MONTREAL — Many young Canadians need community-based mental healthcare services, but access to these services remains uneven, according to research presented at Public Health 2026, the annual meeting of the Canadian Public Health Association.

“Mental health and substance use conditions are very common across Canada,” said Shatabdy Zahid, MPH, public health researcher at the Canadian Institutes for Health Information, during her presentation of the findings. “About 20% of Canadians experience mental health or substance use issues in a given year, and about a third of them experience mental health illness in their lifetime.”

While progress has been made in recognizing and treating these individuals, “many do still struggle to find care that is both timely and appropriate for their needs,” she said. We also know that when it’s not treated, this can have a profound impact on people‘s lives.”

‘Focus on Youth’

To better characterize and understand gaps in mental healthcare in Canada, Zahid and colleagues explored the following indicators by age, sex, and geography across Canada: Canadians with a mental health disorder who have an unmet need for mental healthcare, wait times for community mental health counseling, and youth aged 12-25 years who access Integrated Youth Services (IYS). In addition, they looked at same-day or next-day access to a primary care provider.

The investigators focused on youth, explained Zahid, because “an increasing number of young people experiences challenges in mental health and substance use, and studies have shown that young people are more likely to experience mental illness or substance use disorders than any other age group.”

Reports have shown that positive mental health decreased and mental illness increased among youth aged 12-25 years from 2018 to 2021, she noted. “While supports for children and youth mental health have improved, many continue to face barriers — especially things like long wait times or limited availability to community services. For this age group especially, timely and early support is absolutely critical.”

The analysis also revealed that unmet mental health needs, defined as having a diagnosis of a mental health disorder but reporting that those needs were unmet or only partially met, were highest among young adults aged 18-34 years (52%), followed by adults aged 18 years and older (41%), and children and youth aged 2-17 years (36%). Among children and youth, unmet mental health needs were greater for girls (40%) than boys (32%).

Access to a primary care doctor, who is often the preferred point of contact for accessing mental health support, was sparse: 89% of children and youth did not have a designated primary care provider, and only 42% were able to see one on the same day or the next day for mental health support.

Of note, wait times for community mental healthcare were longer for adults aged 18 years and over, at 34 days, compared with 24 days for youth aged 1-17 years. Wait times were longer for patients living in urban vs rural areas (41 vs 25 days). 

Efforts at Improvement

The good news, reported Zahid, is that “there‘s work being done to expand mental health and substance use services among children and youth.” For example, she noted, IYS provides mental health, substance use, and well-being supports for youth aged 12-25 years. Between 2023 and 2024, the use of IYS rose, with a 28% increase in access and a 35% increase in visits. Thirty-eight new sites were added to the network at that time, as well. The heaviest use of IYS was among those aged 17-18 years (20% of users). Girls and women used IYS services about twice as often as boys and men.

“When people can get access to mental health services quickly and easily in their communities, it helps them get access to support much quicker,” said Zahid. “It also makes it more [likely] they will manage their health before it becomes a crisis, and all of this while staying connected to their support networks.”

Other ongoing efforts to provide access to mental health services for Canadian youth, said Zahid, include prevention programs or school-based programs, investment in virtual care options, and building online platforms. Some models include tiered service delivery, where people are screened early to identify their needs and triaged for more appropriate levels of care. 

Furthermore, she said, work is being done to improve the recruitment, training, and retention of healthcare professionals. Other work with indigenous groups seeks to develop and expand community-based and culturally relevant mental health support, she concluded.

This research was supported by the Canadian Institutes for Health Information. Zahid reported having no relevant financial relationships.