Child mental health services lacking in high-income countries: SFU study finds

Most children with a mental health disorder are not receiving services to address their needs--according to a new study from researchers at Simon Fraser University's Children's Health Policy Centre. Their research was published this week in the journal Evidence-Based Mental Health.

Researchers found that of the one in eight children (12.7 per cent) who experience a mental disorder, less than half (44.2 per cent) receive any services for these conditions.

"We have illuminated an invisible crisis in children's mental health and unacceptable service shortfalls in high-income countries -- including in Canada -- to a degree that violates children's rights," says study author Charlotte Waddell, an SFU health sciences professor and centre director.

"Many countries will need to substantially increase, and protect, their children's mental health budgets. This is particularly urgent given documented increases in children's mental health needs since COVID-19--needs which are predicted to continue."

Using systematic review methods, the researchers examined 14 prevalence surveys conducted in 11 high-income countries that included a total of 61,545 children aged four to 18 years. Eight of the 14 studies also assessed service contacts. The 14 surveys were conducted between 2003 and 2020 in Canada as well as the US, Australia, Chile, Denmark, Great Britain, Israel, Lithuania, Norway, South Korea and Taiwan.

Researchers note that mental health service provision lags behind services available to treat physical conditions in most of these countries. "We would not find it acceptable to treat only 44 per cent of children who had cancer or diabetes or infectious diseases," says Waddell.

The costs of not providing adequate childhood mental healthcare are also high. Mental health disorders typically begin in childhood and adolescence and if not prevented or treated early, they significantly interfere with wellbeing and development--with the impact extending across the lifespan.

This study found that the most common childhood mental disorders were anxiety (5.2 per cent), attention-deficit/hyperactivity disorder (ADHD) (3.7 per cent), oppositional defiant disorder (e.g., argumentative behaviour) (3.3 per cent), substance use disorder (e.g., problematic use of alcohol or cannabis) (2.3 per cent), conduct disorder (1.3 per cent) and depression (1.3 per cent).

Crucially, Waddell says effective treatments are well known for all of these disorders, as are effective prevention programs, "so we know how to help children."

Simon Fraser University