Children and youth made 1.35 million visits to physicians for mental health and addictions-related care in 2014, an increase of 25 per cent since 2006 according to a report published today by the Institute for Clinical Evaluative Sciences (ICES). In the same year, children and youth made more than 70,000 emergency department visits for mental health and addictions-related care, an increase of 53 per cent from 2006.
“The Mental Health of Children and Youth in Ontario: 2017 Scorecard” is a comprehensive report that describes child and youth mental healthcare and related outcomes in Ontario. The report is a culmination of two years of work to refine our understanding of child and youth mental health and health system performance in Ontario and inform ongoing efforts to improve outcomes.
“The 2017 scorecard emphasizes the increasing demand for mental health services among children and youth in Ontario,” says Dr. Astrid Guttmann, senior author on the report, chief science officer at ICES and pediatrician at SickKids. “But it also highlights that there is a mismatch between mental healthcare needs and access to physician care for children and youth with mental health issues.”
See more infographics from the report (PDF).
The researchers say this system-wide increase in service use may be pointing to better identification of mental health and addictions issues or less stigma around the topic, leading more children and youth to openly seek care.
At any given time in Ontario, one in five children and youth has a mental illness. About 70 per cent of mental illnesses begin in childhood or adolescence. Anxiety disorders account for the largest disease-specific mental illness that Ontario children and youth suffer, and are among the leading causes for emergency department visits for children and youth with mental health issues.
“The 2017 scorecard found significant regional variation across Ontario when it came to how children and youth access mental health and addictions care and the type of care that they receive. Where a child or youth lives impacts when and what kind of care they receive,” says Dr. Paul Kurdyak, co-author of the report, scientist at ICES and psychiatrist at CAMH.
There is also significant variation in the rate of death by suicide among children and youth depending on where they live in the province, according to the scorecard. Children and youth from the lowest income neighbourhoods and those who live in Northern Ontario are at the highest risk of suicide. In the North West LHIN, the suicide rate is five to six times higher than the provincial average at approximately 33 deaths per 100,000 children and youth. In the North East LHIN, the suicide rate doubled between 2007-09 (7.2 deaths/100,000 children and youth) and 2010-12 (13.6 deaths/100,000). In the Toronto Central LHIN, the suicide rates in 2010-12 (5.7 deaths/100,000) were lower and decreased by 2010-12 (4 deaths/100,000).
This scorecard also highlights 13 new performance indicators for community-based children and youth mental health services, provided by the Ministry of Children and Youth Services (MCYS).The data provided by MCYS shows more than 121,000 children and youth accessed services in community-based agencies in 2015/16. MCYS also measured wait times for services, showing that children and youth waited as little as two days for crisis services and 98 days for intensive treatment services, suggesting a rapid response to crises but long waits for less critical services.
There is some progress in mental health and addictions care. Since 2006, the rate of children and youth seen by a psychiatrist increased by 42.8 per cent, meaning that more children and youth are getting the specialized care they need. Additionally, 10 per cent less children and youth are showing up in emergency departments without prior physician care for mental illness. These trends signal that more children and youth are seeking help for mental illnesses in a primary care setting.
Monitoring Ontario’s child and youth mental health system is an ongoing process. ICES will continue to update the scorecard every two years, including identifying and integrating new data sources, to provide a long-term perspective of where the system is working and where there is room for improvement.
“The Mental Health of Children and Youth in Ontario: 2017 Scorecard,” was published today on the Institute for Clinical Evaluative Sciences website.
Author block: MHASEF Research Team (in alphabetical order): Abigail Amartey, Maria Chiu, Evgenia (Jenny) Gatov, Astrid Guttmann, Michael Lebenbaum, Paul Kurdyak, Natasha Saunders, Simone Vigod and Julie Yang.
The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario
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