Thank you so much for the opportunity to speak with you this afternoon about COVID-19 and children's mental health in Canada.
One basic message, and perhaps the most important, is that pre-pandemic, children's mental health needs were extremely high. Looking at epidemiological evidence, we estimate that 13% of children ages 4 to 18 years at any given time—800,000 young people in Canada—were experiencing mental disorders pre-COVID that needed treatment. Those disorders include 12 common ones, such as anxiety, attention deficit, behaviour problems, substance use, depression, and autism through on to schizophrenia. We know how to intervene for all these disorders, but pre-pandemic, fewer than half of these children were actually receiving any interventions for these conditions, shortfalls we would never accept for physical health problems like childhood cancer or diabetes. Pre-pandemic, then, we already needed to double down on children's mental health services.
The second major point is that needs are expected to rise significantly during and after COVID. Based on data from previous disasters like SARS, or natural disasters like earthquakes or floods, we may see as much as twofold to tenfold increases in problems like childhood anxiety, depression and behaviour. Making things worse, some kids will be more affected than others. For example, families who were already experiencing economic hardship are expected to suffer more greatly, and already are, during the pandemic. Children who had pre-existing mental health and developmental conditions, even if they were getting adequate services, have now had disruptions in what they were getting.
Racism is another issue that affects children's mental health. It's a pressing issue for all Canadians, but there have been flare-ups during COVID—with anti-Asian racism, for example. Indigenous communities make up another group that will be severely affected. They were already coping with the legacies of colonialism with strength and resilience, but now they're coping with COVID with fewer resources than other Canadians. Needs were high before; needs will rise a lot.
Even though this is an unprecedented public health challenge in Canada and globally, there are still some unprecedented policy opportunities. I want to highlight three where federal policy leadership can be crucial and can make a huge difference to addressing these problems.
The first policy opportunity involves making a plan. We haven't done this. Make, implement and sustain comprehensive children's mental health plans nationwide. Comprehensive means covering all kids zero to 18 and covering all 12 common mental disorders, at a minimum looking at promoting healthy development, preventing disorders and treating all the kids with disorders as well as tracking outcomes. In my view, federal leadership is crucial, because it's the only way to coordinate efforts nationwide to keep kids on the national public policy agenda.
The federal government can also offer economic incentives for children's mental health programming to provinces and territories, building equitable access across the country. We've done this before very successfully. In the year 2000, the early child development accord led to funding going out to provinces and territories with strings attached. The benefits have been enduring. We need to do that now for children's mental health.
The second policy opportunity involves ensuring adequate budgets and effective services. If we're going to meet those pre-COVID shortfalls, at a minimum, again, we need to double down. We need to double children's mental health budgets. That's to treat all kids with disorders. We know how to do this. We know of effective preventions. The question is obvious: How do we pay for this?
Here's where the promise of funding new prevention programs also comes in. For example, preventing just one case of a severe childhood mental health problem, such as conduct disorder, can yield lifetime savings of up to $8 million. Similarly, a prevention program like Nurse-Family Partnership, which starts in very early childhood, has shown to improve child mental health and yield benefits of over $6,000 per child when you look at whole-of-government savings in services not needed because of this program. There is potential there to start to pay for some of the increased costs we need to incur. Addressing social disparities will simply help with all of this. The federal government has already been showing leadership there.
The third opportunity is to track our collective progress. To quote Clyde Hertzman, what gets counted counts, and we haven't been counting our kids very well. How else do we know how we're doing? Tracking child outcomes is essential.
It's also a way to measure success as we ramp up these new investments, presuming that we would be able to, and we have unique opportunities. Statistics Canada's very high-quality 2019 Canadian Health Survey on Children and Youth has one of the few data sets in the world with which comprehensive work was done pre-pandemic. We can and should repeat that survey on an ongoing basis. Doing that would position us as a global leader in being able to track those outcomes. The federal government is ideally situated to support that survey continuing.
Just to conclude, I recognize that there are many competing demands on public budgets right now, but I would say that if we don't address children's health now, we're going to have far greater societal costs down the road if these problems persist unabated and unnecessarily into adulthood.
Annual costs are estimated to be at $68 billion in Canada for mental health problems writ large, but beyond the economic costs, if we don't address this, we risk seeing a generation of young people scarred by this pandemic to our great collective detriment.
We need this generation. These are our future front-line workers, nurses, teachers, doctors, and parliamentarians. So children and children's mental health need to be at the front of the line in our pandemic response.
I'll just end with a quote from The Lancet medical journal: “Although the COVID-19 pandemic has threatened child health, it can also be a catalyst to start afresh. Children’s rights must be central in the recovery phase.”
Thank you.