Electronic Thesis and Dissertation Repository

Thesis Format



Master of Arts




Stewart, Shannon L.

2nd Supervisor

King, Colin


Ontario’s capacity to treat children and adolescents in mental health crisis is outweighed by the number and needs of individuals requiring treatment. A lack of standardized assessments for prioritizing individuals has contributed to long wait times for treatment and a paucity of information to help prioritize those requiring urgent services. This study examined whether sector (e.g., school, hospital), sex, age, legal guardianship, interpersonal and school conflict, intellectual disability and comorbid health conditions predicted greater mental health service urgency in 61,448 children (ages 4 to 18 years) assessed using the interRAI Child and Youth Mental Health Screener. Additionally, differences in mental health state indicators across sectors were examined. Binary logistic regression revealed that all predictors, except for sector, showed a significant effect on service urgency. Kruskal-Wallis testing supported differences in mental health states across sectors. Findings are instrumental in prioritization, reducing the likelihood that children with acute needs remain on waitlists.

Summary for Lay Audience

Many children and adolescents experience mental health problems. However, only approximately 25% who actually need services receive them. Evidence-based approaches to triaging and prioritizing mental health services for children and adolescents are desperately needed, but it is unclear which children and adolescents are being properly prioritized due to the lack of standardized evaluations in Ontario. Current practices in the province are resulting in long wait times to be connected to mental health services, which has a negative impact on children’s well-being. Using an assessment developed to assist with prioritizing children and adolescents for mental health services, this study explores characteristics associated with a greater need for urgent mental health services. This study also compares the rates of common mental health problems across schools, hospitals, Local Health Integration Networks, and mental health agencies. The results of this study provide the opportunity to better understand the character profiles of children and adolescents currently receiving services and the factors influencing urgency for mental health services. In turn, this could change current practices in the Ontario mental health care system and improve the lives of children and adolescents who require resources and are being placed on ever-growing wait-lists.