We are mental health researchers who work in prevention and early intervention. We recognize the importance of youth involvement in mental issues, and we present not only our opinions but also the lived experiences and viewpoints of youth.
Our national youth advisory group guides multi-site trials of research and helps develop and implement evidence-based mental health interventions for youth. We present the key challenges in Canada’s mental health care system for youth and propose novel solutions.
Early intervention and prevention of disease are funded through funding.
The continued lack of government funding, particularly for prevention, is a key issue. The federal budget for 2019 places a high priority on mental health literacy and harm reduction treatment of opioid abuse.
70% of adults with mental illness first experience symptoms during adolescence. Therefore, it is important to invest in prevention and youth mental health. Early intervention and prevention, such as the Canadian PreVenture Program, can reduce the prevalence of youth mental health disorders and substance use disorders. The current funding for prevention is less than 1% of the total costs associated with substance use disorders.
Affordability and accessibility are also ongoing issues. Wait times for free psychological assistance are notoriously high. These delays can mean the difference between youth needing preventive services and treatment.
The alternative, privatized care, is often unaffordable. The fees often are between $100 and $225 an hour. This prevents many youth from accessing care, particularly those who exercise their right to privacy by seeking help without a guardian.
It would be better to give youth free access to mental health services. It would be a positive step for Canada’s health plan to include Universal Access to Mental Health Services and to support early intervention and prevention, at least up to age 25.
Accessibility of Services
Our youth advisers stressed the importance of looking beyond affordability. The youth advisers cite the efficiency of services — such as wait times and staff capacities — as well as inclusiveness, suitability for youth needs, and location as major obstacles to care.
The mental health system in Canada is failing young people. (Shutterstock)
It is possible to reach youth who are underserved by adapting programs such as cognitive behavioral therapies and peer support to virtual/distance delivery. It is especially important in light of reports on deteriorating mental health in youth and the substantial disruptions to access mental health care due to the ongoing COVID-19 epidemic.
Our youth advisers discovered that while youth have access to mental healthcare professionals at school, they are often focused on academic issues. In fact, the time and energy of school psychologists may be diverted more towards evaluating and assessing learning disabilities and behavioral problems than to other mental health conditions.
It is also common for the ratio of students per psychologist to be higher than the recommended 1000 youths per professional. This can reach between 2,000 and 8,000 students. Limited evidence is available for many of the school-based drug prevention programs that are delivered to students.
In order to address this issue, school psychologists need national standards that focus on clinical support for students and research that helps improve mental health services for children.
New models of care
As a response to the necessity for reform new, more holistic care models are emerging. These include greater consideration of the developmental stage of the person’s life and the severity of their diagnosis.
Youth-focused integrated services, such as Foundry BC, Youth Wellness Hubs Ontario, and Australia’s Headspace, follow a model similar to ACCESS, Open Minds, Canada’s ACCESS, which provides fast access to innovative, evidence-based mental health services that include in-person care, virtual care, and outreach. The aim is to delay the transition to adult services for young adults.
