title: Mental Health Service Use Among Children and Youth in Ontario: Population-Based Trends Over Time.
abstract: Little is known about mental health service use among Canadian children and youth. Our objective was to examine temporal trends in mental health service use across different sectors of the health care system among children and youth living in Ontario.
  
  
  
  We conducted a population-based, repeated annual cross-sectional study of mental health service use, including mental health- and addictions-related emergency department (ED) visits, psychiatric hospitalizations, and mental health-related outpatient physician visits using linked health administrative databases. Subjects included Ontario residents between 10 and 24 years of age. We tested temporal trends between 2006 and 2011 using linear regression models.
  
  
  
  Between 2006 and 2011, the relative increase in rates of mental health-related ED visits and hospitalizations were 32.5% and 53.7%, respectively. The absolute increase in anxiety disorders, the most common reason for ED visits, was 2.2 per 1000 population (P < 0.001) while mood and affective disorders, the most common reason for hospitalizations, showed an increase of 0.6 per 1000 population (P < 0.01). The overall relative increase in rates of outpatient visits was 15.8%, with the largest absolute increase found among family physician visits (28.7 per 1000 population, P = 0.01).
  
  
  
  Mental health care use for children and youth is increasing over time in all sectors, but appears to be increasing at a greater rate in the acute care sector. Further research is required to understand whether the observed differences reflect difficulty with access to outpatient care.
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario.
authors.forename: Sima
authors.initials: S
authors.lastname: Gandhi
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario.
authors.forename: Maria
authors.initials: M
authors.lastname: Chiu
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario.
authors.forename: Kelvin
authors.initials: K
authors.lastname: Lam
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario McMaster University, Hamilton, Ontario.
authors.forename: John C
authors.initials: JC
authors.lastname: Cairney
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario University of Toronto, Toronto, Ontario.
authors.forename: Astrid
authors.initials: A
authors.lastname: Guttmann
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Ontario Centre for Addiction and Mental Health, Toronto, Ontario paul.kurdyak@camh.ca.
authors.forename: Paul
authors.initials: P
authors.lastname: Kurdyak
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D000328:Adult; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006302:Health Services Research / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009864:Ontario; D055815:Young Adult
keywords: acute care; adolescent; child; emergency department; mental health; outpatient; psychiatric services; service utilization; trends