experience and outcomes
in every community
For the past 15 years, the Centre has supported Ontario agencies, communities and decision makers to help children and youth in our province develop in ways that expand their future opportunities and protect lifelong health.
We work to ensure children and youth in Ontario have access to safe and supportive relationships, environments and experiences to set them up for success throughout their lives. When children and youth grow up with good mental health, they develop the relationships and resilience to cope with the storms of life and the social-emotional skills required to become healthy, well-rounded adults.
Promoting mental health across the lifespan and acting early to prevent mental illness and other challenges helps ensure that Ontario is an ideal place to grow for generations to come.
Since 2004, we have helped provide the key players in our sector with the right knowledge, capacity, connections and tools to meet child and youth mental health needs in their communities. Over time we have adapted to the changing needs of patients, the child and youth mental health system and our funder — and we continue to do just that.
Transition was a recurring theme in 2018, with our sector’s move to the Ministry of Health and our own internal shift to raise the bar on impact (which is reflected throughout this report). As we move away from providing on-demand services at the organizational level, we increase our capacity to focus more and more on system-level changes that break down barriers to better care and strengthen services. This means better patient and population health, better experience and outcomes for children, youth and families, better experience for providers and overall, better value.
There is a crisis in our healthcare system stemming from undiagnosed or unaddressed mental health struggles in children and youth. This is compounded by the challenges many families face in navigating the system of services. Working closely with the Ministry of Health, provincial partners and service delivery stakeholders, we can leverage our collective expertise to create a better future for our children.
Together, let’s improve the mental health of Ontarians from early childhood to their golden years. It is time to raise the bar.
Acting Executive Director
Strategic Advisory Council
As an organization that exists to define, pursue and deliver excellence in child and youth mental health, both setting and raising the bar are central to who we are and all the work that we do.
Vision: The best mental health and well-being for every child, youth and family.
Mission: We drive high-quality child and youth mental health service delivery for Ontario’s children, youth and families by mobilizing knowledge and setting the bar for excellence.
We embarked on a new strategic plan in 2018 and have further refined it over the past year. Our work is anchored by two core goals: to mobilize knowledge and improve quality throughout the child and youth mental health sector.
Recognizing that the needs of babies are different from those of teenagers, our work is also targeted within the various developmental age ranges:
Over the next few years, our work will focus on the following key areas of impact:
Making good decisions requires the latest, high-quality information. We work to identify our sector’s most pressing knowledge gaps and close them with the best available evidence. Then we make sure that knowledge is accessible, understandable and useful for the key players in our sector. Intentionally using information and expertise to align research, policy and practice helps create better care experiences and mental health outcomes for children, youth and families in Ontario.
It has been really nice to work with the advisory committee [established and supported by the Centre] to sort out what the pathways should look like. It has allowed for a lot of great conversations, created a better understanding of the needs of primary care providers and helped to dispel myths they have that community-based mental health services all have long, long waiting lists. Opening up conversations about referral pathways and recognizing that we’re all part of health services has helped with our commitment to work together.
It was exciting to be able to pilot something and have the resources to do some program evaluation. Based on existing research, we know that early intervention is key. So, figuring out a way to engage families with infants differently, then to see the success of it is awesome. Having [the results] to help raise the profile of infant mental health is also really helpful for our sector.
When we needed to understand safe and effective use of self [in the delivery of psychotherapy services to our clients], I went to the research myself but there was very little in the context of child and youth mental health. So, I reached out to the Centre and I was blown away by the quality of the resource they provided. It puts information about evidence-based programs that have data supporting them right at our fingertips. This is so useful to many different parties. We even passed the resource on to our board of directors.
Improving the quality and accessibility of child and youth mental health services requires flexibility, agility and an appetite for change. There is no room for a “this is how it’s always been done” mentality; the status quo is just not good enough. That is why we continuously adapt to new knowledge and respond to the evolving needs of families, the Ministry and our sector.
As an advisory committee, we set the bar high and that goal didn’t waver in the face of challenges. Everyone, including Centre staff, brought their whole selves to the table. Every specific role and perspective were needed. If any one of those pieces was absent, we wouldn’t have achieved the quality that we were looking for. It’s exciting to have phase 2 to continue that.
The Centre delivered some Lean [quality improvement] training for our staff, which was great. It got our staff thinking about that culture of quality improvement and helped us gain momentum on implementing it in our organization.
[Today’s event] will help us make sure we are aligned with other agencies in the province. It’s a good start!
Ontario’s child and youth mental health system is complex. It has traditionally spanned multiple ministries, care settings and communities, with hundreds of agencies providing mental health services for children, youth and families all over the province. We have always embraced the cross-sectoral nature of child and youth mental health, working to dismantle silos, nurture partnerships and build bridges for youth and families to bring their voices into the planning and delivery of services that meet their needs.
In 2018–19, we collaborated with Ministry and sector partners to:
In April 2019 we launched Clearing the air: Informing conversations about cannabis for child and youth mental health and addictions professionals, a learning resource co-developed with partners at Addictions and Mental Health Ontario (AMHO). This resource and the related evidence paper examine the links between mental health and substance use — particularly cannabis use among youth under the age of 25. This work is based on the latest knowledge in this area, along with advice and guidance from addictions and child and youth mental health service providers, youth and families. Later this year, we will wrap up our Ministry-directed work to support the BI Solution and finalize our project on caseload/workload guidelines. We will also continue work with the Ministry-led Ontario structured psychotherapy program’s family, child and youth subcommittee, providing engagement and knowledge gathering support.
Given the recent legalization of recreational cannabis in Canada, there was a need to provide mental health and addictions service providers with access to up-to-date information that would support them in their daily practice. Working with experts at the Centre meant that the information gathered was evidence-informed, tailored to service providers’ knowledge needs and applicable to current practice.
The work we have done with the Centre and PCMH has been invaluable! Their collaborations brought a [new] lens to our work to strengthen family engagement at an organizational and system level that is beginning to transform how we think of and develop programming, moving to a much more co-developed process.
Six new sites were opened in 2018: Eastern Champlain (Cornwall area), Malton, Haliburton, North Simcoe, Kenora and Niagara Region. They joined the four existing sites (Chatham-Kent and three in the Greater Toronto Area). Over the past year we worked with our partners at the Centre for Addiction and Mental Health (CAMH) and its provincial system support program (PSSP) to support the sites in their efforts to engage young people and families in the planning, implementation and evaluation of their integrated youth services.
This year we continue to lead engagement efforts at the provincial level by coordinating and co-leading provincial youth and family advisory committees. As well, we will deploy similar supports at the local level, including developing site specific workplans for engagement and supporting local advisory groups.
Since 2017, our Innovation Initiatives grants have supported Ontario’s child and youth mental health agencies to turn their bold ideas into potential solutions to improve service quality and access — ultimately leading to better healthcare experiences for children, youth and families across Ontario.
Over the next year, we will provide coaching and other supports to seven agencies who are implementing exciting projects addressing access issues in their communities. Collectively, these projects are supporting mental health from infancy to early adulthood and addressing barriers, such as wait time, culture and language, stigma, geography and health literacy.
To find out more on our 2019–20 projects, click to download.Innovation Initiatives 2019–20
To find out more on our 2018–19 projects, click to download.Innovation Initiatives 2018‑19
Vanier Children’s Services in London was one of 10 agencies who received funding in the Centre’s second Innovation Initiatives grant cycle in 2018–19. They used the funding to co-create and evaluate infant mental health drop-in clinics in neighbourhood-based, multi-service Family Centres throughout their community. Their clinics offered single session therapy focused on the parent and infant relationship (PAIR) as well as informal consultation services during early years drop-in groups.
By integrating the clinic into existing Family Centres, Vanier was able to access families who would not normally have sought mental health services due to stigma or other barriers. As a result, they were able to provide early intervention and targeted prevention services for over 260 families who otherwise might not have received such services.
Over a third of the 42 infants who participated in therapy sessions with their caregivers presented with attachment challenges, and many of the families experienced other family factors or risk factors for toxic stress. This included parental mental health challenges, family isolation, settlement issues, history of trauma, post-partum depression, addiction and exposure to violence. Some families received multiple sessions and close to one third of all families who participated in therapy sessions were referred to Vanier for more intensive supports. Another four were referred elsewhere for other supports.
At the end of the pilot, 93 percent of parents said they felt more confident in their ability to connect with their baby and 97 percent said they felt better able to give their child the emotional care needed. Family Centre staff members also said they better understood the social and emotional challenges associated with infants and parents and 96 percent felt better prepared to initiate discussions with parents when they felt concerned about a child’s social or emotional needs.
With the data from the pilot Vanier was able to see the value in re-allocating funding and made the decision to continue to fund the PAIR clinic under their core services. They are now seeking additional funding to maintain the professional development component for Family Centre staff.
We continue to work to better connect primary care and community-based mental health services throughout Ontario. Standardized pathways — coupled with reliable screening tools like the quick and easy-to-use HEADS-ED — improve patient experience and outcomes. They ensure that families aren't stuck bearing the brunt of navigating a complex system and that primary care providers have the tools they need to quickly and confidently make the best decisions for patient care.
Children and youth have different mental health needs than adults. We help the Ministry of Health and health teams work across the lifespan by speaking to the different needs of each developmental phase, and especially those of our youngest Ontarians. In the coming months we will lead the implementation of two recommendations emerging from our latest policy paper, Beyond building blocks: Investing in the lifelong mental health of Ontario’s three- to six-year-olds and work on validating the HEADS-ED tool as adapted for birth- to five-year-olds.
As the provincial government has said, digital health tools and options “have not kept pace with the growing technological sophistication of Ontarians.” Digital and e-mental health is one of our strategic impact areas. About half of the Innovation Initiatives we are currently supporting integrate technology in some capacity. Given the rapid emergence of digital health and its promising opportunities, we are now also exploring the development of a new quality standard on the use of technology to deliver mental health services.