A Closer Look at Child and Youth Mental Health in Ontario
An Auditor General's report reveals major challenges in wait times, access to care, and funding for the province's youngest residents.
Welcome to your briefing on the latest from Queen's Park. This week, we’re diving into a comprehensive report from Ontario's Auditor General that puts the province's Community-Based Child and Youth Mental Health (CYMH) program under the microscope.
The 2025 performance audit examines how effectively the Ministry of Health (MOH) plans, funds, and oversees mental health services for children, youth, and their families. It's a detailed look into a system that serves some of our most vulnerable citizens. Here is a neutral, factual summary of what the official report found.
The Big Picture: Key Findings
According to the Canadian Mental Health Association, an estimated one in five children and youth in Ontario will face a mental health challenge. The audit provides a high-level assessment of the system designed to support them.
The Auditor General’s main conclusion is that the Ministry of Health "did not have fully effective processes in place" to plan and oversee the mental health services delivered by community agencies. The report states that services were not always provided in a "timely, equitable and co-ordinated manner" and that funding did not fully reflect the needs of different communities across Ontario.
The audit contains 22 recommendations to address the issues found, all of which the Ministry of Health has accepted.
Long Waits and Uneven Access ⌛
A central issue highlighted in the report is the time children and youth spend waiting for care, and the inconsistent availability of services across the province.
Wait Times: In 2023/24, the average wait time for intensive treatment services was 105 days. The wait for counselling and therapy services increased from 104 days in 2022/23 to
120 days in 2023/24.
Measuring Waits: The audit found that the way Ontario measures wait times does not align with the pan-Canadian standard set by the Canadian Institute for Health Information (CIHI). This difference understates the actual client wait by as many as 10 additional days.
Service Gaps: Access to the most intensive services is not uniform. Of the 33 service areas in the province, 13 do not have live-in treatment services. Furthermore, secure treatment programs, the highest level of community-based intervention, are only available at three agencies, all located in the Greater Toronto Area and eastern Ontario. This means youth from northern and western Ontario must travel significant distances from their families to receive this care.
A youth from Northern Ontario shared their experience:
"When you don't have services that are available close to home and those that are available have long wait times, you have to leave your home to find services that are very far away. It's easier to deal with it on your own, which many of my friends had to do, even in times of crisis. It's lonely, and sometimes it can get very serious and lead to hospitalization, but it feels like we don't have any other choice." - Youth, 19, Kapuskasing
A System Divided: Coordination Challenges
The audit points to a fragmented system, particularly for youth transitioning to adult services and those with complex needs.
For more than a decade, a key recommendation has been to consolidate all mental health and addictions programs under a single body. However, the report finds the child/youth and adult mental health sectors remain overseen by two separate entities: the Ministry of Health and Ontario Health, respectively.
This separation creates a "transition cliff" for young people who age out of the children's system at 18.
Jane recently graduated from high school and was experiencing anxiety... Her mother reached out to a local CYMH agency for help. Jane received brief services that she "got so much out of," but was only able to attend two sessions before she turned 18. When Jane's mother asked for adult-related resources, the agency told her that very limited subsidized or free resources were available to adults in the area. - Client Story 3 (
Name has been changed to protect privacy)
Another anonymous youth described the feeling of being left without support:
"My transition from the youth system into the adult system felt very lonely. The only supports I was aware of were for youth, so once I aged out I had nowhere to go and no one to turn to that could help me even find services for adults. My lack of a transitional plan resulted in me giving up on finding services in general." - Anonymous Transition-Aged Youth
The report also found that services are not well-integrated for youth with concurrent mental health and addictions disorders. A survey of CYMH agencies revealed that
70% felt available services are not sufficient to meet the needs of these youth.
Serving All Communities: Data and Diversity
The audit found that the Ministry has limited information to confirm that care is being provided effectively to clients from marginalized communities.
A key reason for this is incomplete data. The Ministry only began requiring agencies to submit client information on race and ethnicity in late 2023, and the data submitted has been incomplete. An analysis from January-March 2024 found that
86% of active client records submitted by agencies did not include race-based data.
A youth from Scarborough shared how this can impact care:
"When you access services, people will make assumptions about your race and even your gender; address you with the incorrect pronouns. And sometimes if you do not fit the racial stereotype, they will assume that race is no longer a part of youth identity. Race affects other parts of my identity and it is a part of my identity. It should be acknowledged appropriately." - Youth, 17, Scarborough
Follow the Money: Funding and Staffing 💰
The audit identified significant issues with how the CYMH program is funded and staffed.
Outdated Funding Model: The base funding for agencies was determined decades ago and is not tied to performance or the current needs of communities.
Unspent Funds: As of July 2024, an estimated $64 million in funding that agencies reported as unspent between 2020/21 and 2022/23 had not yet been recovered by the Ministry.
Staffing Shortages: The report points to significant pay disparities for clinical staff in CYMH agencies compared to those working in schools or hospitals, contributing to major challenges in recruiting and retaining staff. A 2023 review showed wage gaps of 20% to 50%.
High Turnover: The audit found 84% of agencies faced challenges recruiting and retaining qualified clinical staff. High turnover means children and families must often restart their journey with new clinicians.
A parent described the impact of staff turnover:
"What has been most soul crushing is feeling like we have to justify every decision we've ever made as her parent from the time we got pregnant to the time we've sought services. It's exhausting to have to explain over and over again our story because every time our clinician changes, we have to refill in the same forms, we have to go through the same questions." - Liz (
Name has been changed to protect privacy)
The Path Forward: Recommendations
The Auditor General's report outlines 22 recommendations aimed at strengthening the system. The Ministry of Health has agreed to all of them. Key actions include:
Assessing service gaps across the province and creating a plan to improve access to intensive services.
Establishing common, modern wait-time definitions that align with national standards.
Developing a Human Resources strategy to address staff shortages and wage gaps.
Improving the collection and analysis of identity-based data to ensure equitable care.
Completing outstanding financial reconciliations and recovering unspent funds from agencies.
The Ministry has stated it will work with its partners, including Ontario Health and the Lead Agency Consortium, to address these complex issues.
This report covers a lot of ground on the state of child and youth mental health services in Ontario. Which of these findings matters most to you and your community? Share your thoughts below. 🇨🇦