Are mental health services for children distributed according to needs?
OBJECTIVE
The purpose of this study was twofold: 1) to determine whether publicly funded mental health services and resources available in 4 large regions in the province of Quebec were distributed according to the mental health needs of children aged 6 to 14 years and 2) to assess whether the variations in mental health services and resources across the 4 regions had changed over a 5-year period.


METHODS
Indicators of need according to the child's parent (presence of mental disorder, measure of adaptation, and perception of need for help) from an epidemiologic survey of 2400 noninstitutionalized children were compared with both in-school and community professional resources and with physician and hospital services in 1992-1993. Resource and service data were also collected for 1997-1998. Resource and service data came from professional colleges and government administrative databases.


RESULTS
No significant regional differences were found for need indicators, but there were large discrepancies in mental health resources and services in 1992-1993. Differences in professional resources were largest for special education teachers in the school system and for psychiatrists in the community. The regional differences in resources and services were as large in 1997-1998 as they were in 1992-1993.


CONCLUSIONS
Despite universal health care in Quebec and a government mental health policy stressing equity of access, the available mental health resources for children aged 6 to 14 years are not distributed across regions according to needs. More evidence-based planning is required, specifically using epidemiologic survey data, to match resources to needs and to monitor changes over time.
Blais
Régis
R
Department of Health Administration, Groupe de recherche interdisciplinaire en santé, Université de Montreal, CP 6128, succursale Centre-ville, Montreal, QC H3C 3J7. regis.blais@umontreal.ca
Breton
Jean-Jacques
JJ
Fournier
Mylène
M
St-Georges
Marie
M
Berthiaume
Claude
C
D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data / Q000600:supply & distribution*; D006295:Health Resources / Q000600:supply & distribution; D006301:Health Services Needs and Demand; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D008605:Mental Health Services / Q000706:statistics & numerical data / Q000600:supply & distribution*; D011792:Quebec / Q000453:epidemiology; D012040:Regional Health Planning; D000078329:Workforce