Just the Facts

The history of the neglected 'orphan'

• "Mental health has often been described as one of the "orphan children" of medicare. ... The Commission’s recommendation ... takes the long overdue step of ensuring that mental health home care services are included as medically necessary services under the Canada Health Act and available to Canadians across the country." - The Romanow Report (2002)¹

• "The Committee is deeply concerned about the capability of the mental health system to respond to the needs of children and youth. Fragmentation, coupled with under-funding, a shortage of mental health professionals, and a failure to involve younger people, and their families in long-term treatment solutions, has resulted in the delayed application of inadequate treatment interventions. Simply put, this is unacceptable. A much greater investment in children’s mental health is required if it is to shed its label as the "orphan’s orphan" within the health care system." - The Kirby Report (2006)²

Growing demand + shrinking funding and capacity = unmet need

• 1 in 5 Ontarians under the age of 17 has a mental health disorder causing significant distress and impairing their functioning at home, at school, with peers or in the community;³ the most common being anxiety, behavioural and depressive disorders. Mental health problems continue to grow among children and youth, and are predicted to increase by over 50% internationally by the year 2020, to become one of the five most common causes of morbidity, mortality, and disability among children.⁴

• Since 1992, inflation has increased 35.94% according to the Bank of Canada. Although budgets for child and youth mental health services rose by 8% during this same time period, there were also reductions of 1% and 5% in 1992 and 1996, respectively. This leaves an approximate 36.94% gap in inflationary funding for the child and youth mental health sector over the past 18 years – a 36.94% loss in service capacity.⁵

• In their 2009 report - Are We Doing Enough - The Canadian Paediatric Society downgraded Ontario's child and youth mental health care planning from "good" in 2007 to "fair" in 2009 - Ontario was the only province or territory found to be moving backward.⁶ And recently (2008), Ontario's Auditor General found an overall decrease in mental health services in that province.⁷

Consequences of unmet need: The bad and the ugly

• "It is important to understand that when children with disorders are not effectively treated, they do not shed problems as they grow, but become more vulnerable and less resilient as they approach adulthood—a pathway that can result in adult mental ill-health, involvement with the law, and homelessness."⁸

• "When untreated, mental health disorders can lead to school failure, family conflicts, drug abuse, violence, and even suicide."⁹

• Suicide is the 2nd leading cause of death (after accidents) among 10-19 year olds, and in 2005, it represented 19.7% of their deaths.¹⁰ Canada had the 4th highest suicide rate among 15 to 19 year olds out of 29 OECD countries (Organisation for Economic Co-operation and Development).¹¹
  

The benefits of (early) treatment

• "Research suggests that many mental health problems and disorders in children might be prevented or ameliorated with prevention, early detection and intervention. Overall, prevention and early intervention efforts targeted to children, youth and their families have been shown to be beneficial and cost-effective and reduce the need for more costly interventions and outcomes such as welfare dependency and juvenile detention ... early intervention efforts can improve school readiness, health status, and academic achievement and reduce the need for grade retention, special education services, and welfare dependency."¹²

• "About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth."¹³

What you can do

Learn more about what you can do.

¹Commission on the Future of Health Care in Canada. Building on values: the future of health care in Canada. Final report. Ottawa: Commission on the Future of Health Care in Canada; 2002. The Standing Senate.

²Committee on Social Affairs, Science and Technology. Out of the shadows at last: transforming mental health, mental illness and addiction services in Canada. The Committee: 2006.

³Offord, D.R., Boyle, M.H., Szatmari, P., Rae-Grant, N.I., Links, P.S., Cadman, D.T., Byles, J.A., Crawford, J.W., Munroe Blum, H., Byrne, C., Thomas, H. and Woodward, C.A. (1987). Ontario Child Health Study: Six-Month Prevalence of Disorder and Rates of Service Utilization. Archives of General Psychiatry, 44, 832-836.

⁴U.S. Department of Health and Human Services. (2000). Report of the Surgeon General’s conference on children’s mental health: A national action agenda. Washington, DC: U.S. Government Printing Office.

⁵Children's Mental Health Ontario. (2010). Pre-Budget Submission. Toronto, ON: Canada.

⁶Canadian Paediatric Society. Are We Doing Enough? A status report on Canadian public policy and child and youth health (2009 ed.). Ottawa, Canada.

⁷Office of The Provincial Auditor, Community Services, Child and Youth Mental Health Agencies, Chapter 3, Section 3.04. 2008.

⁸Wattie, Brenda: The Importance of Mental Health of Children; Canadian Mental Health Association, Ontario Division, 2003.

⁹Child and Adolescent Mental Health fact sheet CA-0004. SAMHSA's National Mental Health Information Center, Center for Mental Health Services, SAMHSA Health Information Network. Rockville, MD: U.S.

¹⁰Mortality, Summary List of Causes 2005 (Release date: March 30, 2009) Catalogue no.: 84F0209XWE. Table 2 Deaths by selected grouped causes, age group at time of death and sex, Canada. Statistics Canada.

¹¹OECD (2009), Doing Better for Children.

¹²The National Institute for Healthcare Management Research and Education Foundation (NIHCM). Children's Mental Health: An Overview and Key Considerations for Health System Stakeholders. Washington, DC: NIHCM; 2005. NIHCM Foundation Issue Paper.

¹³Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE: Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005, 62:593-602.