More teens and young adults in Ontario are experiencing mental health issues
Mental health or addiction–related emergency visit rates in those under age 25 increased by 89.1 per cent from 2006 to 2017, with the greatest rise observed in 14 to 21-year-olds, according to a new study by researchers at ICES, a non-profit research institute based in Toronto that uses population-based health information to produce knowledge on a broad range of health care issues.
The study, published today in Health Affairs, included all children and young adults under the age of 25 years living in Ontario during the 12-year study period and found that between 2006 and 2017, the number of mental health or addiction (MHA)–related emergency department (ED) visits increased from 46,130 to 87,538; and rates increased from 11.5 to 21.7 per 1,000 population.
“We found that the rise in emergency department visits during the study period was driven by increasing numbers of people making visits, rather than by more visits being made per person, and the reason for the visits was most often anxiety and mood disorders,” says Dr. Maria Chiu, lead author of the study and scientist at ICES and assistant professor at the University of Toronto.
Previous research has shown that one in five children and youth in Canada experience a mental illness at any given time and about 70 per cent have an onset during childhood or adolescence.
The study showed that while both MHA and non-MHA ED visits increased from 2006 and 2017, the percentage increase for MHA emergency department visits (89.1 per cent) was far greater than for non–MHA (2.7 per cent) suggesting that this phenomenon is specific to MHA, rather than a general trend towards more ED visits overall.
“What is particularly interesting about our findings is that we observed a significant increase after 2009. We cannot pinpoint the reason, but we speculate it’s due in part to several socioenvironmental changes occurring around that time that have contributed both to more mental health problems but also more willingness to seek care. These include the emergence of social media platforms like Facebook and YouTube, the Great Recession, the opioid crisis, but also things like the Bell Let’s Talk campaign which created more awareness for the public to seek help for mental health issues,” adds Chiu.
The researchers add that the greater number of teenagers and young adults experiencing mental health issues as well as the increase in emergency department visits have important implications for both hospital staffing and outpatient mental health care. Better access to evidence-based therapy for anxiety and depression, mental health and addictions case management, more flexible after-hours primary care services could all reduce the need for ED care.
In addition, the researchers note that this study was completed before the COVID-19 pandemic. Therefore, future research should look at how the pandemic will affect these trends, since similar factors that were seen in 2009 have now seen a rise, like increased screen time, greater anxiety, looming recession and more opioid overdoses, and it will be important to examine the effects of the pandemic on the mental health of children and youth.
Author block: Maria Chiu, Evgenia Gatov, Kinwah Fung, Paul Kurdyak and Astrid Guttmann.
The study “Deconstructing the rise in mental health-related ED visits among children and youth in Ontario, Canada,” was published in Health Affairs.
ICES is an independent, non-profit research institute 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 health care 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. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario
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