Care for children and youth with mental disorders
Authors: CIHI (Canadian Institute for Health Information)
Overview
Abstract (English)
Child and youth mental health is a significant concern in Canada and globally – according to the World Health Organization, mental disorders accounted for 13% of the global burden of disease. It is estimated that between 10% and 20% of Canadian children and youth may develop a mental disorder. If not identified, diagnosed and effectively treated, mental disorders with onset early in life can lead to substantial negative health and social outcomes, including early mortality. While most mental health care services for children and youth are accessed in the community, hospital-based emergency and inpatient care can often be the first point of access for children and youth dealing with significant mental disorders. Emergency departments (EDs) can be used for emergency mental health care needs related to mental disorders, as well as other concerns related to emotional, behavioural or social challenges. Inpatient hospitalizations may be necessary depending on the nature and severity of the mental disorder, availability of community -based support and the safety of the child and his or her loved ones. Treating mental disorders in youth involves a variety of interventions, including psychosocial therapy and medications. Pharmacotherapy alone is not recommended for youth and should ideally be preceded and/or complemented by psychosocial therapy. Concerns have been raised about the appropriate use of psychotropic medications and whether there is sufficient clinical monitoring of youth taking these medications. Using mainly administrative data from the Canadian Institute for Health Information (CIHI), this study examines ED visits and hospitalizations for mental disorders among children and youth, and youth dispensed psychotropic medications. The study’s main findings are as follows: 1. Rates of ED visits and inpatient hospitalizations for mental disorders among children and youth have increased 45% and 37%, respectively, between 2006- 2007 and 2013- 2014. 2. The greatest increases in rates of hospital service use are among youth 10 to 17 years old, those with mood and anxiety disorders and those living in urban areas. 3. Use of psychotropic medications is common – 1 in 12 youth were dispensed a mood/anxiety or antipsychotic medication in 2013- 2014 – and has increased over time. 4. For youth dispensed psychotropic medications, the increase in use is confined to those living in urban or suburban areas and dispensed the most commonly prescribed medications, selective serotonin reuptake inhibitors (SSRIs) and the antipsychoticmedication quetiapine. 5. Quetiapine is dispensed to youth almost exclusively at dosages below the Food and Drug Administration’s recommended range for treating schizophrenia and bipolar disorders . This report’s findings can be used to assist in planning for services and to gauge the success of interventions targeted to children and youth with mental disorders.
Abstract (French)
La santé mentale chez les enfants et les jeunes est une préoccupation importante, au Canada comme à l’étranger; selon l’Organisation mondiale de la santé, les troubles mentaux représentent 13 % du fardeau mondial de la maladie. On estime que 10 % à 20 % des enfants et jeunes canadiens sont susceptibles de développer un trouble mental. Les troubles mentaux qui apparaissent de façon précoce, s’ils ne sont pas dépistés, diagnostiqués et traités efficacement, peuvent entraîner d’importants résultats négatifs pour la santé et la vie sociale, y compris la mortalité prématurée. La plupart des services de santé mentale pour les enfants et les jeunes sont dispensés dans la collectivité. Toutefois, les services d’urgence des hôpitaux et de soins aux patients hospitalisés constituent souvent le premier point d’accès pour les enfants et les jeunes atteints de troubles mentaux importants. Les services d’urgence peuvent être utilisés lorsque des soins de santé mentale d’urgence sont nécessaires en raison d’un trouble mental, ou que surviennent d’autres problèmes d’ordre affectif, comportemental ou social. Une hospitalisation peut s’imposer selon la nature et la gravité du trouble mental, la disponibilité du soutien dans la collectivité et l’état de sécurité de l’enfant et de ses proches. Le traitement des troubles mentaux chez les jeunes repose sur diverses interventions, dont la thérapie psychosociale et la médication. La pharmacothérapie seule n’est pas recommandée chez les jeunes; de plus, une thérapie psychosociale devrait idéalement la précéder ou l’accompagner. Deux questions ont soulevé des préoccupations, à savoir si l’utilisation des médicaments psychotropes est pertinente et si les jeunes bénéficient d’un suivi clinique suffisant. La présente étude, fondée principalement sur des données administratives de l’Institut canadien d’information sur la santé (ICIS), traite des visites au service d’urgence et des hospitalisations en raison de troubles mentaux chez les enfants et les jeunes, ainsi que de la prise de médicaments psychotropes chez les jeunes.
Details
Type | Report to policy group |
---|---|
Author | CIHI (Canadian Institute for Health Information) |
Publication Year | 2015 |
Title | Care for children and youth with mental disorders |
City | Toronto, ON |
Institution | Canadian Institute for Health Information (CIHI) |
Publication Language | English |
- CIHI (Canadian Institute for Health Information)
- CIHI (Canadian Institute for Health Information)
- Care for children and youth with mental disorders
- 2015
- Canadian Institute for Health Information (CIHI)
- Toronto, ON