Nov. 20--While local retailers are hoping for a surge in business as the holidays approach, despite hard economic times, mental health providers have been seeing more patients since the economy first started heading south.

And, they expect it only will get worse through the holidays and in the weeks immediately after Christmas and New Year's Day.

Steve Cavender, administrator of behavioral health services at Parkview Medical Center, said during an interview Wednesday that every program operated by the hospital "has seen an increase in census, and we're talking double-digit increases" since the latter part of 2007.

Intake specialist Dana Eccher said she has been turning patients away from the Chemical Dependency Unit. Eccher said the average wait for a bed right now is 14 days because the 65-bed inpatient treatment center has been at capacity for several months.

And that's with 10 beds added after Parkview contracted with the Army to serve returning servicemen and women. Most are being treated for post traumatic stress disorder and co-occurring substance abuse or addiction. Cavender and Eccher agreed the largest recent increase in demand for services has been among local residents.

"Most of them are men. We see a lot of them who have lost a job and they give up and start self-medicating" with drugs or alcohol, Eccher said.

Cavender said patient numbers are up, as well, at the hospital's inpatient psychiatric unit, its adult and geriatric program and its 10-bed unit for adolescents.

All of those units also are available to military members and their families.

Cavender said depression and "self-harming behaviors" are the primary diagnoses among those populations and that there has been "an alarming number" of adolescent patients who are using black-tar heroin.

Eccher said those patients include children of military members as well as local adolescents, and most have some history of marijuana use "but not all of them. Some of them are just 'going for the gold' the first time they use any kind of drug because that's what's available, it's cheap and they want to numb out."

Adolescent mental health trends often follow those of the older populations, especially during difficult economic times. If there are financial problems at home, coupled with parental substance abuse, mental illness or violence, youngsters often end up hurting themselves or engaging in dangerous behavior as a way to escape.

Some of the military children have lived up to eight years with one of their parents on active duty in Iraq or Afghanistan, and parental absence during formative years can cause emotional problems without the complicating issues of uncertainty, or learning to live with a parent who returns from war with serious physical or emotional wounds.

"Mom or Dad is home, but they're not the same person they used to be and the kids want to know why Dad is so angry, or why he drinks all the time or doesn't hug them," Eccher said.

Civilian children in the unit often are dealing with parental absence, parents' financial strain and neglect or abuse on top of the normal emotional strains of adolescents, she said.

Most people who end up in one of Parkview's treatment units have reached a crisis stage, but there is help available before plans for suicide or eruptions of violence toward others become part of the equation.

Parkview psychiatric specialists in the hospital's emergency room work with people in crisis to help them find the appropriate level of treatment in the right setting.

But intake workers also can recommend private therapists who charge on a sliding scale and are available to stave off crises, Cavender said.

Although some patients don't seek treatment because they don't have insurance or cash to pay for it, Cavender and Eccher said that a lingering stigma regarding mental illness and addiction often are more of an obstacle to treatment.

"What we always tell people is that, if they had diabetes or a broken leg, they'd go to the doctor or hospital and get it fixed," Cavender said. "These issues are no different. They are diseases, just like any physical disease."

And they tend to get worse when times are stressful, and can be as deadly as some "medical" conditions if left untreated.

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