Waiting for What? An Inquiry into the Fundamental Questions of How to Fix Adolescent Mental Healthcare

Abstract

Improving the effectiveness of mental health and substance abuse care for young Canadians is a complex and pressing issue. Currently, there is a focus on reducing wait times and facilitating "system integration" as proposed solutions to the crisis in mental health care. As resources are being allocated toward pursuing those two solutions, the authors argue that the more fundamental challenge to addressing the crisis in mental health care for Canadian adolescents is to urge treatment providers and agencies to clearly define the goals and mechanisms of treatment while evaluating program impacts in order to generate knowledge about effective approaches to treatment. In essence, the authors suggest asking two fundamental questions: What are we treating? And what works? Drawing from insights gained through the creation of a mental health treatment centre at Pine River Institute and the development of subsequent collaborations with various clinical and research communities, the authors outline the importance of clarifying the goals and mechanisms of mental health treatment and creating better definitions and measures of treatment success as a strong foundation for moving toward decreasing wait times and increasing system integration. More specifically, they suggest that the government's most effective role is to increase system capacity by setting standards for excellence. The government can increase system capacity by requiring accountability through accreditation and outcome evaluation; increasing resources for program evaluation; and encouraging innovation by funding research into potentially effective treatment that can contribute evidence to the field of adolescent mental health and substance abuse treatment.