Guarantee Access: Summary
This article is a summary of a more comprehensive overview of the subject, "Guarantee Access to Mental Health Care for Every Child". In that article, you can find a sample letter, which you may use to contact your local representatives.
I am a school counsellor, and it is my responsibility to advocate for the needs of all students. Every day, I teach whole classes of students, I counsel individual students, I talk to caregivers and families, I collaborate with educators, and much more. Above all else, I have the privilege of getting to listen to children about their lives, their struggles, and their needs. As such, my role offers a unique, frontline perspective for understanding children’s mental health. What I hear, and what many educators and families have seen, is that many children are struggling with their mental health.
This situation is made more precarious by the fact that right now, in BC, many children cannot access qualified mental health care. Although Canadian health care is free and accessible to everyone, not all mental health care services are covered in BC. Private services are simply unaffordable for many families, and the public services which serve children cannot keep up with the level of need.
The main public mental health care services for children in BC are Child & Youth Mental Health (CYMH) and school counsellors. CYMH offers services for children with significant difficulties related to thoughts, feelings, and behaviours. Although the cost is free and there are CYMH offices in 100 communities in BC, the wait times for service can be months long.
School counsellors provide services from within the school system itself, and their services are also free. This makes them the most accessible and affordable service for children in BC. School counsellors are both BC Certified Teachers and mental health care professionals, holding a Master’s degree in counselling psychology or a related discipline. They have a unique combination of experience and training, which prepares them to provide a wide variety of mental health promotion, mental illness prevention, and early intervention services. Like CYMH, there are also barriers to accessing school counsellors. The main barrier is the 20-year-old terms in the Collective Agreement which set student to school counsellor ratios at 693 to 1. This ratio is outdated and it does not align with research evidence which recommends a ratio of 250 to 1.
Recently, Integrated Child & Youth (ICY) teams, which bridge CYMH and the school districts, have also been created to support children, but they are not yet available in all regions of BC.
These barriers have created a precarious situation in our province. Given the seriousness of this problem, it is important for educators and families to be informed about the reality of mental illness, how it affects children, the ongoing children’s mental health crisis, and what we can do about it.
Mental illnesses are common, debilitating, and distressing. They are a risk factor for numerous life-threatening physical illnesses, such as heart disease and diabetes, as well as for suicide - one of the leading causes of death among young Canadians.
Childhood mental illnesses can impact a child’s growth, their learning, their relationships with family and friends, and their future potential. Furthermore, whenever a child experiences a mental illness, so does their family. Childhood mental illnesses are stressful for parents and caregivers, and also expensive, with many families paying out of pocket for services and taking time off from work to care for their child.
When childhood mental illness goes untreated, it can also evolve into chronic, debilitating, and expensive conditions that follow them into adulthood. As adults, mental illnesses can impair the ability to work, to complete higher education, to contribute to the economy, and to fulfil family duties. In addition, untreated childhood mental illness and trauma are both risk factors for experiencing homelessness and substance use in adulthood.
Therefore, student mental health is central to the purpose of the BC school system, to enable our students “to develop their individual potential and to acquire the knowledge, skills, and abilities needed to contribute to a healthy society and prosperous sustainable economy.”
Right now, more than ever before, we must act to care for and protect our students’ mental health. The COVID-19 pandemic has had serious, long-lasting, negative effects on children’s mental health across Canada. However, there was already a children’s mental health crisis before the pandemic.
For more than 20 years, world leading experts in children’s mental health around the world have urged governments to take action. From the Mental Health Commission of Canada, to the US Surgeon General, to the executive director of UNICEF, the message has been loud and clear: “We must address children’s mental health through promotion, prevention, and early intervention… and the time to act is now.”
Caring for children’s mental health costs money. However, the cost of neglect is far greater than the cost of care.
So what is the cost of mental illness? In Canada the total cost in a single year is estimated to be >$50 Billion, rising to $185 Billion by 2041. These costs include both childhood and adulthood mental illnesses, but exclude the costs created by the downstream effects of untreated childhood mental illness. For instance, homelessness and substance use disorders both create immense costs for the health care, justice, and social welfare systems.
Fortunately, childhood mental illness and trauma are treatable. Just like any other health condition, early intervention can make a tremendous difference in a child’s life. When we take care of small problems before they grow, we can prevent chronic, debilitating, and expensive problems in adulthood from ever occurring.
Research shows that comprehensive mental health promotion (e.g. mental health literacy, social-emotional learning), mental illness prevention, and early intervention services (e.g. school counsellors, CYMH), produce favourable results not only for children, but also for families, the economy, and society. For instance, it is estimated that every $1 spent on upgrading mental health services can produce a return of $2.3 to $5.7 in return over the long-term.
There is also a legal rationale for guaranteed access: the Convention on the Rights of the Child (CRC). By ensuring every child gets the services they need to grow and learn, we protect their rights as outlined in Articles 3.1, 3.3, 6.1, 6.2, 24.1, and 29.1 in the CRC. Guaranteed access also aligns with the aims of the Government of Canada and the Government of British Columbia (e.g. The Mental Health in Schools Strategy).
So what is guaranteed access? It means ensuring there are an adequate number of suitably trained mental health care professionals accessible to every child when they need it and where they are.
Ensure there is a school counsellor in every school, every day;
Reduce the province-wide ratio to 250-1;
Ensure every school counsellor holds a BC Teachers’ Certificate and a Master’s degree in counselling psychology or a related discipline.
Enhance the capacity of CYMH,
Hire an adequate number of suitably trained mental health care professionals to meet the needs of children in BC.
Implement an ICY team in every school district in BC.
Build and maintain linkages between all these services.
Every citizen of British Columbia can advocate for guaranteed access. We can start by talking to family, friends, and colleagues about the issue. Then, we can exercise our rights by writing to our local MLA and MP. Let us voice our concern for our children, and demand a commitment to their right to care: "Guarantee Access to Mental Health Care for Every Child."
Click here to read more on the subject and see a sample letter to a local representative.