Ontario’s pediatric hospitals and mental health care providers have come together to sound the alarm about excessive wait times and delayed care for children and families in Ontario, which has been exacerbated by the COVID-19 crisis.

Even before the pandemic, more than 28,000 Ontario kids were on waitlists for mental health services, sometimes waiting up to 2.5 years for specialized treatment.  Meanwhile, an additional 80,000 children are waiting for rehabilitation and child development services in the province. Over 30,000 hospital surgeries, appointments and procedures are backlogged or cancelled altogether. Some kids will wait an astonishing two and a half years for surgeries — far beyond what is clinically acceptable, says the Children’s Health Coalition.

In addition to CMHO, the group includes more than 15 leading children’s health care providers in Ontario such as the Hospital for Sick Children, Holland Bloorview Kids Rehabilitation Hospital, Addictions and Mental Health Ontario and the Ontario Hospital Association and more.

Mental health care for children and youth has had a growing issue with access to timely services and has strained hospitals due to increasing emergency visits by children and youth. “The pandemic has exposed the already frayed and inadequate health care system for children in Ontario,” says Kimberly Moran, CMHO’s CEO. “COVID-19 disrupted children from their routines, amplified pre-existing mental health conditions and is creating a catalyst for new ones. Without proper care, the deterioration of our children’s mental health can be a matter of life or death.”

Uptick in mental health and addictions cases

Mental health and addictions care providers at hospitals and in the community are doing their part to serve families during the crisis, but providers are already seeing a significant uptick in demand for services.

A recent poll by CMHO and Ipsos shows that since COVID-19, 59 per cent of parents have noted behavioural changes in their child, ranging from outbursts or extreme irritability to drastic changes in mood, behaviour or personality. Other impacts include difficulty sleeping/altered sleeping patterns, persistent sadness and more. These kids of significant changes can be signs of mental illness.

Health Canada, using conservative data based on SARS, estimates that over 11 million Canadians will experience increased levels of stress during the COVID-19 outbreak, and over two million Canadians will show signs of traumatic stress.

Family impact of care shortage can be devastating

One family impacted by COVID-19 is the Diamond family in Toronto. Jessica Diamond is a mother of 10-year-old Isaac who has been diagnosed with agitated depression and anxiety and who requires intensive services and live-in treatment. While waiting more than six months to access services, Isaac became suicidal; with every passing day on the waitlist, Jessica feared for her son’s life. “I was so relieved when we finally secured services in March, but within two weeks COVID-19 hit and his treatment was put on hold,” said Jessica. As COVID-19 infections rise again, Jessica worries Isaac’s treatment plan may be further derailed.

Hospitalization of children for mental illness continues to be high

Newly released CIHI data shows that Ontario hospital utilization rates for children with mental illness continue to be high. Young people making emergency department (ED) visits for these concerns in Ontario has increased 64 per cent since 2008/2009; the number who were hospitalized increased by 71 per cent while hospitalizations for other disorders have decreased by 26 percent.

“Every day counts in the life of a child. Their developing brains, growing bodies and mental health are all impacted by the decisions we make,” says Alex Munter, President and CEO, Children’s Hospital of Eastern Ontario (CHEO). “We cannot afford for young people in our province to be collateral damage, especially since COVID-19 will be with us for some time.  We need to organize health services around their reality.”

CMHO and our partners have outlined some solutions to the delays in care for children, youth and families including:

• Building integrated care that wraps around the mental, physical and developmental needs of children and families.
• Redeploying additional clinical workers to cover staff shortages.
• Focused investments in a wait time strategy
• Expansion of technology and digital solutions to continue to provide high-quality, confidential services.
• Improved navigation so families can easily find the help they need.
• Immediate investments in specialized and live-in treatment services for those with the most complex needs.
• Deploying funds directed to the ongoing overdose crisis (need for increase in safe consumption sites, for example).
• Building of community health care teams to respond to young people in crisis rather than taking a law enforcement response approach.
• Focusing on the immediate mental health needs children and youth will have as they re-enter or change their engagement with the school system.

CMHO and its Children’s Health Coalition partners are calling for immediate investment in children’s health care to address wait times for mental health, child development and rehabilitation, hospital surgeries and procedures, and to support pediatric home care solutions to alleviate the suffering of 160,000 kids and their families. “Now more than ever, our children deserve all partners at the table, ready to provide solutions and take action.”