A new report says long delays in mental health care for children and adolescents cost Canada $4 billion each year – and that's a conservative estimate, the authors say.
The researchers behind the new report, titled “Nurturing Minds for Secure Futures,” wanted to model the real strain on the health care system if youth continue to face high rates of anxiety and depression without improvements to the system.
They found that delaying mental health treatment is not only harmful to the patient, but can also be costly to the healthcare system as a whole.
“This report serves as a clear call to action on behalf of Canada's children and youth,” said Emily Gruenwoldt, president and CEO of Children's Healthcare Canada, in a press release. “We have the opportunity to reshape the future. If we act quickly to invest in and right-size children’s health systems, we will not only improve their physical and mental health, but we will also save health systems and families billions of dollars.”
Up to 1.6 million children and young people living in Canada struggle with anxiety or depression, the report estimates, and research has shown that Black, Indigenous and LGBTQ2S+ youth are often disproportionately at risk, with a lack of timely access to medical care contributing to this Problem just made worse.
FIND THE COST OF POOR HEALTH CARE FOR TEENAGERS
So what are the real economic impacts if we fail to dedicate resources to solving this problem?
To arrive at a dollar value, the researchers modeled three types of costs—healthcare, community, and productivity, or indirect—to create a “cost of illness” forecast.
Healthcare costs include the cost of emergency room visits, prescription medications, inpatient hospital stays, and other medical expenses.
Community costs included costs related to the criminal justice system, social services, family support, and mental health provision in public schools.
Indirect costs are the loss of income resulting from a person having to invest an excessive amount of time managing their mental health due to lack of access to health care. In the case of children and young people, this meant considering the parents' loss of income if they took on a higher level of care for a child who does not receive adequate support in our society.
The researchers relied on data from Statistics Canada and the Canadian Institute for Health Information, as well as international sources where necessary, to build the model to estimate these costs.
They also examined scientific studies on the prevalence of various mental disorders to get a better idea of how common these problems are among children and adolescents. The researchers assumed a nine percent prevalence rate for anxiety or depression in their model, a number they said reflects the increasing risk among children and adolescents observed during the pandemic.
Modeling found that our patchwork systems to address anxiety and depression in youth result in this group costing Canada $3.5 billion through publicly funded systems.
The report also estimates that parents lost an additional $280 million in income and $120 million in education and justice costs.
“If Canada invested in mental health services and committed to reducing the prevalence rate of anxiety and depression disorders to pre-pandemic levels, the cost would fall from $4 billion to $1.5 billion per year,” says the report.
The researchers noted that those who struggle with poor mental health in childhood are likely to continue to struggle with their mental health as adults, meaning early intervention could lead to greater resilience in adulthood.
A GROWING PROBLEM
According to the report, mental health issues among young people in Canada have continued to worsen over the past two decades. In 2003, approximately 76 percent of youth ages 15 to 30 reported good mental health. By 2019, this figure fell to 60 percent.
The situation only worsened during the COVID-19 pandemic as young people struggled to cope with societal changes that sparked anxiety across all age groups. There was an increase in emergency department visits for pediatric mental health conditions in 2020 compared to pre-pandemic years, even as the number of children hospitalized overall decreased as the general population sought medical care due to COVID-19 wanted to avoid.
But while the need among children and young people is increasing, many are not receiving the help they need, the report says. Waitlist data from Ontario alone in 2020 found the average wait time for counseling and therapy was 67 days. In some cases, wait times for intensive care were up to two and a half years, which researchers called “essentially irrelevant” when a person was in crisis.
The report relied on numerous scientific studies to estimate the prevalence of mental disorders in children. For example, findings from 12 studies involving more than 53,000 children combined found that about five percent of children ages four to 18 suffered from an anxiety disorder of some kind.
Based on Statistics Canada's most recent 2019 data, it is estimated that at least 290,000 children and adolescents in Canada have a diagnosed anxiety disorder or depressive disorder. But researchers say their work has shown the problem is likely being underestimated, especially since many cases go undiagnosed. and there is limited data on underserved areas such as rural and indigenous communities.
“The combined level of prevalence, persistence and breadth of impact of living with unmet mental health needs is unlikely to be matched by most physical health conditions,” the report said. “Yet Canada’s health financing framework favors spending on physical health care over mental health care.”
The authors added that Canada's mental health spending target in 2022 is nine per cent of total Canadian health spending, which they said is “not enough.”
The report makes a number of recommendations to address the urgency of the problem, including developing and funding a national child health strategy, providing resources for outcomes-based programs to support vulnerable populations, and establishing a national data strategy to track statistics in adolescent mental health care .
“Timely access to mental health services for children is critical, and current challenges are exacerbated by long-standing issues and the impact of the pandemic,” Chad Leaver, director of health and human capital at the Conference Board of Canada, said in the release. “To meet mental health needs, we must not only catch up, but exceed pre-pandemic efforts to ensure rapid and comprehensive support for children and young people.”