Supports and Systems to Respond to Complex Needs Among Children and Youth in Ontario

Issue: How can systems best support children with complex behavioural and mental health needs to improve health, social, and other developmental outcomes, and reduce harm? 

Background: In Ontario, there is growing concern about the inadequate supports for children and youth with complex needs – defined as multiple diagnoses or behavioural problems spanning multiple service sectors, which are anticipated to have long-term consequences. These children often face exclusion from services due to various barriers, including the complexity of their conditions and broader systemic issues. The lack of coordination across systems further complicates the situation, leading to a fragmented care landscape for these children and their families. 

Objective: This report provides an overview and synthesis of the available literature relevant to complex mental health and behavioural needs among children and youth from a transdisciplinary perspective. The primary aim is to inform the development of evidence-based, cross-sector solutions to support optimal development and health equity for children and their families. Key Findings: Overall, findings from the literature revealed that multiple initiatives to support children and youth with complex needs do exist at the local level across Ontario; however, the province is still lacking a well-coordinated or integrated approach across child-serving public sectors (health, education, social services, youth justice). As a result, children and families with complex needs continue to experience challenges in accessing and receiving appropriate services and supports, resulting in inadequate treatment and care. Another theme from the literature is the need for improved coordination and collaboration across systems and services. There is support for a systems of care approach to improve the quality and consistency of care for children and youth with complex needs; however, the lack of strong evidence and guidance around systems of care has limited its implementation thus far in Canada. Policy 

Implications: Because of the complexity of their multiple challenges (i.e. behavioural, emotional, mental health, developmental, educational), it is clear that a “one size fits all” approach will not be enough to meet the needs of these children and families, as no single sector or agency has the necessary capacity to address these challenges effectively. There is a need for integrated solutions that break down existing silos and work towards a more holistic, whole systems approach ̶in which all child-serving systems collaborate and acknowledge their shared responsibility to not only meet the needs of these children but to help prevent them before they escalate and reach the point of crisis.