Rates of hospitalization increasing for children’s mental health concerns

From 2009 to 2019, Canadian hospitals saw a 60.6% increase in children’s emergency-room use for mental health concerns and a 59.7% increase in inpatient admissions. These Canadian data also reveal that ER use and hospitalizations have varied considerably based on children’s age, gender and place of residence. Youth aged 15 to 17 have the highest rates of both ER visits and hospitalizations among young people. The lack of community-based mental health resources for teens may be a possible reason for the disproportionate rates. And among these older teens, girls were twice as likely to be hospitalized as boys. As well, children from rural communities accessed ERs at rates that were nearly 50% higher than those from urban centres. Reasons for higher rural ER use may include a lack of mental health specialists and limited service options in these regions, as well as lengthy travel to access community-based services.

BC data tell a similar story. Here, children’s hospitalizations for mental disorders increased by 68.8% between 2009 and 2019. Notably, these substantial increases occurred despite there being more effective ways to support children. Overall, these data suggest that hospitals are becoming a de facto safety net for the many young people who experience “fragmented care and significant gaps in mental health service systems.”

For more information, see Vol. 16, No. 3 of the Children’s Mental Health Research Quarterly.

A population mental health strategy will help more children

To ensure social and emotional well-being for all children, an important step involves adopting a population mental health strategy. Such a strategy has four crucial pillars. First, policy-makers can address social determinants of mental health — for example, by implementing programs that reduce the number of children living with socio-economic disadvantage. Second, programs can be implemented to prevent disorders before they develop. Third, for those with mental disorders, timely and effective treatments can enable children to recover and resume their progress on positive developmental trajectories. The fourth pillar involves monitoring the success of these efforts and then making any needed adjustments to better address determinants, prevent disorders and provide treatments.

For more information, see Vol. 16, No. 3 of the Children’s Mental Health Research Quarterly.

How practitioners and policy-makers can support children with mental disorders

Findings from a recent systematic review by the Children’s Health Policy Centre offer hope for children with mental disorders. Specifically, the review stresses the need to use a four-pronged population health strategy, including:

  1. Addressing social determinants of health, such as socio-economic disparities, and reducing avoidable childhood adversities that contribute to the development of mental health problems
  2. Providing effective prevention programs for children who can benefit to reduce the burdens and reduce the number of young people needing treatment
  3. Providing effective and timely treatments for all children with mental disorders
  4. Monitoring population needs and outcomes over time to evaluate and improve public policy efforts

The first two prongs of this strategy involve “upstream” issues early in children’s lives, before mental disorders develop. In the longer term, society may recoup these investments, for example, through reductions in the use of health, education, social and justice services when more children and families are thriving. And, mounting research evidence supports effective prevention programs, many of which can be implemented by children’s mental health and school practitioners.

The third prong addresses treatment. This requires reaching children early in the course of their disorder(s) with proven and timely interventions that are of adequate duration and intensity. However, the data suggest that many countries, even those that are high income, are far from this goal. But Australia stands as an example of a high-income country that could double the proportion of young people accessing services for mental disorders over a period of approximately 15 years. This was achieved through increasing funding for mental health services overall, as well as changing how funding was used. For example, Australia increased spending for community mental health care services and decreased spending for psychiatric hospitals.

The final prong of this strategy involves measuring collective progress towards improving children’s mental health, through monitoring outcomes and adjusting course over time.

For more information, see Vol. 16, No. 2 of the Children’s Mental Health Research Quarterly.

Celebrate National Indigenous Peoples Day

National Indigenous Peoples Day is a time to recognize and celebrate the history, heritage, resilience and diversity of First Nations, Inuit and Métis across Canada. The day was established in 1996 following concerted advocacy efforts and calls for the creation of such a day by the National Indian Brotherhood (now called the Assembly of First Nations), the Sacred Assembly and the Royal Commission on Aboriginal Peoples. The date was chosen because many Indigenous groups have long celebrated their culture and heritage on or around June 21 due to the significance of the summer solstice.

National Indigenous Peoples Day offers an opportunity to not only celebrate Indigenous Peoples, but also to reflect on how our programs and institutions can better serve Indigenous youth and families. To learn more about the impact of racism on children, see Vol. 15, No. 3 of the Children’s Mental Health Research Quarterly.

Mark Action Anxiety Day on June 10

Action Anxiety Day educates Canadians about anxiety, reduces stigma and builds awareness of resources and raise funds for programs addressing anxiety. Held annually on June 10, the day was founded by Anxiety Canada, a Vancouver-based organization whose mission is to reduce the barrier of anxiety and its related disorders so people can live the lives they want.

Action Anxiety Day’s organizers encourage participants to use the hashtag #ACTonAnxiety to share stories and promote the event. ACT stands for the following:

  • Awareness: Raise awareness of anxiety and trusted, evidence-based resources.
  • Colours: Wear blue and orange on June 10 to show support.
  • Talking: Tell your anxiety stories and encourage others to share.

Anxiety Canada also offers several resources for promoting the day, including a social media guide and a toolkit for educators.

To learn more about preventing and treating anxiety in children and youth, see Vol. 10, No. 2 and Vol. 10, No. 3 of the Children’s Mental Health Research Quarterly.

June is Pride Month

This June and all summer long, members of the LGBTQ+ community and friends, family, allies and advocates will celebrate Pride Season in Canada. While June is designated as International Pride Month, Pride events take place throughout the year in many communities.

The first Pride march was held in New York City on June 28, 1970, on the one-year anniversary of the Stonewall Uprising. In Canada, the first Gay Liberation and Protest March took place on August 28, 1971, when approximately 100 people gathered on Parliament Hill to present the government with a list of demands for equal rights and protections. Two years later, in 1973, organizers began holding Pride Week events in major Canadian cities.

This year, Vancouver will host Canada Pride from July 26 to August 4, an event that highlights the critical importance of advocating for LGBTQ+ rights on a global scale. To learn more about supporting LGBTQ+ youth, see Volume 11, No. 2 of the Children’s Mental Health Research Quarterly.

More data is needed to make better decisions about children’s mental health

More comprehensive data on children’s mental health services are greatly needed, including from BC and Canada. It would be especially beneficial to track the number of children with disorders, the specific services they are receiving over time, and their responses to treatment. This type of ongoing measuring children’s mental health status and access to services is crucial to inform planning. To address the service shortfalls and ultimately improve children’s mental health, better measurement is needed — and is overdue. In essence, “What gets counted counts.”

For more information, see Vol. 16, No. 2 of the Children’s Mental Health Research Quarterly.

Age and other factors play a role in treatment for childhood mental disorders

A study from Ontario reveals important information on factors that may influence children’s mental health service use. For example, researchers found considerable differences in service use based on age. Among children between four and 11, 61.5% received service for their mental health concerns; however, for youth between 12 and 17, this figure was only 43.7%. Study authors also found differences in service use based on other factors. Specifically, immigrant children were much less likely to receive mental health services compared with non-immigrants. As well, children who had both behaviour and mood or anxiety disorders were significantly more likely to receive services than children with just one of these disorders.

For more information, see Vol. 16, No. 2 of the Children’s Mental Health Research Quarterly.

May 7 is child and youth Mental Health Day

Child and Youth Mental Health Day, marked annually on May 7 in Canada, offers an opportunity to raise awareness of the struggles that children and youth face. It encourages individuals, communities and policymakers to prioritize mental health initiatives.

Family Smart, a BC-based non-profit, established the day in 2007. Their goal is to facilitate caring, connected conversations between young people and adults. Since then, the day has spotlighted both the existing mental health supports for young people and the work that remains to be done.

The Children’s Health Policy Centre conducted a systematic review on the prevalence and impact of childhood mental disorders in 2022. You can learn more about the findings in Vol. 16, No. 2 of the Children’s Mental Health Research Quarterly.

Almost half of children with mental disorders receive no help

Given the high burden of childhood mental disorders, all children with these conditions should have rapid access to effective treatments. Access to mental health services is also a fundamental right of all children, as evidenced by Canada and many other countries declaring their obligation to provide such services. To understand how well Canada is meeting its obligation to these children, The Children’s Health Policy Centre conducted an analysis to identify how many children with mental disorders received interventions for these conditions. We did so using data from our review on the prevalence of childhood mental disorders, which was originally published in Evidence Based Mental Health. 

Eight of the 14 high-quality epidemiological studies that we reviewed provided data on services children with mental disorders received. While all the data were high quality, each study defined and evaluated services somewhat differently. For example, some covered only mental health care, such as psychotherapy or psychiatric medications, while others covered a wide range of interventions, such as self-help groups and probation services. We also found gaps in the data, such as missing details on specific types of psychotherapy or medication and the duration of services. Our analysis nevertheless revealed that for children who were coping with mental disorders, only 44.2% — or fewer than half — received any services for these conditions.

For more information, see Vol. 16, No. 2 of the Children’s Mental Health Research Quarterly.