This article was published in the Times Colonist, October 26, 2023
Imagine a world where only one in five children with cancer, diabetes, or serious injuries receive the appropriate treatment. We would be appalled and demand change.
Yet, right now, only one in five Canadian children with a clinical mental illness will receive treatment, which amounts to thousands of children who suffer unnecessarily every year. Researchers at Simon Fraser University have called this situation a violation of children’s rights.
While rates of mental illness were worsened by the pandemic, this sad situation existed long before COVID-19. In 1970, a team of Canadian researchers found more than one million children had unmet mental health needs. This group urged our government to make changes, concluding “We [cannot] afford to do it later. One million children look to us for help. We cannot fail them.”
In 2019, the year before the pandemic, B.C.’s Ministry of Mental Health and Addictions stated a rising number of school students had mental health challenges. Seventeen per cent of students surveyed said they had seriously considered suicide in the past year.
We cannot ignore the call to action made 50 years ago any longer — our children must be able to access mental health care.
Mental illnesses have profound negative impacts on children’s development, such as lower academic and graduation rates; increased risk of homelessness, severe mental illness in adulthood, substance use, and suicide; and reduced family income due to caregivers taking time off or leaving work altogether.
School-based mental health services are vital to resolving this crisis because they are accessible to every school-aged child within their community.
School counsellors, also called “teacher-counsellors,” are both certified teachers as well as mental health professionals with master’s degree level training. They are qualified to provide services such as individual and group counselling, teaching lessons focused on social-emotional skills, supporting families, consulting with agencies, and coordinating school-wide mental health promotion.
Since most mental illnesses begin in childhood and adolescence, school counsellors are positioned to identify and intervene in the early stages, preventing more severe and costly future challenges.
Every child should be able to access a qualified mental health professional when they need it, where they are. The Convention on the Rights of the Child states that governments must ensure the number and suitability of staff working in institutions responsible for children meets standards established by competent authorities.
School counsellors are suitable for the job, given their experience and training. But are there enough?
B.C. has a ratio of 693 students to one counsellor, far higher than the ratio of 250 students to one counsellor recommended by both the B.C. Teachers’ Federation and the American School Counselor Association.
Studies indicate that a lower ratio would bring better outcomes. Benefits of lower ratios range from improved academic achievement, attendance, discipline, graduation, and college/university application rates; to increased time spent directly supporting students with mental health challenges; to reduced risk of burnout (especially relevant given B.C.’s challenges with recruitment and retention).
In B.C., many students cannot access what should be the most accessible mental health-care provider.
B.C.’s 693-to-1 ratio is higher than 49 of the 50 American states; only Arizona has it worse at just over 700-to-1. In Europe, Ireland and Croatia maintain ratios of 250-to-1, while Bulgaria and the Russian Federation maintain 500-to-1.
Reducing the school counsellor ratio will cost money — but the cost of neglect is far greater than the cost of care.
The national cost of child mental illness on families and the economy is estimated to exceed $15 billion per year. Programs designed to improve children’s mental health produce high returns on investment in the long term, from $2.30 to $31 for every $1 spent.
Investing in children’s mental health will pay for itself.
Reducing the ratio to 250 to 1 is just one of the many changes that need to be made if we are to resolve this crisis. We must speak out together against the violation of children’s rights and demand universal, guaranteed access to mental health care for every child.