DATA GAPS ARE FUELING CANADA’S CHILDREN’S MENTAL HEALTH CRISIS, DURING COVID-19 AND BEYOND
Katholiki Georgiades, Harriet MacMillan, Stelios Georgiades, Charlotte Waddell, Peter Szatmari, Tracy Vaillancourt and Emily Gruenwoldt | February 22, 2021
Katholiki Georgiades is Associate Professor and the David R. (Dan) Offord Chair in Child Studies at the Offord Centre for Child Studies, Faculty of Health Sciences at McMaster University
Harriet MacMillan is Distinguished University Professor and Chedoke Health Chair in Child Psychiatry at the Offord Centre for Child Studies, Faculty of Health Sciences at McMaster University
Stelios Georgiades is Associate Professor, Faculty of Health Sciences at McMaster University
Charlotte Waddell is University Professor and Director of the Children’s Health Policy Centre, Faculty of Health Sciences at Simon Fraser University
Peter Szatmari is Chief, Child and Youth Mental Health Collaborative, Hospital for Sick Children, Centre for Addiction and Mental Health, University of Toronto
Tracy Vaillancourt is Professor and Tier 1 Canada Research Chair, University of Ottawa & Chair of the Royal Society of Canada’s Working Group on Children and Schools
Emily Gruenwoldt is CEO, Children’s Healthcare Canada
Judging from the headlines, the mental health of Canada’s children has never been worse. Indeed, it seems the next epidemic will involve a mental health crisis. But how do we know? The problem is we don’t.
Unlike other countries, Canada does not have a national longitudinal study of children and youth that can provide timely evidence on their health and well-being. The need for such evidence was urgent before COVID-19 and is even more urgent now. Many countries have mobilized quickly to monitor the impacts of the pandemic on children, yet almost on year into the pandemic, Canada is only beginning to develop a coordinated, national response to determine how children are doing, and what their current and future needs are.
A recent UNICEF report suggests a grim picture before the pandemic with Canada ranking 30th out of 38 high-income countries on overall child well-being. This ranking includes indicators of mental well-being, physical health, and academic and social skills. The pandemic is likely making all these outcomes worse, especially for children who were already struggling. But again, we have no way of knowing.
Measuring COVID-19’s impact on children must also go beyond “convenience” samples, which only include participants who are easy to reach. These methods can lead to inaccurate estimates because they omit certain groups in the population, often those who are most in need. Existing administrative data, such as records of healthcare visits, also do not capture accurate numbers to help policy-makers develop appropriate responses. This is partly because healthcare visits declined dramatically during the pandemic and partly because these data only capture children who actually receive care, while many may not.
Canada actually has an exceptional opportunity to address these data gaps. The Canadian Health Survey on Children and Youth was conducted by Statistics Canada in 2019, which means there are pre-pandemic data about how children were doing before COVID-19. This survey involved a nationally, representative sample of more than 42,000 children aged 1 to 17 years across the country.
We must build on these data to learn how children are doing now and what they need in the future.
Investing in a comprehensive follow-up survey represents our best opportunity to obtain accurate information about how the pandemic is affecting all Canadian children, and how some are being disproportionately affected. This also creates a unique opportunity to assess how COVID-19’s impact may have differed across provinces and territories — including assessing the impact of diverse public health and policy responses.
Follow-up data from the Canadian Health Survey on Children and Youth will be essential in helping policymakers make the best choices about where and how money is spent to help children and their families. Continuity in data collection is also the only way to tell if we are doing the right things and doing them right — for all children.
Children are not the immediate face of COVID-19, but they are the face of its future. This future may well involve lasting harms to a generation, if we do not act now. The pandemic has caused many unprecedented hardships for Canadians. Yet it also provides an extraordinary opportunity to track children’s mental health and well-being in a rigorous way on a national scale. We urge the federal government to take leadership now by investing in a follow-up of Statistics Canada’s Canadian Health Survey on Children and Youth.
This article initially appeared in the Globe and Mail on February 22, 2021.