This past week, Kids Help Phone released a report showing that 22 per cent of Canadian teens have considered suicide in the last year and nearly half of those formulated a plan.  Also this week, the Canadian Medical Association Journal released an editorial stating that there is a “public health crisis” that needs a funded prevention plan. Sadly, this is not surprising to those of us who support children and youth with mental illness. Despite the recent research and news revealing a disturbing trend of an increase in Canada’s children and youth battling mental illness in crisis, approaches to care and funding continue to be short-sighted. 

We are failing our youth by not creating an effective children’s mental health system. We have insufficient resources to intervene in the early stages of a mental health issue, which is proven to garner the most effective results, and are waiting to intervene when children are suicidal and in crisis. Hospital in-patient admissions for children and youth with mental illness in Ontario have increased by a startling 42 per cent and emergency room visits have risen by 50 per cent, for example.

Based on these studies and data published by Children’s Mental Health Ontario (CMHO) in its 2016 Report Card, we estimate that this year alone, we could prevent up to 40,000 kids in Ontario with mental illness from seeking care in hospitals by providing effective community or neighbourhood-based treatment at Children’s Mental Health Centres.  However, with thousands of children and youth with significant mental illnesses currently waiting for sometimes a year for treatment in the community, many will continue to become critically ill and end up in hospitals or worse. The evidence is clear – early intervention can avert crisis but our resourcing strategy is focussed on crisis treatment.

The first meaningful mental health intervention should not occur in an emergency room.  Hospitals play a critical role in a system of care for youth with mental illness, but for acute stabilization, rather than long-term treatment.  Families tell us that youth with mental illness should be treated the same way as youth with a physical illness and should have timely access to treatment.

We must remember that the system of care for children and youth with mental health issues includes teachers, nurses, physicians, hospitals and community-based children’s mental health centres.  When there is insufficient funding in one part of the system, the pressure moves to another area – in this case hospitals. CMHO has been urging Government to increase capacity in community-based mental health centres, which, if properly funded with a $65 million investment this year, could generate savings of $145 million in hospital costs. And, more importantly, will save lives.

And the solution to creating a better system also lies in communities.  CMAJ is correct. We are facing a national public health crisis that needs a prevention plan. For our part, CMHO will be convening teachers, family physicians, child psychiatrists, hospitals, school boards, together with youth and parents to build a vision of an integrated system that works. We want to partner with government to implement a strategy to close the gaps between the failing system we have now and what we need.

It is recognized that the most effective mental health and addiction services for children and youth are those delivered at home and in the community. However, Ontario’s current funding approach for child and youth mental health is reactive and short-sighted. Let’s stop this disturbing trend and take a long-term, effective, and cost-savings approach to supporting children and youth with mental illness.

Kim Moran
President and CEO, Children’s Mental Health Ontario