The second of four special issues prepared with The Hospital for Sick Children, Toronto, Mary Jo Haddad, Editor-in-Chief

 

In this Issue

The Editor’s Letter

Mary Jo Haddad

Where We Are and Where We Need To Be

The State of Child and Youth Mental Health in Canada: Past Problems and Future Fantasies

Simon Davidson
How can it be, that in 2010, despite the best efforts of many, the state of child and youth mental health in Canada is unknown to countless people? It is a shameful state of affairs that, the author states, makes one wonder how much our society really cares about the well-being of our children and youth. In this article, the author examines several facets of the current, and unfortunate, state of child and youth mental health in Canada. But not stopping there, he outlines two promising initiatives under way and shares his hopes for the future.

Facing the Challenge of Care for Child and Youth Mental Health in Canada: A Critical Commentary, Five Suggestions for Change and a Call to Action

Stan Kutcher
Much is currently known about what could be done to improve the organization and delivery of mental health care for young people; yet there is a gap between what we know can be done and what is being done. The challenge is to move quickly and efficiently to address how to best deliver widely accessible, effective and efficient care, realizing that this may require a transformation of how we have traditionally approached this issue. Concurrently, it is essential that action be driven as much as possible by best evidence not by best practice. In this article, the author discusses five areas in particular need of urgent address.

Facing the System Challenges

Improving Mental Health Outcomes for Children and Youth Exposed to Abuse and Neglect

Ene Underwood
Children exposed to abuse and neglect are at a significantly higher risk of developing mental health conditions than are children who grow up in stable families.  The author draws on case studies, the literature and proven initiatives that have been implemented in a number of children’s aid societies to demonstrate four strategies that can improve mental health outcomes – increasing admission prevention and early intervention to support at-risk youth at home; supporting transitions from intensive residential treatment back to the community; ensuring youth transitioning to the adult system have the supports they need; and increasing integration in service delivery between children’s mental health and child welfare.

“We Suffer from Being Lost”: Formulating Policies to Reclaim Youth in Mental Health Transitions

Melissa A. Vloet, Simon Davidson and Mario Cappelli
The greatest financial and institutional weaknesses in mental health services affect individuals between the ages of 16 and 25. The authors describe a project that sought to identify bodies of evidence supporting effective transitional pathways and to engage policy leaders in a discussion of youth mental health transitions to highlight stakeholder perspectives.

Reducing Mental Health Stigma: A Case Study

Heather Stuart, Michelle Koller, Romie Christie and Mike Pietrus
The authors describe a study that evaluated a contact-based educational symposium designed to reduce mental health–related stigma in journalism students. They found a significant reduction in stigma after the symposium, with the majority of students indicating that their views of mental illness had changed.

Child and Youth Mental Health in the Community

The “Mental” Health of Canada’s Indigenous Children and Youth: Finding New Ways Forward

Michael Chandler
The author discusses the common misperception that all First Nations, Métis and Inuit youth are equally at risk of, or already manifest, some disproportionate array of mental health problems. The real truth, he explains, is that while some fraction of Indigenous communities do have more than their “fair” share of childhood psychopathologies, it is equally true that many more do not. The author then endeavours to persuade the reader that Indigenous knowledge is an untapped resource in our efforts to deal with Indigenous health and mental health problems where they occur.

Youth Justice and Mental Health in Perspective

Alan W. Leschied
Research indentifies that a significant proportion of youth within the justice system possess some form of mental health disorder, and that the presence of an emotional disorder can provide important explanatory value regarding the causes of crime. Evidence is now overwhelming that services within the youth justice system need to account for the causes of crime in order to effectively reduce the likelihood of reoffending.

Experience of Emotional Stress and Resilience in Street-Involved Youth: The Need for Early Mental Health Intervention

Elizabeth McCay
Mental health challenges are of paramount importance to the well-being of Canadian adolescents and young adults, with 18% of Canadian youth, ages 15–24, reporting a mental illness. However, it is unlikely that this statistic accounts for those invisible youth who are disconnected from families and caregivers, bereft of stable housing and familial support. Mental health risk is amplified in street-involved youth and must be recognized as a priority for policy development that commits to accessible mental health programming, in order to realize the potential of these vulnerable, yet often resilient, youth.

Why Worry about Bullying?

Debra J. Pepler, Jennifer German, Wendy Craig and Samantha Yamada
In this article, the authors review research to identify bullying as a critical public health issue for Canada. There is a strong association between involvement in bullying and health problems for children who bully, those who are victimized and those involved in both bullying and being victimized. The authors argue that by understanding bullying as a destructive relationship problem that significantly impacts physical and mental health, healthcare professionals can play a major role in promoting healthy relationships and healthy development for all Canadian children and youth.

Effectiveness of School-Based Violence Prevention for Children and Youth: A Research Report

Robert G. Santos, Mariette J. Chartier, Jeanne C. Whalen, Dan Chateau and Leanne Boyd
Aggression, bullying and violence in children and youth are prevalent in Canada (18%) and internationally. The authors evaluated the effectiveness of Roots of Empathy (ROE), a school-based mental health promotion and violence prevention program for children that has been widely implemented but rarely evaluated.

Transforming Child and Youth Mental Health Care via Innovative Technological Solutions

Antonio Pignatiello, Katherine M. Boydell, John Teshima, Tiziana Volpe, Peter G. Braunberger and Debbie Minden
Live interactive videoconferencing and other technologies offer innovative opportunities for effective delivery of specialized child and adolescent mental health services. In this article, an example of a comprehensive telepsychiatry program is presented to highlight a variety of capacity-building initiatives that are responsive to community needs and cultures; these initiatives are allowing children, youth and caregivers to access otherwise-distant specialist services within their home communities.

Making a Difference…

Faith in the Goodness of People

Gail Donner, in conversation with Karen Minden
Karen Minden is a founding board member and first chief executive officer of the Pine River Institute, a residential treatment and outdoor leadership centre northwest of Toronto, Ontario, which aims to heal young people ages 13–19 who are struggling with mental health issues, particularly substance abuse. In 2010, Minden was awarded the Order of Canada for Social Service. In this interview, Minden candidly discusses how struggles within her own family motivated her to start up the institute, and shares the journey from an idea to the reality of Pine River.