As the province of Ontario tries to build capacity and reduce wait times for mental health care and addictions, it shouldn’t overlook the child and youth mental health care system.
Just as we treat physical health, prevention and monitoring of mental health should start at birth.
Research shows that if mental health issues are treated early, better health outcomes are the result. We also know that 70 per cent of mental illness and addiction problems have their onset in childhood and adolescence.
Early intervention is critical not just for improved mental health but for an improved health care system.
If we can get kids the help they need, we can prevent issues in adulthood or provide tools to better equip those with mental illness as they grow older.
In some cases, this would even help to lessen the severity and need for ongoing psychiatric supports later in life.
In short, if we triage child and youth mental health, we can avoid overspending later in life.
Unfortunately, most kids do not get the help they need until they are adults, if at all.
Wait times for treatment for children and youth are very long, at up to 18 to 24 months. And in some communities, services are not available at all.
Further, even the young people who are able to access care “age out” of the child and youth system when they turn 18. They then face long wait times and service unavailability in the adult system.
As a result of these system gaps, kids and young people are increasingly seeking treatment in hospitals because they have nowhere else to turn.
Emergency department visits for children and youth with mental health disorders and addictions has risen by 83 per cent and hospitalizations by 90 per cent in Ontario since 2006 — rates higher than the national average. (Meanwhile, during this same period, the rate of hospitalizations for other conditions in the child and youth populations have fallen by 24 per cent.)
Despite all those challenges, community child and youth mental health care has shown that even with few resources, a lot can be done.
Proven models and innovations already exist. They just need to be built on.
For example, child and youth mental health centres offer mobile, team-based care that can meet kids and families where they live or at or nearby schools and in the community.
And more than 70 walk-in clinics are up and running across the province that provide young people with same-day access to service without a doctor’s referral. About half of the children and young people using walk-in clinics require only one to three sessions of counselling. For the remaining young people with more severe mental illness, there are models of specialized treatment that can be delivered.
The problem is demand far outstrips supply, and there is a funding shortfall.
In fact, funding has fallen by over 50 per cent over the past 25 years at a time when demand is exploding. Without political intervention, the gap between demand and supply will continue to grow.
To counter this shortage of care, we need more practitioners. Fourteen hundred professionals would reduce wait times to 30 days or less for those seeking mental health care and kids in crisis could be seen immediately.
Some practitioners, such as psychiatrists, will take longer to hire. But other mental health care professionals are more readily at hand.
Both are needed.
Interprofessional care teams are more efficient and allow our most specialized and expensive interventions to be matched to patients with the most significant needs.
Parents, youth, researchers and child and youth mental health providers have been sounding the alarm to government for years about long wait times and a shortage of resources for treatments. They have also warned that early interventions are critical.
It’s time politicians listened.
If you want reform, start at the beginning with children and youth.
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