Student mental health at a glance

What the data tells us about child and youth mental health in Canada:

Mental health concerns often begin early

• About 70% of mental health and substance use concerns begin in childhood or adolescence.
• In Ontario, approximately one in five students aged four to 17 meets criteria for a mental illness.
• The most common concerns for children and youth include:
  • anxiety disorders (generalized anxiety disorder, panic disorder, separation anxiety disorder, social anxiety disorder) mood disorders (major depressive disorder, persistent depressive disorder, bipolar disorder) attention-deficit/hyperactivity disorder (ADHD)
  • behaviour-related disorders (conduct disorder, oppositional defiant disorder)

Student experiences shifted during the pandemic

• During the pandemic, rates of reported psychological distress among young people, including symptoms of anxiety, depression and other mental health concerns, increased globally.
• Older adolescents, and particularly those identifying as female aged 15 to 17, were especially affected.
• In 2021, 39% of Ontario students reported that the pandemic negatively affected their mental health “very much” or “extremely.” This decreased to 27.1% in 2023.
• Several indicators of mental health suggest trends towards stabilization relative to pandemic period reports (e.g., declining rate of visits to the emergency room or hospital for mental health problems, stable rates of suicidal ideation and attempts and ratings of psychological distress), however, in most areas these rates are still higher than observed prior to the pandemic, especially for female adolescents.

Patterns of substance use and other addictive behaviours are changing

Alcohol and cannabis use among students has generally declined over the past two decades. The use of vapes/electronic cigarettes significantly increased between 2015 and 2019, followed by a decrease since then. However, significant increases have been reported for non-medicinal use of opioids and cough syrup.

During the pandemic, concerns related to:

• excessive social media use and
• Internet gaming and gambling

increased sharply, peaking around 2021 and declining somewhat by 2023, though not yet back to pre-pandemic levels.

How and where young people access care is evolving

During the pandemic, emergency department visits for mental health concerns increased. Recent data suggests:

• Overall hospital visits for children and youth aged 5 to 24 have declined over the past 5 years.
• More young people are receiving care from physicians in the community.
• Prescriptions for psychotropic medications have increased, alongside higher physician visits and lower emergency department use, suggesting a shift toward community-based care.

Some concerns remain elevated

• There was a significant increase in help-seeking for eating disorders during the early years of the pandemic.
• While emergency visits and hospitalizations for eating disorders have declined since, they remain higher than pre-pandemic levels, especially among females aged 10 to 17.
• Over the past five years, most mental health-related hospital visits involved females aged 15 o 17.
• Children and youth from lower-income neighbourhoods experience higher hospitalization rates but lower rates of physician visits.

Equity matters

Mental health is shaped by social conditions, identity and access to supports. Because of racism, marginalization and other inequities, some young people face greater risks than others.

For example:

• Indigenous youth experience higher rates of suicidal thoughts and behaviours than non-Indigenous peers. Access to culture, language and strength-based mental wellness and life promotion programming in schools and communities is protective.
• 2S/LGBTQIA+ youth are more likely than their cisgender heterosexual peers to experience:
  • mental health or substance use concerns (56% vs. 29%)
  • suicidal ideation (25% vs. 5%)

Family support and safe, affirming spaces at school are critical protective factors.

Service utilization: where young people get help

Many young people still face barriers to care:

• Despite growing need, access to appropriate mental health services remains limited, with only about one in five youth accessing care, and many continuing to report unmet needs.
• Barriers include limited availability, long wait times, stigma and challenges navigating the system.

Community and school-based supports matter

• More young people are now seeking mental health support in community settings rather than hospitals.
• According to the Canadian Institute for Health Information (CIHI), 74% of children and youth with early mental health needs accessed at least one community mental health or substance use service in 2024, up from 61% in 2022.
• In Ontario, schools are the most common first point of contact for students with mental health concerns:
• Approximately 40 to 45% of children and youth who receive mental health services access them in school-based settings, compared with about 25-30% who receive services through community mental health agencies.
• Between 2020 and 2021, 115,890 Ontario students received school-based mental health services.

For many students, prevention and early intervention services in schools provide the right support at the right time, in familiar, low-barrier environments. When students can access help early at school, fewer go on to need more intensive services in community or hospital settings.

Student voices

School Mental Health Ontario, in partnership with the Centre for School Mental Health at the University of Western Ontario, gathered input from students across Ontario about their priorities for mental health learning and programming in their school communities. The #HearNowON survey and focus groups were conducted in 2019, 2021 and 2024/2025.

Five key findings were identified through #HearNowON 2024:

1. Students want mental health to be meaningfully incorporated into their education.
2. Students want their parents and caregivers to be equipped to support their mental health.
3. While not all students are interested in school mental health leadership, they are aware of opportunities to promote mental health at school.
4. Students recognize the connection between identity and mental health, and value opportunities to celebrate their own cultures and identities and learn about others as a way to bolster connectedness at school.
5. Many students know where to find mental health support at school and have at least one trusted adult they can turn to.

Learn more: #HearNowON 2024: Student Voices on Mental Health – Final Report

The Thrive student web page  was created alongside students across Ontario. The Thrive student group supports School Mental Health Ontario on a variety of projects related to improving student mental health and reducing stigma.

Parent/caregiver voices

The By Your Side Resource Hub was created alongside a team of parents/caregivers and school mental health professionals to meet the needs identified.

The role of schools in mental health and substance use health

Schools are an ideal place for mental health promotion, prevention and early intervention. Supporting mental health at school encourages wellness, enhances learning and carries economic benefits.

It takes a village

Supporting the mental health and well-being of young people in Ontario, particularly in the years following the pandemic, requires coordinated efforts across ministries, sectors, organizations and communities. While young people and their families can learn about ways to nurture their mental health and can build strategies to support personal resilience at an individual level, advances in overall well-being will be better achieved when we work and think as a community. Proactively wrapping effective supports and services around young people and their families, before mental health concerns escalate, is responsive and cost-effective.

An integrated system of care is a comprehensive spectrum of services organized into a coordinated network of care that is centred on meaningful partnerships with young people and their families. The services within this network are culturally responsive and span mental health promotion, prevention and more intensive treatment services. An integrated system of care involves three central characteristics:

1. Integration – coordination and cohesion across key aspects of the design and delivery of care systems that are fragmented, so that parts are combined to form a whole.
2. Care – delivery of evidence-informed, culturally-responsive services across a continuum of care (mental health and substance use health promotion, prevention, early identification, early intervention, core and intensive treatment).
3. Person-centred– collaboration with people who use services, centring their unique identities and intersectionalities, and ensuring they have the knowledge, skills and confidence they need to more effectively manage their care.

The role of schools

Schools play an important role in an integrated system of care. Young people spend a significant portion of their lives at school, making schools well-positioned to support mental health and well-being.

Schools are an excellent place for students to:

• build positive mental health habits
• develop mental health and substance use literacy
• have early signs of concern noticed and supported
• access prevention and early intervention services

Supporting student mental health at school

At times, students may not be able or willing to access services outside of school, or may require immediate crisis intervention. School mental health professionals are available to provide stabilization and short-term support while next steps are coordinated.

Everyone has a role

Mental health and academic learning

Mental health and academic achievement go hand in hand. When students are mentally well, they’re more available for learning. Research has linked mental health promotion programming, including participation in high-quality social-emotional skill development at school, with students’ emotional wellness and their academic achievement. Further, for young people who experience mental health problems, evidence suggests that early identification and intervention is key to supporting more positive life trajectories. That is, when students get the help they need for their mental health early, they do better in school and have more positive long-term outcomes. Given that school is the first place that most young people seek help for mental health problems, having appropriate, accessible and responsive supports available is important.

The return on investment in school mental health

Effective school mental health practices make economic sense. Across many jurisdictions, studies have shown that investing in mental health promotion early yields a strong return. For example, economic models from the UK show a significant return on investment for social emotional learning (83.73 £ Return/£ Invested) and anti-bullying programming (14.35 £ Return/£ Invested). Studies in Canada indicate particular value for early years mental health promotion ($6-16 Return/$ Invested). It has also been noted that investments in school mental health yield cost savings in other sectors such as health and justice.

Ontario has invested in school-based mental health promotion, prevention and intervention services with the goal of strengthening protective factors for all students, providing early support when challenges arise, and ensuring effective pathways to more intensive services when needed. While this investment in and of itself cannot be expected to immediately reduce child and youth mental health disorders, particularly in the years following a global pandemic, it provides an important contribution to an integrated system of care designed to offer comprehensive wraparound mental health support to young Ontarians and their families.

The multi-tiered system of support

Across the globe, a Multi-Tiered System of Support (MTSS) approach is seen as foundational for school mental health service delivery. This structure helps to establish priorities, clarify roles and ensure service coordination and quality within a complex and evolving field. Broadly, it includes a continuum of services: mental health promotion, early identification and support, prevention and early intervention and intensive supports and service pathways for more complex mental health needs.