New Mental Health Strategy for children develops new pathways to care

That one in five children have a mental health disorder is a hard stat to hear. That only one in six of those children are able to access the mental health care they need is even harder to accept.

SickKids’ comprehensive Mental Health Strategy – the first of its kind encompassing the entire SickKids mental health enterprise – sets the stage to develop new pathways to care  for children, youth and families to access the mental health services they need more quickly and more efficiently than ever before. Likewise, the strategy empowers SickKids staff to provide a more seamless child and family experience – a strategic direction of the SickKids 2025 Strategic Plan.

“For more than a decade there has been a ‘great awakening’ with respect to child and youth mental health,” says Christina Bartha, Executive Director, Brain and Mental Health Program at The Hospital for Sick Children (SickKids) and Executive Director, SickKids Centre for Community Mental Health (CCMH). “This is one of the best early intervention and prevention strategies you can invest in. The downstream benefits of this are enormous – and essential.”

Bartha, who is also co-Chair of the Mental Health Strategy Steering Committee at SickKids, says the strategy is big and complex, but points to three elements she considers crucial in the five-year plan’s success:

  • Supporting SickKids staff. Clinical staff are well-trained in the delivery of physical medical services, but some may not have had enough support in developing their skills around the management of distress and mental health. At the only paediatric ICU in the Greater Toronto Area, SickKids staff may be faced with tough situations related to mental health crisis and SickKids believes it can do more to support them in acquiring the right competencies.
  • Engaging stakeholders. Consultations included 21 community organizations, 56 patients and families, 23 focus groups and more than 350 SickKids staff. Indeed, the principle of co-design is embedded in the strategy, which means having stakeholders involved in crafting the plan from day one.
  • Committing to integration. The delivery of mental health care and physical health care should not be done in silos or in parallel because these conditions are often related. That’s why, underlying the strategy, is the overall aim to provide improved and holistic treatment across the SickKids network – hospital, research, education, community.

Even before its integration with SickKids in 2017, SickKids CCMH staff collaborated with SickKids staff to support children and families with complex needs.

“The new SickKids Mental Health Strategy envisions staff, community partners and families working together to build on years of clinical experience and collaboration to create a more integrated continuum of care between the hospital and the community,” says Neill Carson, Clinical Director and Site Lead at SickKids CCMH. “This strategy will not just improve access. It will extend our service reach to better meet the needs of our clients and community, giving children, youth and families the right level of care where and when they need it.”

Dr. Peter Szatmari, Chief of the Child and Youth Mental Health Collaborative (SickKids/CAMH/U of T) and Co-Chair of the Mental Health Strategy Steering Committee, sees SickKids in its entirety as a “learning health system.” He’s particularly excited by the dynamic interplay between clinical services and research that figures prominently in the strategy.

“Clinical services and research are dependent upon each other and should always be learning from each other. The mental health strategy is a framework for that interdependence, that collaboration, that integration,” he says. “We want to build a sufficient critical mass of researchers, with a mental health lens, all working together.”

Bartha acknowledges the strategy was a massive undertaking but one that will lead to a major culture shift that benefits patients, families and staff. Although it’s a strategy for the long term, a year from now she sees SickKids being in a better place in terms of trauma-informed care, safety planning and the prevention of escalations and distress in kids and youth who present for care.

“When I think back to the parents, caregivers and youth who communicated such a sense of urgency upon us to move forward on a new mental health strategy, their messages were received loud and clear.  I feel really proud of the work that we’ve done, and will do, to bring it to life,” Bartha says. “The strategy empowers us to do a much better job and we’re going to deliver on that for the families, children and youth we serve.”

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