Child and Youth Mental Health Inpatient Unit

When you come to The RBC Child & Youth Mental Health Unit, located in 3G, team members will talk with you and your child to better understand what led to this hospital stay and how we can best help. Your child or youth will complete a behavioural analysis (BA). By working through the BA, your child shares important information with the team. This will help us:

• understand why your child was admitted
• identify the skills your child can learn to prevent coming back to the hospital

After completing the BA, your child can attend groups with other children and meet with different team members. Our staff will be your child’s coach. We will help your child learn and practice new skills in new situations.

What can my child/youth bring to the 3G unit?

• Toothbrush, toothpaste
• Deodorant
• Feminine hygiene products (new, unopened box)
• Enough clothing for 3 days (without strings, any strings will be removed)
• Pajamas, slippers, socks, underwear, shoes (without laces/strings, any laces/strings will be removed)
• School work, books (max of 2), one journal for writing (without metal bindings)
• A single small stuffed animal (should your child want one)

The 3G unit is not responsible for any lost or stolen articles. Staff may remove or send home any unsafe items at their own discretion.

What things are not allowed on the unit?

The following is a list of items that will not be allowed on the unit. For everyone’s safety, we search all children’s personal belongings when they arrive, after off-ward visits and as needed. Any unsafe items are sent home or disposed of safely.

• Communication devices such as cell phones, computers and smart watches
• Handheld gaming devices, portable DVD players
• Recording devices such as cameras and digital recorders
• Sharp objects such as glass mirrors, tweezers, scissors, cans, hangers and pencil sharpeners
• Plastic bags including Ziploc bags
• Belts, cords and strings including shoelaces, ties in hoodies, headbands, scrunchies and pants
• Nail polish, nail polish remover
• Cigarettes, lighters
• Alcohol, drugs
• Weapons
• Hair straighteners, curling irons, hair dryers
• Electric toothbrushes
• Anything with metal including pump bottles, retractable pens, Pringles cans, metal water bottle
• Modelling clay
• Energy drinks
• Metal buckles on shoes, hats and clothing
• Knee high socks
• Watches
• Any clothing that supports violence, aggression, racism, sexism and/or negative comments about sexual identity

• Towel, bedding and linens
• Shampoo, conditioner and body wash
• Writing, drawing and colouring materials
• MP3 player

We suggest that visits occur after 4:00 p.m. on weekdays when programs on the unit are finished but visits can happen throughout the day on weekends.

If this timing does not work for you, please discuss with our staff. For safety reasons we ask that all parents, caregivers and visitors do not bring personal items with them to the unit. If necessary, please secure them in a locker on 3G.

Everyone’s safety is important to us, including all children, youth, staff and visitors. We need to provide a safe environment, free from:

• violence, aggression, self-harm, lying, racism, sexism and/or negative comments about sexual identity. We do not allow clothing or any items that support any of these ideas
• bullying, threatening and verbal abuse
• substances including cigarettes, alcohol and drugs (and the supplies related to drug use)

Tell your child to talk to staff immediately if they feel unsafe or think they may do something dangerous. Staff will coach and guide your child to identify and practice skills that will help them.

Any time that a patient’s behaviour causes safety concerns, staff will work with the patient to become calm. If this does not work, and the safety of the patient or others remains a concern, we would need to consider methods of restraint as a last resort.

Assessing the risk of violence

If we receive information that a child/youth is at serious risk of harming others, we may participate in a “Violence Threat Risk Assessment”. This assessment determines how best to support the child so their behaviour does not become dangerous.

To conduct the assessment, we contact the child’s school and other community agencies. We also tell the police that a Violence Threat Risk Assessment is occurring.

As this assessment is a standard response for community agencies in Hamilton, we may be contacted by a school or community agency if they are conducting a Violence Threat Risk Assessment. If your child is at risk of harming others, we will meet with you or your child to discuss our concerns. We will ask you or your child for permission to share information with the community. Please note that in some situations we are required to disclose information, without consent.

We want you to feel comfortable sharing your concerns with us. We will keep these concerns within your child’s/youth’s care team, unless we have consent to share it.

We also must protect the privacy of your child’s personal information. We will ask for your child’s consent before sharing their information with others or getting information from others.

• If your child is capable, they have the right to keep their information private from anyone they choose, including their parents
• If your child is not capable to provide consent, then we will look for a substitute decision maker

There are times, however, when we cannot maintain confidentiality. If we become aware of a situation in which a child needs protection, we will report it to the appropriate authorities.

Those situations include:

• if any child or youth under the age of 16 is being hurt or abused, or at risk of being hurt or abused
• if anyone is in imminent danger of hurting themselves or someone else
• if a regulated health professional is or has been sexually inappropriate with someone
• if the courts ask for our records

Research is an important part of the work we do. Through research we learn how to best help children and youth with mental health needs.

While on 3G, we may ask you and your child if you would like to be involved in current or future research. Whether or not you wish to take part in research is up to you. Your decision will not affect your child’s care in any way.

Who will be involved in the care?

A team of health care providers and support staff will work closely with your child and your family. The health team may include:

As we are a teaching hospital, medical residents and students in health professions may also be involved in your child’s care.

As a parent or caregiver, what do I need to do while my child/youth is on 3G?

We ask parents/caregivers to attend our “Caregiver Connections” group and other meetings so we can share information about our program and what your child is learning. These meetings are scheduled during normal business hours.

How long will my child/youth stay on the 3G unit?

How long your child will stay on 3G depends on their needs. Each person’s needs are different, but most stay only a few days. When you arrive, the health care team will work closely with you and your family to determine your needs and plan your care. This includes making plans for when you leave 3G (discharge planning).

Can my child/youth leave the 3G unit?

The option of leaving the unit with staff or visitors is based on information from you, your child and the health care team. Safety is of the utmost importance in making this decision. To help you and your child prepare for discharge, the team may plan day or overnight passes. When possible, your child will have passes over a weekend.

What about my child/youth’s school work?

Please bring in your child’s school work. Our team includes teachers who can help your child continue their homework.

We may ask for consent:

• send a letter to your school principal explaining your child’s absence from school
• speak with the school to learn more about your child’s school experience and plan their return to school

Can my child/youth make treatment decisions?

The hospital operates under the Health Care Consent Act. This Act states that a capable patient of any age can consent (agree) to a treatment. The consent of their parent or caregiver is not necessary.

The health care team decides whether a patient is capable. Your child is capable of making a treatment decision if they can:

• understand the information relevant to the treatment decision
• understand the possible consequences of making the decision
• tell us their decision

If the team finds your child incapable of making a specific treatment decision, then someone else (usually a parent or guardian) will be assigned to make the decision. This person is called a substitute decision maker (SDM).