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The privatization agenda in children’s mental health

Three OPSEU units in the child treatment sector have taken strike votes in 2015: OPSEU Local 511, Radius Child and Youth Services, OPSEU Local 539, George Hall Family and Child Services and OPSEU Local 666, Child and Family Centre Sudbury.

Collective bargaining in the child treatment sector is occurring against a backdrop of dramatic service restructuring that threatens the stability of a highly specialized workforce. Mental health workers are concerned about the disruption of services to clients, the potential of the opening of for-profit services funded by public dollars, and the impact of funding constraints on how services are delivered.

The need for children’s mental health services has increased while funding has almost been stagnant for over two decades. The Ministry response to this growth in demand has been to restructure rather than invest and to further download accountability to third party agencies. 

There are currently 472 agencies that are funded directly by the Ministry of Community and Youth Services, (MCYS) to provide children’s mental health services across Ontario. Under the new MCYS service framework, “Moving on Mental Health,” the Ministry will designate 33 Lead Agencies to coordinate and directly fund services, shifting its funding responsibility onto Lead Agencies within the next three years. 

Lead agencies will be responsible to ensure that children’s mental health services are available in local communities and will administer funding to sub-contract services. In addition, they will also continue to provide direct service.  

This model of service provision parallels that of the Community Care Access Centres in the health sector which have had innumerable problems delivering quality, accessible services in the communities that they serve. 

Mental health professionals are deeply concerned about the introduction of wholesale sub-contracting out of mental health services. Rather than fund agencies directly to develop the best practices to meet community needs, the Ministry will allocate a set amount of dollars and ask Lead Agencies to provide services based on what the funding “can buy.” 

The danger with this business model is that it will force agencies into competition with each other to ‘win’ funding from the Lead Agency. Inevitably, this new form of service delivery will leave the actual needs of children and families behind.

Children’s mental health services should not be determined by the lowest bidder.

Ultimately Ontarians will pay more for children’s mental health services in a system of sub-contracted out services. Under this new model of service planning the Ministry is taking an arms-length approach, further distancing itself from exercising direct oversight of services and instead focusing on imposing ‘accountability agreements’ and ‘performance indicators’ to justify funding.

This approach to delivering services runs counter to the notion that services should be developed according to what children and youth need to be healthy. A service model based on meeting pre-determined funding requirements rather than client treatment needs, risks undermining clinical interventions that address the whole child, such as coordinated service collaboration and will limit access to services considered ‘too expensive’ such as residential treatment placements.

The emphasis on funding, “getting value for money,” will encourage the development of a new model of service that promotes short-term intervention and less time available working across disciplines to ensure that children have the best chance to succeed in all areas of life. 

Children need stability and help they can count on.

The OPSEU Children’s Treatment sector is committed to continue to promote and defend an accountable, publicly-delivered and funded agency system for children and youth. A service model that is informed by asking first, what do children and youth need?