Together, we are redesigning mental health care for children and youth

Today is the first day of Children’s Mental Health Week, a time of year that elevates the importance of child and youth mental health and builds public awareness of this critical health issue for the generations of today and those of tomorrow.  

As someone who has worked in mental health her entire career, in the last five years I have witnessed more gains made in the redesign of service delivery and improvements in care than in the previous 20 combined. At the same time, I have been part of a system that has struggled to keep up with the steady increase in demand for services. 

The numbers tell an important story: 70 per cent of mental health conditions will emerge before the age of 18; service demand continues to increase by 10 per cent every year; while hospitalizations for all other childhood conditions have declined by 16 per cent since 2005, hospitalizations for children and youth with mental health conditions have increased by a staggering 60 per cent. Today, one in six children will be diagnosed with a mental health condition, while only one in five can access the help they need. Anxiety disorders have become one of the leading conditions that prompt parents to seek help for their children. The World Health Organization now estimates that by 2030, mental health disorders will be the leading cause of disability worldwide. That’s only 13 years away!

So in the face of these daunting statistics, my message is a compelling call to action and optimism that we can do a better job for our kids and youth.

There has never been greater determination to facilitate access to appropriate care and improve mental health outcomes for our patients. Here in Ontario, innovative partnerships and collaboration have led the early stages of system reform, from the Moving on Mental Health policy initiative from the Ministry of Child and Youth Services, to the ‘what’s up’ Walk In clinics led by East Metro Youth Services, which have integrated a host of partners, including SickKids.

Over the past few years at SickKids, a major renewal of our own mental health services has been underway, streamlining access to patient care through our Mental Health Access Program; expansion of our Tele-Link Mental Health Program to serve both rural and urban patients; and, through the Medical Psychiatry Alliance, an enhanced Consultation-Liaison Psychiatry Program that is now helping a previously under-served population of children with both medical conditions and co-occurring mental health concerns. Referrals in this area have increased by 30 per cent. The Centre for Brain and Mental Health has established itself as an engine of innovation and academic productivity. Supporting brain science and mental health research across SickKids, the Centre’s role will become increasingly important as we help build the evidence base to better understand mental health conditions.

In February 2017, SickKids integrated with Toronto’s largest community-based children’s mental health agency, The Hincks-Dellcrest Centre. This initiative aims to create the first fully integrated community-to-hospital continuum of care for kids and youth and to build the best training ground for our future psychiatrists and allied health clinicians, including child and youth workers, social workers and psychologists. Reflecting SickKids’ commitment to building a more seamless, effective and efficient system of mental health care for kids and families,  this integration is expected to better meet the mental health needs of children and youth. This model is driven by emerging evidence on the impact of neurobiology, genetics, life events and social determinants of health that influence these conditions. But it is also driven by the reality that more and more of us acknowledge that we know of a family member, a friend, a colleague or a neighbour with a child or youth who is struggling with a mental health issue – and similar to so many other health conditions – we are now willing to talk about it, share our stories, overcome stigma and make a difference.

This Children’s Mental Health Week, let’s celebrate the actions currently underway and those yet to be developed, and look optimistically at the possibilities, scientific and systemic, that will allow us to collectively create more positive outcomes for kids and youth over the next decade.

Christina Bartha is Executive Director of the Brain and Mental Health Program at SickKids.