Families seeking services for autism and other neurodevelopmental issues accounted for 35 per cent of requests fielded by the OPA, while issues with emotional regulation was the second biggest category.iStockPhoto / Getty Images
Requests for privately delivered mental health services for children through the Ontario Psychological Association’s e-referral service increased last year, according to the organization. For children aged six to 12, the increase was 178 per cent, with a total of 365 requests.
Data from askforhelptoday.ca, the OPA’s e-referral service, shows that service requests for children aged 13 to 18 reached 562 in 2022, an increase of 51 per cent compared with the year prior. For children three to five years old, the total was 63, and children up to two years old accounted for 16 cases.
The increases are likely because of pandemic-related factors such as concerns over developmental delays, and show the need for more public funding for mental health services, said Sylvain Roy, past president of the OPA and the organization’s clinical and digital health lead.
“We do have a health human-resource crisis on our hands in the public system … So that means our services are going to be more sluggish. It’s going to be more challenging to respond to needs because the workers are just not there.”
An internal poll conducted by the Canadian Mental Health Association’s Ontario division in January and February of 2022 found that the biggest issue facing its 27 branches is a lack of capacity because of staff members leaving their jobs. Stress, burnout and low pay compared to other jobs in the health sector were the most commonly cited reasons for resignations, according to the poll.
Families seeking services for autism and other neurodevelopmental issues accounted for 35 per cent of requests fielded by the OPA, while issues with emotional regulation was the second biggest category.
“Children are having difficulty managing their behaviours. They might be more reactive, they might have trouble in schools or even at home managing those strong emotions,” Dr. Roy said.
Such issues would typically be addressed by publicly funded services like pediatricians, hospitals or schools. But with so many psychologists, psychotherapists and social workers leaving the public system, Dr. Roy said, many parents are having to turn to privately delivered care for help.
The rise in service requests could also be due at least in part to delays in obtaining services during the pandemic, said Dillon Browne, a clinical psychologist who works in both the public and private systems. For example, school closures might have led to issues not being identified earlier.
“What you’re seeing a lot of, I think, is the other side of a bottleneck,” he said.
Prior to the pandemic, children and youth faced significant wait times for mental health services in Ontario.
In a report released in January, 2020, CMHO noted wait times were at an all-time high. The average wait time for counselling and therapy was 67 days, while it was 92 days for intensive treatment. The longest wait times for services lasted two-and-a-half years. An estimated 200,000 children with serious mental health issues have no contact with mental health services at all, according to the report.
Jennifer Felsher, a clinical psychologist at Toronto’s Hospital for Sick Children, said it is likely that in cases involving young children, many families are seeking services related to emotional and other developmental delays that were noticed during the pandemic.
“The impact of lockdown on children was significant. And so we’re now sort of seeing the after-effects of not having children socialized, not going to their activities, not going to school …. They’ve missed out a lot, and it’s really impacted them,” she said.
Dr. Browne emphasizes that the OPA data only shows the increase in requests for services, not the outcomes of them, adding that many people who sought help might have been told they had nothing to worry about.
And although the total numbers may be relatively small, with just over 6,000 people in the province seeking help through the OPA’s online referral platform, the increase points to a gradual rise in a two-tiered mental health system, Dr. Roy says.
“Families who are richer, who have extended health benefits or money to pay for services, are going to be ahead of the line. Their kids are going to be taken care of much more quickly than in a public system.”
Take, for example, a child who needs a psycho-educational assessment. Such an assessment is used, among other things, to identify a child’s learning difficulties. Schools are then required to offer any necessary accommodations to help that student succeed.
In the private system, the wait time to have such an assessment done can be up to approximately four months, Dr. Felsher said. Families who need to have one completed in the public system face wait lists that are two years long.
Dr. Felsher said she is always apologizing to clients who have finally made it to see her after a long wait. “I say, ‘I’m terribly sorry. The system is overburdened, we can’t manage.’ ”