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Recent articles in CMAJ and elsewhere have illuminated the ongoing concerns about the capacity of children's mental health services.1–3 These articles have correctly attempted to focus the attention of health policy-makers on the importance of providing succour to children who need basic mental health services and to their families. Failure to alter the current situation will no doubt have catastrophic consequences for our society. One may take away from the Kirby report a clear message of impending disaster for children, families and society.4
McEwan and colleagues1 praised the recent interest in children's mental health by the federal government.4 However, Kutcher and Davidson accurately identified the long-standing gap between need and capacity: there is simply not enough expert knowledge to go around.2
In August 1949, Paul Martin Sr., the federal minister of health at the time, identified children's mental health as a priority and indicated the need to expand all phases of service to increase treatment capacity.5 That the children's mental health agenda has been at the forefront of political concern for nearly 60 years is a testament of sorts.
At the 2007 Mental Health Research Showcase of the Alberta Mental Health Board, Vince Filetti presented results of a large study that may reshape current attitudes about providing adequate resources for children's mental health. The results of the Adverse Childhood Experiences Study (www.acestudy.org) show that people who experience trauma early in life have substantially more health problems and use more health services later in life than those who do not. Interestingly, Filetti's team found that patients who received an assessment that took into account indices of trauma during childhood used 35% fewer health services in the 2-year period after the assessment than patients who were assessed using a different approach. Felitti's findings on the negative impact of an early traumatic experience on subsequent health care use are both intriguing and ominous. As this work becomes more widely known, it will be increasingly difficult to ration the scant professional resources that are available to serve children with mental health needs in Canada.
Footnotes
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Competing interests: None declared.