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Article
Children’s Mental Health Need and Expenditures in Ontario: Findings from the 2014 Ontario Child Health Study
Canadian Journal of Psychiatry
  • Laura Duncan, McMaster University
  • Katholiki Georgiades, McMaster University
  • Stephen Birch, McMaster University
  • Jinette Comeau, King's University College at Western University Canada
  • Jinette Comeau, King's University College at Western University Canada
  • Li Wang, McMaster University
  • Michael H. Boyle, McMaster University
  • Michael H. Boyle, McMaster University
  • Tracie O. Afifi, University of Manitoba
  • William R. Avison, Western University
  • Graham Reid, Western University
  • Kathryn Bennett, McMaster University
  • Terry Bennett, McMaster University
  • Khrista Boylan, McMaster University
  • Michelle Butt, McMaster University
  • Charles Cunningham, McMaster University
  • Eric Duku, McMaster University
  • Jim Dunn, McMaster University
  • Katholiki Georgiades, McMaster University
  • Stelios Georgiades, McMaster University
  • Andrea Gonzalez, McMaster University
  • Geoffrey Hall, McMaster University
  • Magdalena Janus, McMaster University
  • Melissa Kimber, McMaster University
  • Ellen Lipman, McMaster University
  • Harriet MacMillan, McMaster University
  • Peter Rosenbaum, McMaster University
  • Roberto Sassi, McMaster University
  • Louis Schmidt, McMaster University
Document Type
Article
Publication Date
4-1-2019
URL with Digital Object Identifier
10.1177/0706743719830036
Abstract

Objective: To estimate the alignment between the Ontario Ministry of Children and Youth Services (MCYS) expenditures for children’s mental health services and population need, and to quantify the value of adjusting for need in addition to population size in formula-based expenditure allocations. Two need definitions are used: “assessed need,” as the presence of a mental disorder, and “perceived need,” as the subjective perception of a mental health problem. Methods: Children’s mental health need and service contact estimates (from the 2014 Ontario Child Health Study), expenditure data (from government administrative data), and population counts (from the 2011 Canadian Census) were combined to generate formula-based expenditure allocations based on 1) population size and 2) need (population size adjusted for levels of need). Allocations were compared at the service area and region level and for the 2 need definitions (assessed and perceived). Results: Comparisons were made for 13 of 33 MCYS service areas and all 5 regions. The percentage of MCYS expenditure reallocation needed to achieve an allocation based on assessed need was 25.5% at the service area level and 25.6% at the region level. Based on perceived need, these amounts were 19.4% and 27.2%, respectively. The value of needs-adjustment ranged from 8.0% to 22.7% of total expenditures, depending on the definition of need. Conclusion: Making needs adjustments to population counts using population estimates of children’s mental health need (assessed or perceived) provides additional value for informing and evaluating allocation decisions. This study provides much-needed and current information about the match between expenditures and children’s mental health need.

Citation Information
Laura Duncan, Katholiki Georgiades, Stephen Birch, Jinette Comeau, et al.. "Children’s Mental Health Need and Expenditures in Ontario: Findings from the 2014 Ontario Child Health Study" Canadian Journal of Psychiatry Vol. 64 Iss. 4 (2019) p. 275 - 284
Available at: http://works.bepress.com/graham-reid/6/