Two-Plus-Two Equal-Four

"The most startling finding is the dramatic increase in hospital admission for self-harm among our young people."
"We knew from previous studies that this type of behaviour is there, but just seeing the numbers and the upward trend is particularly distressing."
Juliana Wu, manager, decision support and trauma registries Canadian Institute for Health Information

The Twins. Courtesy Jonathan Hobin

"It certainly confirms our experience as care providers across North America. In the last three to five years there's really been a surge in kids who are self-harming, particularly the girls."
"What we hear from the kids is that they're having a really hard time dealing with negative emotions or stress and that cutting or hurting themselves reduces that. They really have trouble handling negative emotions like fear, sadness, anger or despair. It just bubbles up inside them ... and they have not developed the coping strategies to deal with them."
"You will see kids whose arms look like railway tracks or have done a very deep cut or in a serious place. The question then is, why are these kids not picking up better ways to reduce stress?"
"With social media, kids are essentially always with their peers. And if their peers are abusive -- as they often are -- then they are constantly exposed to an environment in which they are being taught maladapted techniques. In many ways, they are being raised by their peers."
"Many things have changed in our society over the last ten or 12 years and now it's starting to catch up. We've all heard that 'it takes a village to raise a child' -- well the village is changing rapidly."
"The culture is allowing girls to be in more fights. We're living in a more violent society. But I would say that all bets are off. We just don't know about this group of kids. This is a different phenomena."
Dr. Kathleen Pager, head of psychiatry, Children's Hospital of Eastern Ontario

It's an unfortunate fact of life that there have always been neglected children, children left to their own devices, to try to figure out on their own, through observation and experience, how they will fit into the world around them. Needless to say it's the parents' responsibility when they have children to raise them in an emotionally supporting familial environment, giving them confidence, and endowing them with values that will sustain them throughout their lives.

That's the best-case scenario for child-raising, along with the provision of shelter, nutrition and exposure to learning experiences, including schooling. Part of that support comes from the state as well, in reliable access to health care when it is required, and academic opportunities to equip the young with knowledge and social skills. When these are lacking the fallout is confusion, sometimes resentment, and sometimes social aversion.

Perhaps it's a bit too smug to offer the opinion that when children come into the world those who bring them there have an obligation to prepare them for entry to the world around them. And in raising children nothing can be more important and vital to their well-being than emotional stability, support, understanding and encouragement at every step of the way, as well as discipline in the imparting of values.

In modern society much of that obligation fell to the mother, with the father's support. Usually one of the parents was always available at home busy with domestic duties, the most vital of which was the raising of children. When a cadre of women in the West decided that this convention was demeaning to a women's independence, leaving her a virtual slave to the wage-earner to whom she was linked, and by extension the children to whom she was intrinsically obligated, changes occurred.

Dignity and fulfillment were seen to be had in working outside the home, for a salary. When children were involved, as they invariably were, the search was on for someone, not the parents, to take the parents' children in hand in a 'minding' capacity and something elemental was irretrievably lost. The concern deeply held by parents in the well-being of their offspring had been off-loaded and contracted out to someone who had no such concerns.

Left adrift, but clinging to the 'quality time' that parents could manage to spare for their children in off-work hours, the consequences could very well have led to a basic insecurity in their children. Little wonder that an evolution occurred where peers took the place of adults in forming children's values and attitudes toward life. And perhaps for far too many a permanent anomie set in to plague a child's psyche.

That, and abuse of any kind that might be perpetrated and perpetuated in a less-than-ideal familial setting. Resulting in findings that conclude that self-harm accounts for over 80 percent of intentional injuries and such self-harm has increased by over 85 percent in recent years, and girls account for 80 percent of the young admitted to hospital for self-harm injury. Poisoning by alcohol, prescription and non-prescription drugs represents the most common self-harm administered by both boys and girls.

"When you work in this area [helping vulnerable children and youth] the thing that strikes you is how common it is. It is children from Vanier, Barrhaven, Kanata, Orleans and outlying areas [within the greater Ottawa area]. It is everywhere."
"I think people think this is a problem for those families or those children who are not in their demographic or their neighbourhood and that is just not the case."
"Some are affected by poverty, mental health issues and addictions, and some are not."
"People recognize the physical issues and don't recognize the mental health issues, particularly in young children."
Dr. Michelle Ward, head, Child and Youth Protection Clinic, Children's Hospital of Eastern Ontario

An estimated two percent of children in the greater Ottawa area with its million-plus population has experienced some manner of childhood trauma or abuse. Doctors at CHEO saw only those children requiring hospitalization or emergency care, resulting from abuse or neglect, in the past. Many high-risk children were left untreated for issues that could impede their growth and development.

A new clinic has opened at CHEO, headed by an expert in child maltreatment. Children are identified by the Children's Aid Society and often become their wards and are referred to CHEO for treatment. From all across the city they are seen at the clinic, from toddlers to teens, to be assessed for physical, psychological neglect, and for sexual abuse. The function of the clinic is to provide early, comprehensive, expert assistance in the treatment of issues of abuse and neglect.

At the same time, children can be screened for medical, developmental and behavioural concerns which might be associated with trauma and if left unchecked could escalate, leaving them incapable of leading a well balanced life in the future. Physicians proactively assess children and youth in need of intervention and treatment.