Facing the challenge of care for child and youth mental health in Canada: a critical commentary, five suggestions for change and a call to action.

Neuropsychiatric disorders contribute most to the global burden of disease in young people (World Health Organization [WHO] 2003), approaching about 30% of the total global disease burden in those aged 10-19 years. Comparative data are not available for Canada, but the proportional burden of mental disorders in Canadian youth would be expected to be higher as our rates of human immunodeficiency virus/acquired immunodeficiency syndrome, tuberculosis, malaria and iron-deficiency disorders are substantially less than those in low-income countries. National estimates identify that about 15% of Canadian young people suffer from a mental disorder, but only about one in five of those who require professional mental health care actually receive it (Government of Canada 2006; Health Canada 2002; Kirby and Keon 2006; McEwan et al. 2007; Waddell and Shepherd 2002). And recent reports suggest that the human fallout from this reality may go beyond the well-known negative impacts of early-onset mental disorders on social, interpersonal, vocational and economic outcomes. For example, rates of mental disorder are very high in incarcerated youth, suggesting that, for some, jails are becoming the home for mentally ill young people (Kutcher and McDougall 2009).