The Role of Schools in Improving Children’s Mental Health

1. The Role of Schools in Improving Children’s Mental Health Presentation to the April 2008 School Health Conference By The Honourable Michael Kirby Chair, Mental Health Commission of Canada

2. My Focus Today • Significance of children’s mental health • Approaches to children’s mental health • About the Mental Health Commission of Canada and what we are doing

3. Significance of Children’s Mental Health

4. ‘Reaching for the Top’ • Report on children’s health and wellness, released in March 2008 – Reaching for the Top by Dr. K. Kellie Leitch • Follows/confirms ‘Out of the Shadows at Last’ • Top three issues facing children: • Obesity • Mental health • Injuries • Children’s health issues are multi-faceted and complex • Children with mental health issues who do not receive treatment are more likely to have health and social issues as adults

5. Children’s Mental Health Challenges and Issues • Bullying • Mental stress/anxiety, e.g., exams, getting into good schools • Labelling, e.g., ADHD • Peer pressure • Refugee/immigrant stresses • Eating disorders • Substance abuse • Depression • Psychiatric illnesses, e.g., schizophrenia, bi-polar disorder

6. Facts about Children’s Mental Health in Canada • 80% of all psychiatric disorders emerge in adolescence • Mental health is the single most common illness beginning in adolescence • 15% of children/youth affected by mental illness (1.2 million) • 15% of those who suffer depression commit suicide • Depression is getting younger: 10% of boys, 11% of girls age 4-11 • Mental health problems to increase by 50% by 2020 (Reaching for the Top, p. 131)

7. Young Suffer Stigma • In addition to neglect, young people suffer from ‘self stigma’ • 63% of youth have indicated that embarrassment, fear, peer pressure and/or stigma are major barriers to seeking help • 75% of youth do not speak to family or health care professionals about mental health concerns • 38% of Canadians said they would be embarrassed to admit that their child had a mental illness • Health providers and teachers influenced by stigma associated with mental illness • Family doctors receive little training in diagnosing or treating mental health problems among children and youth

8. Canada’s Report Card: F • 50% of depressed/suicidal youth not accessing services • No uniformity in hospital and community services levels • Most provinces/territories have no child mental health plans • Extreme shortage of service providers • Only children in crisis receive treatment • Higher cost to social service system because of untreated childhood mental health illnesses • It is in the economic interest of government to diagnose and treat children’s mental illnesses • Canada is the only country among G8 with no national mental health strategy

9. The Bottom Line • Only one in five children who NEED services receive them • What would happen if one in five adults needed a hip or knee replacement and wasn’t able to receive treatment? • Why should it be different for our children with mental health problems??

10. Approaches to Children’s Mental Health

11. Role of Schools • Early intervention needed, even as early as pre-school • About 70% of childhood mental health problems can be solved through early diagnosis and intervention • Children/families uncomfortable in hospital settings -- more comfortable in schools • Mental health services need to move into schools – the natural habitat of children • Services should be delivered by mental health professionals – not teachers • Transitions need to be managed – from pre-school into school, high school and beyond

12. School-Based Health Promotion Framework • Acknowledges interconnectedness of issues • Whole School Strategies (as per framework, p. 5) “More comprehensive strategies that engage entire systems (not only the front line), as well as the community, agencies, professionals and families working closely with the school.” • Many positive elements in this framework that can be applied to mental health

13. School-Based Health Promotion Framework • Support 10 key points: • address needs of whole child • serve all children • understand the context • strive toward a comprehensive approach • use evidence-based programs • use evidence-based implementation strategies • coordinate multiple programs • seek congruence with educational mandate • build capacity • use a strategic approach to system characteristics

14. Mental Health Commission of Canada What We’re Doing

15. History of MHCC • Senate Committee Mental Health Report, Out of the Shadows at Last May 2006 • Creation of a mental health commission was a recommendation • In 2007, I was asked to chair the new commission • A non-profit organization to focus national attention on mental health issues • Funded by federal gov’t, but operates at arm’s length from all levels of gov’t • Board of Directors includes 11 NGO members and 7 appointed by federal, provincial and territorial governments • Eight advisory committees

16. Child and Youth Advisory Committee • Provides advice to the Board/support to the Commission • Engaged with the broader stakeholder community • Developed a workplan – school component: • Establish school-based subcommittee involving youth, parents, mental health professionals, leaders, academics and school/education leaders • Identify current school-based mental health programs • Implement recommendations from Out of the Shadows at Last for full continuum of mental health services within the school system • Review and develop competencies that empower/encourage collaboration between families and school personnel • Encourage collaboration between families/school

17. MHCC Three Key Initiatives • National mental health strategy • Anti-stigma campaign • Knowledge Exchange Centre • All linked together and need to be pursued simultaneously

18. Time to Act is Now!! • We’ve compromised long enough • Compromised the growth and development of our children • Compromised their future as contributing adults • Schools must play a vital role in early identification and intervention – an early warning system

19. ‘Orphan of the Orphan’ • Mental health often described as the orphan of the health care system • Children and youth mental health has rightly been called the ‘orphan of the orphan’ • Children are our future • We all have a responsibility to address this issue -- It takes a village to raise a child • Let’s make sure that ‘the orphan of the orphan’ is an orphan no longer!!