We either invest in children's mental health now – or pay a steep price later

Youth violence, particularly in Toronto, has been grabbing headlines. Governments and the public fret about solutions. As a partial remedy, the Ontario government has identified two key priorities for youth, to ensure this province's long-term prosperity and competitiveness: education, and access to timely and effective health care. There is a sense that progress is possible. But children's mental health is never mentioned.

The current Ontario government is the first in many years to invest new money in children's mental health, but more is needed. The stigma that attaches to mental health among adults ripples, with harsh effect. Every day, 120 young people attempt suicide in Ontario; every week, on average, two or three succeed. Youth violence, dropout levels, drug addiction, crime and high-risk lifestyles are directly related to mental and emotional distress. One in five children and youth between the ages of 3 and 17 suffers from a treatable mental-health problem. Suicide is second only to accidents as the leading cause of death in young people 10 to 17.

Children all around us are trying to cope with extreme situations - at school, on the playground, at home. Physical and emotional abuse are often unnoticed and untreated.

Why? Because there is a dearth of accessible mental-health professionals.

Why? Money.

In economic terms, every self-sufficient and emotionally stable adult who engages in the community and society is an economic and social engine that fuels all aspects of the economy and community. Measuring the true economic cost of mental illness and emotional distress is impossible. But the toll it takes on individuals, families and communities is more apparent every day. Some suffering is done in silence, and some effects are seen daily on the six o'clock news. Many parents struggle with stigma that saturates our perception of mental-health problems. Many don't know how to access help, or, when they figure it out, are told help is not available: "We're sorry. We can't treat your suicidal child, because we are overwhelmed with cases. Take a number."

Help should be available when symptoms present - e.g. when the child refuses to go to school, or substance abuse. No parent, or child, should have to wait until a crisis presents. No child should be pushed to the brink of despair because they have to wait a year for help. Childhood mental-health crises require triage, immediate and effective intervention. Telling an eight-year-old, who turns out to be an incest victim, that she must wait eight to 12 months to be assessed by a professional is bad medicine, bad social policy, and bad economics. A small investment in children's mental health reaps incalculable benefits. Clinical experience has demonstrated that effective intervention has a profound positive effect on children, one that will have an impact on the course of their lives. It prevents chronic mental-health challenges, and gives society and the individual the gratification of a productive life.

Ontario's child and youth workers, social workers, early childhood educators, psychiatrists and psychologists have a tough job. These professionals maintain a passion and a drive to keep working and advocating for their clients and their communities. They adapt and innovate, making do with resources that are diminishing in real terms while the need for services grows. They give the children a voice and hope. This week also presents an opportunity to shed light on children's mental-health centres across Ontario. These community-based and community-managed centres should be celebrated as models of common sense, effective delivery, clinical excellence and good fiscal management. They are places where children, youth and families in trouble meet competent professionals who can help. Boards of directors are made up of individuals from the community, who work co-operatively with government. The influence and skill they bring to this work is making a difference.

Having hit the wall financially through periods of cuts and freezes in provincial funding, many centres reached out to the community for financial help. The results are encouraging but inadequate. Still, a material portion of service delivered today is funded by individuals, foundations and corporations. This precarious sustainable-funding model is a significant management challenge, but a welcome boost to short-term capacity. In an ideal world, such funds would be gravy - facilitating innovation and research - but reality is far from ideal. Common sense demands that we bridge the gap.

Brigid Murphy chairs the board of the George Hull Centre for Children and Families, a children's mental-health centre in Toronto.

Brigid Murphy
11 May 2006

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