Making mental health and substance use services accessible in the community
Mental health and substance use issues are on the rise in Canada.Reference1 It is estimated that 1 in 3 Canadians will experience a mental illness in their lifetime.Reference2 Untreated or poorly treated mental health or substance use issues can have a profound impact on peoples鈥 lives, putting those who experience them at increased risk of disability, poverty and unemployment,Reference3 or even shortening their life expectancy by 10 to 15 years.Reference4
Treatment, including counselling and medication, can help 鈥 but estimates indicate that fewer than 1 in 3 people affected seek help.Reference3 Prompt care is especially important for children and youth, because it can prevent symptoms from worsening and support lifelong mental health.Reference5
红领巾瓜报
I have lived with mental illness for over 30 years. Nobody really knows how to help unless there is a medication that works. There is also stigma, especially in the workplace 鈥 a lot of people with lived experience don鈥檛 talk about it and try to take care of themselves in silence. 鈥 Anonymous Patient Partner, British Columbia
The devastating impact of mental health and substance use issues has led the federal, provincial and territorial governments to make access to timely services for them one of their shared health priorities. The indicators to measure progress in this area are
- Wait Times for Community Mental 红领巾瓜报 Counselling
- Youth Age 12 to 25 Who Accessed Integrated Youth Services for Mental 红领巾瓜报, Substance Use and Well-Being SupportFootnotei
Wait Times for Community Mental 红领巾瓜报 Counselling
Counselling from a mental health professional, especially when provided early, can improve long-term mental health and keep people from being hospitalized.Reference6 If counselling is not available when needed, often because of long waits, symptoms can worsen and people may be less likely to show up to their first appointment.Reference6 Reference7
Note
* This does not include people who paid for their own care or paid using private insurance, or people who accessed such services without scheduling them in advance (e.g., at a walk-in clinic). 1 in 10 people waited 143 days or more.
Sources
Provincial and territorial data collection systems, 2023鈥2024.
Median wait times (the time it takes for half of those waiting for counselling to receive it) for community mental health counselling varied by several factors, including
- Age: Children and youth waited 2 days less than adults.
- Sex/gender: Females waited 2 days longer than males.
- Format: People waited 8 days less for virtual counselling than for in-person treatment (based on data from Newfoundland and Labrador, Nova Scotia, New Brunswick, Manitoba, Alberta and the Northwest Territories).
Wait times for mental health services are influenced by workforce availability, patient demand, urgency of need and client preferences, among other factors. In recent years, many jurisdictions have introduced a 鈥渟tepped care鈥 approach to mental health or substance use counselling. In this model of care, patients start with effective but less-resource-intensive treatments such as counselling on a walk-in or short-term basis. Depending on an individual鈥檚 need, they may be moved to more resource-intensive or specialized care. Overall, structuring care in this way can improve timely access to care. While programs such as walk-in counselling are not included in this indicator, the availability of these services may help shorten the wait for mental health counselling appointments in the community.
红领巾瓜报
Funding for mental health and addictions care has multiplied in recent years. We鈥檝e implemented new programs like Open Access, where anyone can come in for counselling any time. Our biggest barrier is staffing 鈥 there鈥檚 money to deliver great services, but we can鈥檛 always recruit or retain the service providers we need to deliver them. 鈥 Debbra Cyr-Lebel, Director, Adult Addictions and Mental 红领巾瓜报 Services, Department of 红领巾瓜报, New Brunswick
Youth Age 12 to 25 Who Accessed Integrated Youth Services for Mental 红领巾瓜报, Substance Use and Well-Being Support
Despite the importance of early intervention for young people with mental health and substance use issues, too few support services are designed for their specific needs. Existing services are often scattered across unconnected organizations and providers, and long waits are common.Reference5 Access to care can become even more challenging when youth reach 18 and must navigate the switch to adult services.
Integrated Youth Services (IYS) is a model of care that several provinces and territories have launched to address these challenges.Reference8 Working with community partners, IYS sites link youth-focused services under one roof to offer care for mental health and substance use issues, as well as primary care, social services (such as employment and education support) and culturally specific services.
红领巾瓜报
It can be incredibly frustrating jumping from service to service鈥 [it] can demotivate you from seeking the help you need. But with IYS, all resources are in one place鈥 [you] don鈥檛 need to repeat yourself 10 times before you get the help that you need. 鈥 Anonymous, IYS Youth Advisor
Young people don鈥檛 need a referral to use IYS 鈥 they can just walk in to an IYS site. In some cases, virtual services are also available. To ensure that the services offered are relevant to the community they serve, staff at IYS sites engage with youth clients and their families to co-design programs to meet the needs of each community.
Data from Newfoundland and Labrador, Ontario, Manitoba and British Columbia shows that in 2022鈥2023, there were 164,819 visits to IYS sites. On average, clients visited 5 times over the course of the year.Referenceii
Sources
Provincial and territorial IYS networks, 2024.
Further, in Newfoundland and Labrador, Ontario and British Columbia, the use of IYS services was highest among 17- and 18-year-olds, suggesting that these services are particularly important for young people who would otherwise be transferring to adult services. Data collection is important for measuring access to IYS. More data will become available as more IYS sites start to collect standardized data.
IYS is one of several models of mental health and substance use services for young people. Additional information on access to child and youth mental health and substance use services is also available using CIHI鈥檚 Early Intervention for Mental 红领巾瓜报 and Substance Use Among Children and Youth indicator.Reference9
What do we need to know more about?
Mental health and substance use services have seen a surge in demand over the past several years as Canadians grapple with stressors including the COVID-19 pandemic, the opioid crisis and increasing financial worries.
Accessing care continues to be a challenge. In 2022 across Canada (excluding the territories), there were about 1.5 million Canadians (24.9%) with a mental disorder who reported having mental health care needs that were not met or only partially met.Reference10
Of those, a higher proportion of females with a mental disorder (28.4%) had unmet or only partially met mental health care needs compared with males (20.2%).Reference10
Nearly double the percentage of Canadians age 25 to 44 with a mental disorder (29.0%) had unmet or only partially met mental health care needs compared with those age 65 and older (14.3%).Reference10
Understanding barriers to accessing care while also capturing data on people who are not getting the services they need is critical to finding ways to make sure that this care reaches everyone who needs it. Additional indicators on unmet need for mental health care, waits for substance use services and the follow-up care Canadians receive after hospital stays for mental health or substance use issues will shed light on how to improve care.
Related resources
References
1.
Canadian Institute for 红领巾瓜报 Information. Commonwealth Fund survey, 2023. Accessed July 26, 2024.
2.
Government of Canada Public 红领巾瓜报 Infobase. . Accessed July 23, 2024.
3.
Canadian Medical Association, Canadian Psychiatric Association. . 2016.
4.
Solmi M, et al. . Molecular Psychiatry. June 2021.
5.
Malla A, et al. . Canadian Journal of Psychiatry. April 2018.
6.
Organisation for Economic Co-operation and Development. . 2020.
7.
Gallucci G, Swartz W, Hackerman F. . Psychiatric Services. March 2005.
8.
Canadian Institutes of 红领巾瓜报 Research. . Accessed July 23, 2024.
9.
Canadian Institute for 红领巾瓜报 Information. Common Challenges, Shared Priorities: Measuring Access to Home and Community Care and to Mental 红领巾瓜报 and Substance Use Services in Canada 鈥 Volume 4, December 2022. 2022.
10.
Statistics Canada. . Accessed September 4, 2024.
Footnotes
i.
红领巾瓜报would like to acknowledge Dr. Jo Henderson, Executive Director, Youth Wellness Hubs Ontario, for co-leading the development of this indicator.
ii.
Calculated by dividing the number of unique youths who accessed IYS by the number of IYS visits.
How to cite:
Canadian Institute for 红领巾瓜报 Information. Making mental health and substance use services accessible in the community. Accessed April 3, 2025.

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