Historical Sketch

Overview

The JGH Division of Child Psychiatry has been providing care for children and families since 1967 Starting with a small in-patient unit and a Day Hospital, clinical programs have evolved throughout the years to include a Day Hospital, Evening Hospital and Outpatient services for children 2-15 years old.

In 2017, the division treats an average of 400 children and their families in a year. Children come from a large territory determined by English School boards, and present with a broad range of issues relating to maturational, behavioral, or emotional disturbances, or having experienced emotional trauma. Clinical programs provide multidisciplinary, multi-modal treatments including psychological, psychosocial, and psycho-pharmacological interventions. Family commitment and participation are mandatory components of the program.

The program’s approach is unique in Canada in its innovative treatment of children within their family system and community.. Children in the Day Hospital typically spend one academic year in treatment, and receive specialized academic teaching aimed at their gradual reintegration in the community school, with psycho-social support.

This innovative approach led the Child Psychiatry division at JGH to be, since its inception, a sought after training and teaching site for McGill residents and students from several Montreal universities and CEGEPs. Equally, the JGH Child psychiatry division has been a fertile ground for research with strong anchors in psycho-social, trans-cultural psychiatry and, more recently, epigenetics.

Administrative History

The JGH Child Psychiatry division was first envisioned by Dr. Nathan Epstein, the JGH Department of Psychiatry director (1960-1967) . Dr. Epstein introduced Canadian Psychiatry to an innovative way of assessing and treating mental disorders within the family system, which was very different from the prevailing psychoanalytic and individually centered psychiatric therapy model at the time. Expanding on this novel approach, Dr Epstein supported the development of a child psychiatry unit alongside adult psychiatry, and enabled a young resident, Dr. Ronald Feldman, to acquire the necessary training to make the vision a reality.

The Child Psychiatry division was opened in 1967 at the JGH in Pavilion B, 4NE wing, with Dr Ronald Feldman as its first director. In its first two years of operation, the division included a 7-bed In-Patient unit for distressed children and a Day Hospital unit that provided care for 15 children, aged 2-12, some of whom had severe autism while others were severely impaired by behavioral issues. Using a multidisciplinary approach, the first clinical team included Kathie Carnaghan Sherrard (head nurse), Judy Labow Wugalter (head teacher), and Linda Schecter (occupational therapist).

By 1970, the Inpatient Unit was closed and the Day Hospital had expanded to offer treatment to 40-50 children, aged 2-12, and their families. The division also developed an Evening Hospital, an after-school program focusing on social skills, and parenting groups. The Outpatient Service offered specialized assessment and follow-up services for children up to 15 years old presenting with behavioral, emotional, and trauma issues, bridging the service gap for 12-16 year olds. Family therapy and parenting support were an integral part of the programs. From the early days, child care workers and educators ran various support groups: mothers' groups, parents' groups, neighborhood groups. Home visits were also part of the program until the early 2000s.

Staff members were initially trained in family therapy by Dr Ronald Feldman, and later benefitted from Couple and Family Therapy training at the JGH. In the 1970s, Kathie Carnaghan Sherrard (head nurse), was involved in the development of a special care counselling program at Vanier College.

The expansion of the Day Hospital in the 1970s necessitated the hiring of more teachers from the Montreal English Protestant School Board in order to provide primary school education to children in treatment. Classrooms at the JGH Child Psychiatry were adapted for the therapeutic environment, providing increased individualized attention and interventions. The reintegration of the children in their community schools was a main focus of the program, so the monitoring, support and communication with the community school staff became key to the program’s success. Head teacher Judy Labow Wugalter pioneered the establishment of special relationships with the childrens’ schools after their post-treatment reintegration. Typically, children returned to their neighborhood school after 6 to 12 months in treatment at the JGH.

From the 1970s, additional therapeutic programs were offered. Among these were summer camps held at scout camp locations in the Laurentians, initiated in 1971 and continued until mid 2000s. The camps were run by child care workers and nurses on staff at the JGH. To fund such programs, and other enrichment activities, the division organized regular fundraising activities and campaigns: Bake Sales, Annual Bazaar, Movie Nights, and Conferences.

In 1977, Dr. Feldman stepped down as the Child Psychiatry Director, and was succeeded by Dr. Martin Solomon who continued in this function until 2004.

By the 1990s, as space in the hospital became scarce, the Child Psychiatry service was spread over several sites: Pavilion B at the main Jewish Hospital, the basement of the Institute of Community and Family Psychiatry and also in several community schools: Coronation school, and then Bedford and Bancroft schools.

In 1992, the service reached a crucial moment: the serious threat of closure. Judy Labow Wugalter (head teacher), Judy Gradinger (psychologist) and Judy Fish (teacher) created a very effective advocacy and action group called “The Three Whales”, inspired by the “Save the Whales” campaign of the time. The service enjoyed tremendous support from families, school principals, and the community. After a series of meetings with community leaders, the JGH Board, , and government officials, the “Three Whales” succeeded in preserving the service.

Despite its survival in the face of closure threats, the department was still finding the provision of services without a centralized location with adequate space to be a major challenge. Therapy often had to be given in corridors or shared rooms. Interdisciplinary teams faced long commute times and isolation in satellite locations.. Between 2005 and 2009, several proposals by the Head Nurse Rosemary Short, in function from 1990-2017, and the newly appointed director, Dr. Jaswant Guzder, were submitted for funds to further improve the service. Envisioning a new building solely dedicated to Child Psychiatry, the proposals aimed to definitively resolve the chronic issue of inadequate facilities.. Tremendous support was given by the JGH Foundation, through which several private donors and benefactors responded, including but not limited to the Kaplan, Goodman, and Steinberg families. September 14, 2010 saw the grand opening of the new “Ruth and Saul Kaplan Centre for Child Development and Mental Health” building at 4335 Cote St Catherine Road. Government, hospital, and First Nations representatives were present for this event. The new facilities are designed and specially scaled to children’s needs, and enable efficient and effective care in a centralized venue. With collaboration from the “Art for Healing Foundation”, the Centre includes art in its therapeutic milieu.

In 2012, the Child Psychiatry Director Dr. Jaswant Guzder was awarded the Queen’s Diamond Jubilee Award for her significant contributions to the community, the promotion of health equity and diversity, and excellence in research.

In 2015, the Quebec Health Ministry’s reform envisionned a continuum of care across first, second and tertiary lines within the larger organization of the CIUSSS West-Central Montreal “Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Ouest” that JGH is part of.

In 2017, Dr. Jaswant Guzder stepped down as director and Dr. Paola Habib became the new Chief of Child psychiatry at the Jewish General Hospital.

Staff, children, families and community cooperated in creating a true “village” in the JGH Child Psychiatry division. This camaraderie benefits not only the work environment, but advocacy, fundraising activities, and camps. A regular highlight of the academic year is the “Child Graduation Ceremony” held each June, when staff and families come together to acknowledge and celebrate the children’s hard work and progress.

Teaching

From the beginning, the JGH division of Child Psychiatry has been a magnet for trainees and interns from various programs and universities in Montreal. Staff in JGH Child Psychiatry taught and supervised students in the accredited Certificate Course in Couple and Family Therapy (CFT) given at JGH. This program eventually became the MSc Applied CFT under McGill University’s School of Social Work in 2013, led by Dr Sharon Bond, JGH’s CFT clinic director. Through this alliance with the CFT clinic, a Fellowship Program in Family Therapy training began to be offered in 2013 at the JGH Child Psychiatry division, which is a unique opportunity in Canada.

Research

Research is very active in the JGH Child Psychiatry division, and from early on has benefited from collaboration with the psycho-social and transcultural psychiatry research units of the JGH Department of Psychiatry. Dr Phyllis Zelkowitz, Dr John Sigal, Dr Laurence Kirmayer, Dr Cecile Rousseau, Dr Joel Paris, and others have led work in these areas. A young generation of researchers led by Dr Ashley Wazana and Dr Rachel Kronick is continuing this strong tradition and expanding to new areas.

People

To care and advocate for children with behavioral and mental health needs, it takes indeed a “Village”. This “Village” at JGH Child psychiatry was created by people from many different disciplines and backgrounds, with passion, dedication, resilience, and a pioneering spirit.

The service was developed and sustained with help of the larger community, including numerous volunteers, students in training, families, community members and generous donors, as well as the support of the JGH Department of Psychiatry directors.

Here are the pioneers, those who made special contributions and those who dedicated over 25 years of service to the JGH Child Psychiatry:

Dr. Nathan Epstein, Director of Psychiatry at the JGH, initiator of the division of Child Psychiatry and proponent of family therapy in psychiatry, 1960s.

Division Directors:

  • Dr Ronald Feldman (1967-1977), on staff until 2015
  • Dr Martin Solomon (1977-2004), on staff until 2016
  • Dr Jaswant Guzder (2004-2017) continuing as a consultant and researcher
  • Dr Paola Habib (2017 –

Psychiatrists over the years: Dr. Ed Levinson (Day Center), Dr. Dave Weiser (OPD), Dr Nancy Carpenter, Dr Judy Vogel (currently OPD head, longstanding service), Dr Marsha Heyman, Dr Ashely Wazana, Dr Rachel Kronick, Dr Cecile Rousseau (consultant), Dr Lucie Nadeau (consultant) , Dr Toby Measham (consultant)

Head Nurses: Kathie (Carnaghan) Sherrard (1967- 1984), Rosemary Short (1990 - 2017), Andre Riendeau (2017-   )

Nurses: Vincy Pulikakudyl, Joe Mootasawmy, Rochelle Margolese, Mia Grillakis

Social Workers: Janet Sutherland (1969-2016), Sherrie Poplack (1969-2017)

Psychologists: Judy Gradinger (1968-   ), Linda Greenberg (1968 -   )

Teachers (Special Ed): Judy Labow Wugalter (1967-2016, first teacher hired, Head Teacher from 1967 to 2013), Judy Fish, Olga Sher, Goldie Welik, Chava Respitz, Eva Feil (1979-2016), Carol Sector (35 years in service)

Specialized Child Care Workers and Educators: Ed Miller, Steve Trowbridge (first coordinator of Day Treatment Center), Tina Roth, Cynthia Roth, Ilana Haller, Esther Watts (Day Hospital Coordinator, 1987-), Joe Della Cioppa, Stephen Hennessey, Rosmund Richards, Gerry Goodfriend, Carole Summers, Sonia Papakonstantinou

Music Therapists: Eddie Wugalter, Bryan Highbloom

Speech Therapist: Elaine Wohl (p/t 1980s-2000)

Occupational Therapists: Linda Schecter, Carole Weiner, Anne Brice

Support Staff: Nicole Roach, Suzanne Racine, Anita Perrone, Elvira Ammendolea, Michael Buonvino (IT)

Volunteers: Barbara Gallay , Joan Charlap (retired teacher, long term), Eva Kuper (retired teacher), Pearl Gruber (retired teacher), Judy Kronick (retired teacher)

Donors and Benefactors: Kaplan Family, Arnold Steinberg, Goodman family, Bell Let’s Talk Foundation, Guzzo Family, Black family (1970s and 80s), Solomon Family Foundation

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