Public Data Sources for Monitoring Children’s Mental Health: What We Have and What We Still Need in British Columbia

December 10, 2020

Waddell, C., Catherine, N., Krebs, E., Nosyk, B., Cullen, A., Hjertaas, K., Lever. R., MacKenzie, D., Yung, D., Barican, J., Schwartz, C. (2020) Public data sources for monitoring children’s mental health: What we have and what we still need in British Columbia. Vancouver, British Columbia: Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University.

Executive Summary:

Children’s mental health is crucial for the wellbeing of individuals and of populations. Yet rigorous epidemiological studies show high disorder prevalence — with nearly 12.7% or 95,000 children aged 4–18 years being affected at any given time in British Columbia (BC). These studies also depict stark service shortfalls — with only 44.2% of children with mental disorders receiving any services for these conditions. Beyond epidemiological studies, improving children’s mental health requires comprehensive ongoing population monitoring of determinants, status, interventions and service use across all age groups, from infancy through late adolescence, to assess public investments aimed at better meeting the needs. We conducted an audit of such sources with potential application in BC, applying a population health framework to ensure comprehensiveness.

We found 25 data sources. Several show potential — if used in aggregate — for ongoing monitoring:

  1. For determinants and status: Canada Census and BC Education data (determinants; covering all ages); Early and Middle Years Development Instruments (status; covering younger and middle school-age children only); and Canadian Community Health, Health Behaviour in School-Age Children and McCreary Adolescent Health Surveys (status; covering adolescents only); and
  2. For interventions and services: Brief Child and Family Phone Interview (BCFPI) combined with BC Medical Services Plan (MSP) diagnoses from fee-for-service practitioners (mental healthcare encounters; covering all ages).

None of these sources is adequate alone, however. They therefore should be used in aggregate — and benchmarked against rigorous epidemiological data on both prevalence and service use in the population. For example, combining BCFPI and MSP data can give a picture of children receiving mental healthcare, which can then be compared to population estimates — informing planning to address service gaps.

Monitoring is also just one component of a comprehensive population health strategy for children’s mental health. Such a strategy includes:

  1. Addressing social determinants and reducing avoidable childhood adversities that contribute to the development of mental health problems;
  2. Providing effective prevention programs for children before disorders arise;
  3. Providing effective treatments for all children with disorders; and
  4. Monitoring needs and outcomes across the population.

Vigorous central leadership is required to ensure that such a plan is sustained over time, coordinated across all relevant sectors within government, and accompanied by adequate and dedicated children’s mental health budgets. BC’s children will benefit, as will everyone, if their mental health is made a high public policy priority. A monitoring system can contribute to this aim by enabling ongoing assessment and reporting on public investments designed to help all children flourish.

See full report here.