge from the Emergency Department.   

If you have immediate concerns about your child’s mental health, please go to your closest emergency room. 

The SickKids Ambulatory Psychiatry Clinic provides comprehensive psychiatric consultations, short-term treatment and follow-up to children and adolescents with complex mental health needs. Our areas of focus include treatment resistant ADHD, anxiety disorders, including Selective Mutism, Obsessive Compulsive Disorder (OCD)depressionas well as the management of psychiatric disorders in children and adolescents who also have significant physical health disorders, including somatic symptom and related disorders.

Typically, a child or adolescent and their caregivers attend an initial consultation, which is usually done in one visit; however, may be conducted over several visits. Several people may be involved in this first appointment, including learners (e.g. medical students, or residents). A typical assessment involves the clinician speaking with all who attend the appointment together. In addition, the clinician will speak with the child or adolescent on their own and will also speak with the parents or caregivers on their own.  

Children in a row holding paper plates over their faces. The paper plates have faces drawn on in marker.

After completing the assessment, the clinician will discuss their assessment and make recommendations regarding the next steps. These recommendations may include connecting with local mental health services closer to home, or may include attending some form of short-term treatment offered through our Department.  Treatment recommendations may include various forms of talk therapy, such as cognitive behaviour therapy (CBT) or medication management. Sometimes recommendations about medications will be made to the referring physician while at times, short-term medication management or a course of short-term therapy may be offered within our Department. In general, our Department provides only short-term treatment. 

For anxiety disorders: 

For 4 to 7 year-old children and their caregivers, we offer the Taming Sneaky Fears CBT Group Sessions (8 caregiver sessions).   

For 8 to 12 year-old children and their caregivers, we offer group CBT sessions (10 sessions) where caregiver and child sessions run separatelyat the same time; or alternatively for those who may require individual sessions, we offer individual therapy where the clinician meets with the child on a weekly basis followed by spending a few minutes with the parents or caregivers (total of 10 sessions).  

For older adolescents we offer individual CBT sessions (8 to 10 sessions).  

For OCD: 

We offer individual CBT for children 8 and older. 

For Somatization Disorder: 

We offer a Mind Body Together (MBT) group therapy for somatization disorder (6 weeks).

This is a clinical research clinic within Ambulatory Psychiatry that recognizes the association between depression and the risk factors for heart disease. The CLIMB Clinic integrates physical health into the mental health assessment and treatment of patients with depression.   

Patients who are referred to this program undergo a thorough psychiatric and health assessment during their visit.  

The CLIMB Clinic accepts referrals for children and youth between the ages of 8-17. Referrals to the CLIMB clinic must be made by a physician through EpicCare. Learn more about how to refer a patient to SickKids.

The Consultation-Liaison (CL) Psychiatry inpatient service at SickKids consists of an interprofessional team of psychiatrists, advanced practice nurses and behavioral specialists who provide comprehensive psychiatric assessment and integrated care to children and adolescents with complex physical health and mental health conditions across the hospital’s medical and surgical units.

The inpatient team works with the hospital's inpatient units to support patient care around a number of psychiatric disorders such as anxiety or depression, as well as acute psychiatric management after suicide attempts 

The inpatient CL service also provides assessment and treatment of functional disorders and somatization (physical expression of emotional distress), and support around difficulties children and adolescents may have with medical or surgical treatment, as well as management of delirium (severe confusion due to medical reasons).   

Smiling adolescent with assistive device and caregiver

The CL inpatient team provides education and support to staff across the hospital to enhance early recognition and identification of psychiatric concerns among physically ill children and adolescents and promotes early integrated care.  

In addition, CL Psychiatry provides out-patient assessments to assess and manage psychiatric concerns presenting in physically ill children and adolescents (as described via Ambulatory Psychiatry above). 

In both inpatient and outpatient settings, our CL team works as part of the child’s health care team and partners with medical/surgical teams with the goal of ensuring cohesive care from inpatient to outpatient at an individual level and hospital level.  

Referrals to the CL service for both inpatient and outpatient care must be made by a physician through MHAP (referral.mhap@sickkids.ca). 

This is a clinical research clinic within Ambulatory Psychiatry, that conducts detailed neurodevelopmental assessments for children with genetic disorders. The clinic team includes psychiatry, psychology, and psychometry, with experience in Applied Behaviour Analysis (ABA) 

The clinic’s main objective is to provide recommendations around family coping, behavioural strategies, safety, environment and activities, as well as principles of applied behavioral analysis (ABA).  

Referrals to the DAGSY program must be made by a physician through MHAP (referral.mhap@sickkids.ca)

For 13- to 17-year-old adolescents with a variety of mental health illnesses, including severe anxiety omood disorders and psychotic disorders, which may have interfered with their ability to function, we provide an intensive day-treatment program.   

The program uses primarily a cognitive behaviour therapy (CBT) approach. Patients typically attend the program for two to three months with the goal of having them transition back to school or other services. 

The SickKids inpatient psychiatry unit is a short-stay unit for children and youth ages 6 to 17 years with mental health issues that require an admission to hospital for acute safety concerns. Admission to the unit is via the SickKids Emergency Department or medical and surgical units at SickKids, on a voluntary basis.  

Children and adolescents are admitted for acute situations such as suicide attempts or for severe mental health symptoms such as psychosis. The focus of the unit is on assessment and stabilization of the mental health crisis and working with the child/adolescent and family on strategies to address safety concerns. The inpatient program is a family-based program and has caregivers participating in regular therapeutic meetings with staff and the child/adolescent.   

As the inpatient unit is a voluntary unit, children, adolescents, and caregivers must agree to the admission. If a doctor determines that an admission is required for mental health reasons and the child or adolescent is not in agreement, they will be transferred to a youth psychiatry unit at a local hospital that accepts involuntary admissions.   

The Tics and Tourette Clinic is a provincial clinic at SickKids that works with children and adolescents to assess and treat Tourette Syndrome and associated symptoms such as tics. This is an outpatient clinic within the Department of Psychiatry. With a physician’s referral, child and adolescent patients will receive consultation on the diagnosis and management of symptoms, education about tics and Tourette Syndrome and related conditions, pharmacological management, and recommendations for home, school and other settings.

Referrals to the Tics and Tourette Clinic must be made by a physician through EpicCare. Learn more about how to refer a patient to SickKids. 

Key staff

Our Staff in the Department of Psychiatry are professionally trained clinical child and adolescent mental health care providers, educators and researchers who work closely with patients and their caregivers as well as other clinics within the hospital and the community.

 

Our goal is to destigmatize psychiatric care, promote wholistic care and well-being, while working together with patients and their caregivers to ensure that we achieve the best mental health outcomes for them 

 

Division Head:

Dr. Louise Gallagher, MB BCh MRCPsych PhD

Chief, Child and Youth Mental Health Collaborative

The Hospital for Sick Children, Centre for Addiction and Mental Health

Professor and Head of Division of Child and Youth Mental Health, University of Toronto 

Patsy & Jamie Anderson Chair in Child and Youth Mental Health 

Suneeta Monga MD, FRCPC  

Associate Psychiatrist-in-Chief & Medical Director, Ambulatory Psychiatry 

Associate Professor of Psychiatry, University of Toronto  

 

Darryl Yates RN, MHSc, CHE 

Executive Director, Brain and Mental Health ServicesGarry Hurvitz Centre for Community Mental Health & Garry Hurvitz Centre for Brain and Mental Health

Dozens of blood samples with red, orange and purple lids

Research activities

COVID-19 & Mental Health 

This study aims to determine the impact of COVID-19 emergency measures on child and family mental health, well-being and functioning. This includes understanding how children and their parents are feeling and coping as well as understanding the impact of the COVID-19 emergency measures, on their relationships (i.e. with friends and extended family members) and daily activities (ex. physical activity, eating habits, screen time, and sleep). 

This study is conducted in collaboration with the SickKids Child and Youth Psychiatry Outpatient Program, the Province of Ontario Neurodevelopmental (POND) NetworkThe Applied Research Group for Kids (TARGet Kids!), and Spit for Science.  

Learn more about the COVID-19 & Mental Health study. 

Below, check out more research initiatives associated with the SickKids Psychiatry Department.

Research conducted through the neuropsychiatric research unit is dedicated to the understanding and treatment of neurodevelopmental disorders such as ADHD, OCD, Tics, and Tourette's Syndrome by examining both the genetics underlying these disorders, as well as the behavioural and cognitive traits that influence development. Our research uses a combination of behavioural, academic, genetic, and cognitive methods, and involves working with both typically-developing and clinical populations of children and youth.   

For more information please see Schachar-Crosbie Lab. 

From June 2019 to September 2021, we will invite 30,000 children and youth visiting the Ontario Science Centre to become Junior Scientists as part of our research project called Spit for Science. Children and youth will have the opportunity complete a computer game that will provide us with information about how they act and think. Using postal codes, we will also be able to estimate an understanding about different aspects of environment in which our Junior Scientists live in (e.g., how close they live to green space or exposure to air pollution). Finally, we will ask our Junior Scientists to spit in a small tube so that we can collect DNA. 

The aim of this study is to better understand how genes work with the environment to impact mental and physical health of children and adolescentsLearn more about Spit for Science. 

Children with disorders that impact neurodevelopment often have difficulties with executive functions and regulating emotions. The Mega Team study is testing the effects of a highly engaging, take-home video game-based intervention designed to improve executive functioning in children with various brain-based developmental disorders. 

In collaboration with a national leader in medical engineering and technology, our team is creating novel virtual reality tools for assessment and intervention of cognitive trait (executive functions) common in neurodevelopmental and brain-based disorders.  

The POND Network brings together a multidisciplinary team of scientists, clinicians, engineers and community stakeholders who share the goal of improving the long-term outcomes for children with ASD, ADHD, OCD and ID.  

The POND Network hopes to: 

  •  increase awareness and knowledge around neurodevelopmental disorders; 
  • support Ontario’s health researchers, clinicians and policy-makers in their efforts to better understand and implement evidence-based treatments for these conditions; and 
  • improve health outcomes and quality of life for children and youth with neurodevelopmental disorders in Ontario, Canada and around the world. 

One of the aims of the research arm of the DAGSY Clinic is to try to understand why some people develop psychiatric symptoms, while others do not. The differences in our genes are part of what makes each of us unique; the colour of your eyes, how tall you are, how easy (or difficult) it is for you to learn math or play a music instrument. What this study wants to know is if our genes also play a role in how likely (or unlikely) it is that someone develops psychiatric symptoms.  

Research through the CLIMB Clinic is focused on understanding the link between depression and heart disease as children and adolescents with depression are more likely as adults to have serious heart disease. The focus of this research program is to understand why this happens and what we can do about it.  For example, as part of this clinical research program we are examining the ways in which diet and activity can affect inflammation, blood vessels, and mood.  

One tragic problem associated with depression is suicide. Suicide is a leading cause of death among youth in Canada, and we need better treatments that are more widely available. Currently SickKids is leading a large multi-site study to test a youth suicide prevention intervention that was developed at SickKids. The study is for adolescents who come or are brought to the emergency department due to a concern around their safety. 

We know that mental health outcomes (e.g., the results of treatment) to date are poorly defined with little standardization across both clinical practice and research, making it difficult to identify the best or most effective treatment for various mental health concerns. This is the case with adolescent depression. In other areas of healthcare, the development of a core outcome set (COS), which is a set of outcomes that should be measured and reported in all clinical trials, has led to better outcome selection and measurement across research studies and this has led to better understanding which treatments are best for which patients.   

The IN-ROADS Initiative is planning to develop a core outcome set for adolescent depression studies. With this goal, we will seek out input from stakeholders including active engagement of patients and their caregivers to ensure what outcomes matter most to patients and their caregivers are included in the final core outcome set for adolescent depression. 

Early research is underway to use smartphones as a tool to learn more about someone's behaviour. Think about it: A smartphone automatically collects all kinds of information, for example, how often you go outside and how often you communicate with others (texting, InstagramSnapchat, etc). Our department in collaboration with others is looking to see if smartphones can help us see changes in behaviour that may tell us that someone has mental health problems and may need help. 

Education and training opportunities

The Department of Psychiatry at SickKids offers a variety of educational experiences in child and adolescent psychiatry for interprofessional trainees, such as students, residents and fellows, as wellas social work students and psychology interns.

Through Ambulatory, Consultation-Liaison, Inpatient and Day Hospital Programs and our various clinics within Ambulatory Psychiatry, our department provies valuable learning opportunities within collaborative interdisciplinary teams. Options for clinical opportunities vary and include training in pharmalogical interventions, as well as psychotherapy, with cognitive behaviour therapy (CBT) being a particular strength of our department. Training opportunities also involve virtual experiences, including virtual care and telepsychiatry.

Our Department provides core child & adolescent psychiatry training for the University of Toronto Psychiatry clerkship block, which builds on the Foundations Curriculum.  

In addition, the Department offers elective experiences for medical students from the University of Toronto and elsewhere. Electives are typically two weeks in length but can be up to four weeks.   

Find more information around the process for U of T, and other Canadian and International medical students.

 

Our department is a core training site for general Psychiatry Residents in the University of Toronto Residency Program as well as a core training site for aspects of the Child & Adolescent Psychiatry Subspecialty stream.   

Given the diversity of clinics and expertise of our staff, we also regularly attract senior residents seeking further experiences such as electives in child & adolescent psychiatry as per the U of T Post-graduate Medical Education guidelines. We are also able to provide electives of 2 to 4 weeks for psychiatry residents across the province and country for elective opportunities.    

Our department also provides training in child & adolescent psychiatry to paediatrics residents and fellows from the University of Toronto Paediatrics training program. These training opportunities allow for collaborative and interdisciplinary learning with a focus on ensuring that interested pediatric trainees obtain the necessary skills to assess and manage common pediatric mental health presentations. These opportunities are open to pediatric residents in the general pediatric program as well as subspecialty pediatric fellows in Community Pediatrics, Developmental Pediatrics, and Adolescent Medicine Fellows. 

See application details for electives via University of Toronto PGME. 

 

Our department also offers fellowships in child and adolescent psychiatry in affiliation with the University of Toronto’s Psychiatry Fellowship Program. These clinical and/or research fellowships are typically 1 to 2 years and graduate child and adolescent sub-specialty residents or pediatric residents may apply.

We also offer fellowship opportunities to both national and international candidates.  Fellows work with a primary Supervisor to obtain skills and expertise in one or two specific clinical or research areas within the department and report to the Fellowship Director.   

All applicants must follow the application process through the Post-Graduate Medical Office (PGME) and they must meet The Hospital for Sick Children’s application requirements as well.     

For more information on Department of Psychiatry fellowship application requirements and how to apply for a fellowship, visit University of Toronto Fellowships

The Hospital for Sick Children (SickKids) is offering a unique training fellowship opportunity in Neurodevelopmental Child and Youth Psychiatry under the supervision of Dr. Jacob Vorstman and Dr. Louise Gallagher. The fellowship offers an exciting opportunity to work in an interdisciplinary clinical and research environment. The fellowship will provide training in:

  • assessing children and youth with various degrees of intellectual disability and other neurodevelopmental conditions (e.g., autism, language disorders, etc.) in the context of rare genetic disorders
  • diagnostic assessment of children at risk for neurodevelopmental and psychiatric conditions
  • structured clinical interviewing and observational assessment (e.g., KSADS, ADI, DAWBA, ADOS)
  • clinical research methods (e.g., eye tracking and EEG data acquisition)

Eligibility

We are seeking applications from physicians with at least 3 years of specialty training in any of the following areas:

  • child and adolescent psychiatry
  • general adult psychiatry
  • other recognized subspecialties outside Canada (e.g., psychiatry of intellectual disability)
  • paediatrics with a strong interest in neurodisability

Expected start date in September 2023

How to apply

Please email your cover letter and CV (including 1–2 recent references) to jacob.vorstman@sickkids.ca and louise.gallagher@sickkids.ca by March 25, 2023.

Learn more about the fellowship by reading the information sheet.

Download the Clinical Research Fellowship Information Sheet

Toddler engaging with a learning ipad beside two big teddy bears

Educational awards

Susan Bradley Scholarship Fund

The Susan Bradley Scholarship Fund is a scholarship for medical students in their first or second year who are interested in developing a better understanding and appreciation for child and adolescent psychiatry through a summer student placement.  The scholarship enables the successful student to spend 10 to 12 weeks gaining clinical experience in child and adolescent psychiatry at SickKids or the Centre for Addiction and Mental Health (CAMH). Opportunities to explore research interests in child & adolescent psychiatry may be available to those students with an interest in research.   

Scholarships are awarded based upon completion of an application form, academic record, curriculum vitae and one reference letter.  The scholarship stipend is $5,000 for the summer placement.  Students will be required to prepare a summary of their clinical and/or research experiences.  

Please contact Comfort Thompson for further informationcomfort.thompson@camh.ca 

Contact Psychiatry

Phone: 416-813-7005

If you require information or have questions about an upcoming appointment, it is best that you reach out to the Administrative Assistant that contacted you about the appointment. If you are unable to recall that person’s name, email or phone number, please reach out to Charon Paul at 416-813-6600 (Ambulatory Psychiatry Patient Information Clerk), who will assist you 

For the DAGSY Clinic please reach out to Laura Goldhopf at 416-813-7654 ext. 408748.

If you are a physician looking to make a referral, visit Refer a Patient for more information.

Address

555 University Avenue,

Toronto, On M5G 1X8 

Ambulatory Psychiatry 

1st Floor – Burton WingRoom 1115 

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