Raising the bar
for children, youth
and families

Improving service
experience and outcomes
in every community

Impact Report 2019

Girl in a superhero costume

Leaders’ message

Ensuring Ontario is a place to grow with good mental health

For the past 15 years, the Centre has supported Ontario agencies, communities and decision makers to help children and youth in our province develop in ways that expand their future opportunities and protect lifelong health.

We work to ensure children and youth in Ontario have access to safe and supportive relationships, environments and experiences to set them up for success throughout their lives. When children and youth grow up with good mental health, they develop the relationships and resilience to cope with the storms of life and the social-emotional skills required to become healthy, well-rounded adults.

Promoting mental health across the lifespan and acting early to prevent mental illness and other challenges helps ensure that Ontario is an ideal place to grow for generations to come.

Purnima Sundar and Cathy Curry

Raising the bar on impact

Since 2004, we have helped provide the key players in our sector with the right knowledge, capacity, connections and tools to meet child and youth mental health needs in their communities. Over time we have adapted to the changing needs of patients, the child and youth mental health system and our funder — and we continue to do just that.

Transition was a recurring theme in 2018, with our sector’s move to the Ministry of Health and our own internal shift to raise the bar on impact (which is reflected throughout this report). As we move away from providing on-demand services at the organizational level, we increase our capacity to focus more and more on system-level changes that break down barriers to better care and strengthen services. This means better patient and population health, better experience and outcomes for children, youth and families, better experience for providers and overall, better value.

There is a crisis in our healthcare system stemming from undiagnosed or unaddressed mental health struggles in children and youth. This is compounded by the challenges many families face in navigating the system of services. Working closely with the Ministry of Health, provincial partners and service delivery stakeholders, we can leverage our collective expertise to create a better future for our children.

Together, let’s improve the mental health of Ontarians from early childhood to their golden years. It is time to raise the bar.

Purnima Sundar
Acting Executive Director

Cathy Curry
Strategic Advisory Council

Purnima Sundar and Cathy Curry

Vision, mission

As an organization that exists to define, pursue and deliver excellence in child and youth mental health, both setting and raising the bar are central to who we are and all the work that we do.

Vision: The best mental health and well-being for every child, youth and family.

Mission: We drive high-quality child and youth mental health service delivery for Ontario’s children, youth and families by mobilizing knowledge and setting the bar for excellence.

Boy giving thumbs-up
Jumping girl shouting into a megaphone

Strategic directions

We embarked on a new strategic plan in 2018 and have further refined it over the past year. Our work is anchored by two core goals: to mobilize knowledge and improve quality throughout the child and youth mental health sector.

Recognizing that the needs of babies are different from those of teenagers, our work is also targeted within the various developmental age ranges:

  • early years (birth to age 6)
  • middle years (ages 7 to 12)
  • teen years (ages 13 to 18)
  • transitional aged youth (ages 19 to 25)

Over the next few years, our work will focus on the following key areas of impact:

  • developing, implementing and strengthening care pathways
  • ensuring meaningful and consistent youth and family engagement across the system
  • exploring the power of digital and e-mental health solutions to support child and youth mental health
  • contributing to a strong provincial system of child and youth mental health service delivery

Raising the bar by mobilizing knowledge

Making good decisions requires the latest, high-quality information. We work to identify our sector’s most pressing knowledge gaps and close them with the best available evidence. Then we make sure that knowledge is accessible, understandable and useful for the key players in our sector. Intentionally using information and expertise to align research, policy and practice helps create better care experiences and mental health outcomes for children, youth and families in Ontario.

Girl lifting circus barbells

Bridging the gap between primary care
and community-based mental health services

Boy flexing his arms

Families often feel lost when looking for mental health help for their children and youth. Most of them turn to their family doctors, but even physicians struggle to help families get the care they need. This is often due to the lack of connection between primary care and community-based mental health services. In 2017, we set out to bridge that gap with the publication of Paving the path to connected care. This policy paper offered eight recommendations to better integrate child and youth mental health care by strengthening the ways that providers work across care settings.

Boy flexing his arms
Beginning in 2018, we collaborated with partners in two communities (Toronto and Algoma) to create organizational structures that strengthen and facilitate inter-provider communication. We then supported providers from different care settings to work together to establish mental health pathways in their communities and integrate standardized tools into these pathways. We conducted an evaluation at the end of the first phase of implementation and found that there was already an improved flow of communication between participating providers. Clients provided positive feedback, sharing that they felt relieved not to have to repeat their story multiple times. Building on this success, we grew momentum to scale up by hosting a provincial primary care forum in September 2018 to share what we had learned and identify other communities poised to make similar changes.
This year, we have tripled the number of demonstration sites, putting pathways to the test in six communities across Ontario. Over the next two years, providers in Windsor, Belleville, Elgin/Oxford and Cornwall will join our partners in Toronto and Algoma to create, implement and evaluate standardized child and youth mental health pathways in their communities. Such pathways are an important step in ensuring the system is easier to navigate for families and care providers alike.
Primary care forum attendance: 70; Satisfaction: 4/5; Usefulness: 4/5
Primary care forum attendance: 70; Satisfaction: 4/5; Usefulness: 4/5

It has been really nice to work with the advisory committee [established and supported by the Centre] to sort out what the pathways should look like. It has allowed for a lot of great conversations, created a better understanding of the needs of primary care providers and helped to dispel myths they have that community-based mental health services all have long, long waiting lists. Opening up conversations about referral pathways and recognizing that we’re all part of health services has helped with our commitment to work together.

Sandie Leith, Director of Services
Algoma Family Services

Caring for our
youngest Ontarians

What happens in early childhood can shape the lifelong health and well-being of individuals and their communities. Recent Ontario data suggests that a troubling number of children experience social-emotional vulnerability in their earliest years. These issues are starting to be seen more often in early learning and care settings, as well as classrooms throughout the province.

Boy with A B C and 1 2 3 floating around his head
Our 2014 policy paper on the early years helped create a shared understanding of infant and early childhood mental health in Ontario. In 2018, we partnered with Infant Mental Health Promotion and School Mental Health Ontario to develop a second policy paper — Beyond building blocks: Investing in the lifelong mental health of Ontario’s three- to six-year-olds — deepening our focus on the mental health and social-emotional development of children between three and six years old. We also supported two novel programs aimed at promoting infant mental health through our Innovation Initiatives grants and began adapting the HEADS-ED screening tool for use among children from birth through age five.
This year, we will lead the implementation of two of the recommendations emerging from our latest policy paper: ensuring the availability of preservice training and ongoing learning to support the social-emotional development of three- to six-year-olds; and strengthening partnerships to create efficient service pathways for mental health services in the early years. As well, we will be supporting another novel project focused on the first three years of life through our Innovation Initiative program (2019–20 cohort). And because we recognize the importance of building bridges between primary care settings and community-based services, we will also work on validating a version of the HEADS-ED tool adapted for children five and under. Already in use for older children, the adapted HEADS-ED will help primary care providers (e.g. family doctors and those working in emergency departments) recognize the signs of problems when they arise in younger children and connect families with community services for early intervention. Helping families access the right supports at the right time is the best strategy for a mentally healthy and thriving Ontario.
5 authors from 3 organizations + 23-member advisory committee = 8 recommendations to guide our collective response for supporting positive mental health and well-being in Ontario’s 3- to 6-year-olds
5 authors from 3 organizations + 23-member advisory committee = 8 recommendations to guide our collective response for supporting positive mental health and well-being in Ontario’s 3- to 6-year-olds

It was exciting to be able to pilot something and have the resources to do some program evaluation. Based on existing research, we know that early intervention is key. So, figuring out a way to engage families with infants differently, then to see the success of it is awesome. Having [the results] to help raise the profile of infant mental health is also really helpful for our sector.

Kathryn Lambert, Vanier Children’s Services
Recipient of the Centre’s 2018–19 Innovation Initiative grants for PAIR Clinic project

Gathering knowledge for system-level impact

To create system-level change, we need to know what the most pressing knowledge gaps are in Ontario’s child and youth mental health sector. We also need to understand how to fill those gaps based on the information needs of the key players in our sector, from providers to decision makers. Filling these gaps and mobilizing the best available knowledge puts information to work to deliver measurable benefits for children, youth and families.

Smiling student carrying books
Throughout 2018–19 we continued to provide on-demand knowledge supports to agency staff and leaders, helping them to make evidence-based changes in their agencies and communities. By vetting the evidence on a range of topics, we produced literature reviews, annotated bibliographies and other knowledge products to equip sector partners with the latest information to ensure high-quality, evidence-based service delivery.
This year, we are completing the shift we started last year in our approach to gathering knowledge. Rather than providing on-demand services on topics brought forward by individual agencies, we are narrowing our scope to be able to dig deeper into areas of significant impact for our sector. Our current strategic areas of impact are care pathways, youth and family engagement, technology (that is, digital and e-mental health services) and system-level initiatives.
9 research resources completed based on agency requests
9 research resources completed based on agency requests

When we needed to understand safe and effective use of self [in the delivery of psychotherapy services to our clients], I went to the research myself but there was very little in the context of child and youth mental health. So, I reached out to the Centre and I was blown away by the quality of the resource they provided. It puts information about evidence-based programs that have data supporting them right at our fingertips. This is so useful to many different parties. We even passed the resource on to our board of directors.

Raising the bar by cultivating quality

Improving the quality and accessibility of child and youth mental health services requires flexibility, agility and an appetite for change. There is no room for a “this is how it’s always been done” mentality; the status quo is just not good enough. That is why we continuously adapt to new knowledge and respond to the evolving needs of families, the Ministry and our sector.

Girl holding a basketball

Setting quality standards, alongside youth and families

Research shows that meaningfully engaging youth and families has significant positive impacts on client experience and cost-effectiveness. There’s no one better than children, youth and families to tell us what they need and how best to engage with them. Over the past several years, youth and family engagement have been gaining momentum across Ontario. However, there are still inconsistencies with how engagement is understood and practiced, particularly at the system level.

Girl looking through a magnifying glass
In 2018 we led the development of quality standards for youth and family engagement in system planning. These evidence-based standards were developed in partnership with the Child and Youth Mental Health Lead Agency Consortium, young people, families, clinicians and researchers from all around the province. Engagement at the system level is about improvements affecting the whole network of people and organizations delivering care, the pathways that connect them and the resources and structures that enable care. By setting the bar for consistent engagement practices and formalizing expectations for system decision makers, we ensure youth and families have a voice in creating a seamless mental healthcare experience, no matter where in the province they seek care.
In the coming months, we will continue to develop implementation and coaching resources and work with system-level decision makers to put these newly developed quality standards into practice. But we won’t stop there — we also will be exploring the development of more quality standards, with their focus determined by the needs of the sector and in alignment with our key impact areas.
80 youth, 43 family members, 107 service providers participated in consultations via online surveys or focus groups; 75% of youth and 73% of families believed the draft statements very much capture successful youth and family engagement, respectively
80 youth, 43 family members, 107 service providers participated in consultations via online surveys or focus groups; 75% of youth and 73% of families believed the draft statements very much capture successful youth and family engagement, respectively

As an advisory committee, we set the bar high and that goal didn’t waver in the face of challenges. Everyone, including Centre staff, brought their whole selves to the table. Every specific role and perspective were needed. If any one of those pieces was absent, we wouldn’t have achieved the quality that we were looking for. It’s exciting to have phase 2 to continue that.

Louise Murray-Leung, Member of the Centre’s family engagement quality standard advisory committee

Prioritizing quality improvement throughout the sector

In Ontario, the six domains of quality in health are safe, effective, patient-centred, efficient, timely and equitable care. Children, youth and families deserve timely services and an integrated, easy-to-navigate healthcare system, regardless of where they access care. Still, many don’t receive the right care at the right time due to inconsistencies in service delivery, quality and wait times. A focus on quality means ensuring consistency in mental health services across the province.

Girl brushing her teeth
We have always worked to increase our sector’s capacity to plan, implement and measure its work by providing resources, coaching and other supports for direct service providers and agency leaders. With the introduction of our new strategic directions in 2018, we began to adapt and refine our quality improvement (QI) support, based on the Lean Six Sigma methodology and the evolving needs of the sector. Through 2018–19, we offered on-demand consultation and capacity building in the realm of evaluation and QI. Our quality services were among our most popular supports, with 11 agencies and two communities accessing them.
This year, we will build on our successes implementing quality improvement to support child and youth mental health agencies across the province. We are working with Children’s Mental Health Ontario (CMHO) to develop a QI cohort program for child and youth mental health agencies with an approach also rooted in the Lean Six Sigma methodology. As well, we will continue to explore collaboration opportunities with the Excellence through Quality Improvement Project (E-QIP) to support alignment of QI supports for agencies working across the lifespan.
Those using our services said Centre supports helped increase quality knowledge (8.8/10) and capacity (8.9/10)
Those using our services said Centre supports helped increase quality knowledge (8.8/10) and capacity (8.9/10)

The Centre delivered some Lean [quality improvement] training for our staff, which was great. It got our staff thinking about that culture of quality improvement and helped us gain momentum on implementing it in our organization.

Ashley Hoffmeister, Director of Systems and Performance Management

Helping improve data integration and access for decision-making

In a 2017 survey, less than one third of Ontario’s lead agencies told us they felt truly confident to generate, manage and use high-quality data to inform service planning and delivery. With hundreds of child and youth mental health agencies using a wide array of client information systems (CIS), there was no clear way to aggregate data on a regional or provincial level and make it available to those who need it to develop and deliver programs and services. This is exactly the sort of data that is required to produce the greatest impact at both the organizational and system levels.

Happy boy with his hands on his cheeks
The Government of Ontario recognized the need for a common performance measurement framework, a crucial first step to being able to generate data to help inform system planning. Ministry partners began working to implement a Business Intelligence (BI) Solution for child and youth mental health, and we were brought on board to develop and lead the training component for phase 1. Through 2018–19 we developed five online training modules and accompanying resources to support agencies. Because no such solution can be implemented without rigorous data sharing agreements, we created data sharing agreement templates for the initiative and produced a sixth module to explain the data sharing process. We then helped bring together agencies using the province’s most common CIS for a learning event, for which we provided both logistical and facilitation support.
This year, we will continue to finalize training content and host live Q&A sessions to supplement the pre-recorded webinars. We also recently added expertise to our team in the form of a senior data analyst to support new and ongoing work around data integration.
Phase 1 includes child and youth mental health agencies using the six most common CIS; about 50% of all child and youth mental health agencies in Ontario
Phase 1 includes child and youth mental health agencies using the six most common CIS; about 50% of all child and youth mental health agencies in Ontario

[Today’s event] will help us make sure we are aligned with other agencies in the province. It’s a good start!

Participant at the CIS learning event

Raising the bar by championing
collaboration and engagement

Ontario’s child and youth mental health system is complex. It has traditionally spanned multiple ministries, care settings and communities, with hundreds of agencies providing mental health services for children, youth and families all over the province. We have always embraced the cross-sectoral nature of child and youth mental health, working to dismantle silos, nurture partnerships and build bridges for youth and families to bring their voices into the planning and delivery of services that meet their needs.

Two girls high-fiving

Working with government and service providers across the province

Collaboration is in the Centre’s DNA. We work strategically with government and service provider partners to align our efforts and produce the best possible tools and services for our stakeholders. Not only does this approach help us to respect healthcare dollars by using our resources wisely, it also leads to better, more consistent care for Ontario’s children, youth and families.

Girl sitting with laptop on her lap

In 2018–19, we collaborated with Ministry and sector partners to:

  • develop and implement tools and resources to support the Ministry-led Business Intelligence (BI) Solution.
  • convene a committee of experts to respond to the Auditor General of Ontario’s 2016 recommendation to establish caseload guidelines, and released an interim report advising the sector how best to move forward.
  • create a multi-year planning template and user guide to support lead agencies across the province to plan and deliver high quality, relevant services to meet the mental health needs of children, youth and families.
  • plan and host a quality improvement symposium (held in June 2018) for sector leaders to begin discussions related to a provincial quality framework.
  • support the work of the Lead Agency Consortium and Community of Practice to identify and work toward addressing child and youth mental health system priorities.
  • finalize work with lead and core service agencies to establish a common approach in the way we interpret and apply core service definitions across the province.

In April 2019 we launched Clearing the air: Informing conversations about cannabis for child and youth mental health and addictions professionals, a learning resource co-developed with partners at Addictions and Mental Health Ontario (AMHO). This resource and the related evidence paper examine the links between mental health and substance use — particularly cannabis use among youth under the age of 25. This work is based on the latest knowledge in this area, along with advice and guidance from addictions and child and youth mental health service providers, youth and families. Later this year, we will wrap up our Ministry-directed work to support the BI Solution and finalize our project on caseload/workload guidelines. We will also continue work with the Ministry-led Ontario structured psychotherapy program’s family, child and youth subcommittee, providing engagement and knowledge gathering support.

72 people attended quality symposium for lead agencies, 4.1/5 satisfaction
72 people attended quality symposium for lead agencies, 4.1/5 satisfaction

Given the recent legalization of recreational cannabis in Canada, there was a need to provide mental health and addictions service providers with access to up-to-date information that would support them in their daily practice. Working with experts at the Centre meant that the information gathered was evidence-informed, tailored to service providers’ knowledge needs and applicable to current practice.

Fostering quality youth and family engagement in every community

When youth and families are meaningfully engaged in treatment planning and service delivery we see stronger organizations and improved outcomes. This includes better relationships with healthcare professionals, a stronger sense that needs are being met and greater satisfaction with care.

Mother and daughter
Long before establishing provincial quality standards for youth and family engagement, our team was working to help agencies and communities build partnerships with youth and families at all levels of planning, implementation and evaluation. In 2018–19, the greatest uptake of our consultation and capacity building services was in the realm of family engagement. We provided individualized supports, in partnership with Parents for Children’s Mental Health (PCMH), to 11 agencies and 10 communities. We provided similar supports on youth engagement to four agencies and eight communities. To better integrate consistent youth engagement in our own work and ensure our policies, approaches, initiatives, etc. are accessible and responsive to the evolving needs of young people, we established a new youth advisory council. The 12-member group met for the first time in January 2019.
In April we released a comprehensive family engagement resource guide (co-created with PCMH). In the coming months, we will focus our efforts on coaching agencies and system planning tables to implement the new youth and family engagement quality standards and their corresponding measurement tools. This fall we will also co-lead forums on youth engagement with the New Mentality in Kenora, Richmond Hill and St. Catharines to increase local understanding of youth engagement efforts and opportunities.
Centre supports increased FE knowledge (7.9/10) and capacity (7.7/10); Centre supports increased YE knowledge (7.6/10) and capacity (7.4/10)
Centre supports increased FE knowledge (7.9/10) and capacity (7.7/10); Centre supports increased YE knowledge (7.6/10) and capacity (7.4/10)

The work we have done with the Centre and PCMH has been invaluable! Their collaborations brought a [new] lens to our work to strengthen family engagement at an organizational and system level that is beginning to transform how we think of and develop programming, moving to a much more co-developed process.

Bill Helmeczi, Director of Strategic Initiatives, Standards and Practices
Pathstone Mental Health

Supporting integrated youth service sites

Integrated youth service sites (also known as YWHO IYS) are a one-stop shop where young people ages 12 to 25 can access the mental health and addictions services they need. Services include mental health assessments, treatment for addictions and substance use, therapy and counselling, peer and family support and referrals to healthcare providers, including psychiatrists. Primary care, education, employment and housing services are also available.

Happy teens with sunglasses

Six new sites were opened in 2018: Eastern Champlain (Cornwall area), Malton, Haliburton, North Simcoe, Kenora and Niagara Region. They joined the four existing sites (Chatham-Kent and three in the Greater Toronto Area). Over the past year we worked with our partners at the Centre for Addiction and Mental Health (CAMH) and its provincial system support program (PSSP) to support the sites in their efforts to engage young people and families in the planning, implementation and evaluation of their integrated youth services.

This year we continue to lead engagement efforts at the provincial level by coordinating and co-leading provincial youth and family advisory committees. As well, we will deploy similar supports at the local level, including developing site specific workplans for engagement and supporting local advisory groups.

Raising the bar by driving innovation

Since 2017, our Innovation Initiatives grants have supported Ontario’s child and youth mental health agencies to turn their bold ideas into potential solutions to improve service quality and access — ultimately leading to better healthcare experiences for children, youth and families across Ontario.

Girl doing the splits
Thoughtful youth with hand on chin

Helping innovative thinkers address system priorities

Through three cycles, we have supported 23 projects with up to $50,000 each to implement new, evidence-based or promising practices that demonstrate potential for broader impact in the provincial child and youth mental health system.

Thoughtful youth with hand on chin
In 2018, we supported the 10 recipients from our second grant cycle to test new ideas to address system priorities (see What the numbers say for more about the 2018–19 Innovation Initiatives). We provided them with funding and tailored coaching supports to implement and evaluate their initiatives. We also opened the call for submissions for our third grant cycle.

Over the next year, we will provide coaching and other supports to seven agencies who are implementing exciting projects addressing access issues in their communities. Collectively, these projects are supporting mental health from infancy to early adulthood and addressing barriers, such as wait time, culture and language, stigma, geography and health literacy.

To find out more on our 2019–20 projects, click to download.

Innovation Initiatives 2019–20
  Innovation Initiatives
  2018–19 2019–20
Investment $400,000 $350,000
of projects
10 7

To find out more on our 2018–19 projects, click to download.

Innovation Initiatives 2018‑19

Innovation Initiatives 2018–19

  1. Designing culturally relevant treatment for east Asian Canadian, Toronto
    Project partners’ plans for a culturally-appropriate adaption of cognitive behavioural therapy were stalled by a delay in ethics approval, so the work has been extended through September 2019.
  2. Testing a culturally appropriate, youth-designed resilience program for Indigenous youth, London
    Despite a community tragedy that led to a rescoping of the project, the youth-designed resilience program was delivered to 193 youth and 51 of their family members. Findings from the pilot were so positive that there was unanimous support for the program to continue.
  3. Infant mental health clinics in community hubs, London
    After their successful pilot reached over 260 families who might not otherwise have sought mental health help, Vanier Children’s Services has fully implemented the infant mental health clinics, funding them under their core services.
  4. Building culturally appropriate services for African Canadian youth, Toronto
    YouthLink increased internal capacity to provide culturally appropriate services for Black youth, deepened relationships with the diverse African Canadian community in Scarborough and built an agency-wide Anti-Black Racism agenda. They also created long-term committee structures that will use this lens to develop the agency’s next strategic plan and shape all its programs, policies and partnerships.
  5. Virtual walk-in clinic for youth, North Bay
    Hands TheFamilyHelpNetwork.ca’s project culminated in preliminary designs for two virtual service pathways: support by videoconference and web chat consultation. The agency is seeking further resources for implementation.
  6. Collaborating to develop an early intervention to foster better mental health outcomes for children of parents with a mental illness, Windsor
    Project partners have convened a community of practice and co-designed resources to support children affected by parental mental illness. Results will be forthcoming after the work wraps up in June 2019.
  7. Improving access to culturally appropriate holistic arts based programming for Indigenous children and youth, Grey-Bruce
    Project partners trained 35 local facilitators to bring evidence-informed, holistic arts-based programming to Indigenous and non-Indigenous children and youth in rural Grey Bruce schools, resulting in improved emotional regulation, mood, coping and social skills, self-esteem, empathy and attention amongst participants.
  8. Cross-sector coordination of community services for infant mental health, Cornwall
    Cornwall Community Hospital’s project created stronger service partnerships and a shared agenda for community action on perinatal, infant and toddler mental health concerns. Partners will continue to refine and pilot through 2019.
  9. Testing free mindfulness intervention for youth wait-listed for mental health services, Chatham
    Over 90 percent of youth who participated in the free mindfulness-based drop-in sessions said they had learned helpful ways to manage and cope with their worries. Given its impact, the agency is scoping resources to bolster and sustain the program.
  10. Managing waitlists with an interactive webinar-enhanced information and system navigation platform, Hamilton
    Child and youth mental health service providers in Hamilton engaged youth and families to co-design and pilot an online resource hub and webinar series to support youth and families waitlisted for services. The Centre is now supporting project partners to implement and test this intervention at full scale.

Connecting hundreds of families to infant mental health services

Vanier Children’s Services in London was one of 10 agencies who received funding in the Centre’s second Innovation Initiatives grant cycle in 2018–19. They used the funding to co-create and evaluate infant mental health drop-in clinics in neighbourhood-based, multi-service Family Centres throughout their community. Their clinics offered single session therapy focused on the parent and infant relationship (PAIR) as well as informal consultation services during early years drop-in groups.

By integrating the clinic into existing Family Centres, Vanier was able to access families who would not normally have sought mental health services due to stigma or other barriers. As a result, they were able to provide early intervention and targeted prevention services for over 260 families who otherwise might not have received such services.

Over a third of the 42 infants who participated in therapy sessions with their caregivers presented with attachment challenges, and many of the families experienced other family factors or risk factors for toxic stress. This included parental mental health challenges, family isolation, settlement issues, history of trauma, post-partum depression, addiction and exposure to violence. Some families received multiple sessions and close to one third of all families who participated in therapy sessions were referred to Vanier for more intensive supports. Another four were referred elsewhere for other supports.

At the end of the pilot, 93 percent of parents said they felt more confident in their ability to connect with their baby and 97 percent said they felt better able to give their child the emotional care needed. Family Centre staff members also said they better understood the social and emotional challenges associated with infants and parents and 96 percent felt better prepared to initiate discussions with parents when they felt concerned about a child’s social or emotional needs.

With the data from the pilot Vanier was able to see the value in re-allocating funding and made the decision to continue to fund the PAIR clinic under their core services. They are now seeking additional funding to maintain the professional development component for Family Centre staff.


Investments: Rent and administration: $813,103.43; Office supplies and expenses: $205,776.31; Purchased services: $357,715.41; Innovation initiatives, demonstration projects and capacity building grants: $516,130.90; Provincial learning events and meetings: $294,195.85; Staff travel and accommodation: $215,160.18; Staff training and development: $53,189.12; Salaries and benefits: $3,239,017.00; Total: $5,869,011.62. Investments: Rent and administration: $813,103.43; Office supplies and expenses: $205,776.31; Purchased services: $357,715.41; Innovation initiatives, demonstration projects and capacity building grants: $516,130.90; Provincial learning events and meetings: $294,195.85; Staff travel and accommodation: $215,160.18; Staff training and development: $53,189.12; Salaries and benefits: $3,239,017.00; Total: $5,869,011.62.

Continuing to raise the bar:
A look ahead

Girl using her fingers as binoculars

Focus on
integrated care

We continue to work to better connect primary care and community-based mental health services throughout Ontario. Standardized pathways — coupled with reliable screening tools like the quick and easy-to-use HEADS-ED — improve patient experience and outcomes. They ensure that families aren't stuck bearing the brunt of navigating a complex system and that primary care providers have the tools they need to quickly and confidently make the best decisions for patient care.

Boy with fidget spinner

Champion the
early years

Children and youth have different mental health needs than adults. We help the Ministry of Health and health teams work across the lifespan by speaking to the different needs of each developmental phase, and especially those of our youngest Ontarians. In the coming months we will lead the implementation of two recommendations emerging from our latest policy paper, Beyond building blocks: Investing in the lifelong mental health of Ontario’s three- to six-year-olds and work on validating the HEADS-ED tool as adapted for birth- to five-year-olds.

Boy holding a trophy

Bolster digital
and e-mental health

As the provincial government has said, digital health tools and options “have not kept pace with the growing technological sophistication of Ontarians.” Digital and e-mental health is one of our strategic impact areas. About half of the Innovation Initiatives we are currently supporting integrate technology in some capacity. Given the rapid emergence of digital health and its promising opportunities, we are now also exploring the development of a new quality standard on the use of technology to deliver mental health services.

Girl looking at a tablet

Set more
quality standards

Quality standards are essential to a system that is accountable and constantly improving. They are also central to ensuring that Ontario children, youth and families access and receive consistent high-quality mental health services wherever they are within the province. Over the next year we will develop implementation and coaching resources with our advisory group, to support the implementation of our newly developed youth and family engagement standards. We will also begin to develop new quality standards. We are exploring several possibilities, including data sharing and the use of technology to deliver mental health services.

Girl wearing a construction hardhat pointing upward with a pen