”(Too many) people are navigating grief, anxiety, neurodivergence, family breakdown, academic pressure, unemployment and major life transitions without timely access to care,” writes Ajirioghene Evi. “Too often, they reach the mental health system only once distress has escalated into crisis.”

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Recent findings from the Centre for Addiction and Mental Health confirm what social workers across Ontario are already seeing every day. Rates of psychological distress are historically high.

Despite sustained public attention, investment and conversation, the mental health system is falling further behind. More people are asking for help, which is a good thing. But too many are waiting too long, paying too much, or falling through the cracks altogether.

People should not have to reach a breaking point before support is available. Yet people are navigating grief, anxiety, neurodivergence, family breakdown, academic pressure, unemployment and major life transitions without timely access to care. Too often, they reach the mental health system only once distress has escalated into crisis.

Since the pandemic, there has been a 136 per cent increase in hospitalization rates for youth with mental health and addiction concerns. One-in-three young people in Ontario report a mental health need that is not being addressed.

From the perspective of social workers, this is a problem. The later we arrive, the harder the work becomes. Early intervention is not a slogan. It’s the difference between prevention and emergency response.

This is why schools and primary care matter so much. For children and youth, schools are where stress, anxiety, and early warning signs most often show up first.

When it comes to adults, primary care is usually the front door to the mental health system.

Yet both settings — schools and doctor’s offices — are stretched thin. In a survey, 91 per cent of schools report needing additional support for mental health.

In primary care, mental health concerns account for roughly one-in-five visits to family physicians in Canada and most primary care practices in Ontario do not have embedded mental health professionals. Too often, patients leave with a referral, not support, and join another wait-list.

Into that gap has stepped something else. People are increasingly turning to artificial intelligence. Not because it is clinically appropriate or safe, but because it is immediate, free and always available.

A teenager who feels overwhelmed at midnight does not encounter a wait-list or a referral form when they open a chatbot. They get a response. That should concern us. AI is not a substitute for human care. For vulnerable young people, it carries real risks. But its appeal tells us something important about where the system is failing to show up.

Our mental health workforce infrastructure has not kept pace with rising need. We are using tools designed for a different era to respond to a problem that has fundamentally changed.

Early intervention only works when people trust the system enough to use it.

Mental health support is most effective when it is visible, relational and integrated into everyday settings like schools and primary care. But it must also be culturally responsive.

Social workers bring lived experience, cultural humility and deep community knowledge into their practice. Many reflect the communities they serve, including Black, Indigenous, racialized, newcomer populations facing systemic barriers and historical trauma.

When care feels familiar and grounded in dignity and belonging, people seek help earlier. For Black and Indigenous youth especially, culturally grounded care is not optional. It is essential to preventing escalation and making early intervention real.

Evidence suggests that when mental health professionals are engaged earlier and more consistently in schools and primary care settings, outcomes improve and pressure on hospitals and emergency services is reduced.

This was demonstrated in a 2023 study based in a rural Ontario community that piloted a school-based social worker role. The social workers were able to intervene quickly and, when needed, connect families to appropriate community services and help parents navigate tricky mental health systems. Overall, teachers and principals reported student distress was identified earlier, before behaviours escalated to crisis.

If we want to meet people where they are and before distress becomes crisis, we must properly resource the system. That means dedicated, sustained funding for mental health workers in schools so every student has access to early support. It means embedding mental health workers as core members of primary care teams across the province. And it means recognizing that mental health care is not only about treatment, but about connection, dignity and belonging.

A mental health system that waits for crisis is not care. It is delay. We must find new ways to invest in early, visible and embedded support.

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By Ajirioghene Evi Contributor

Ajirioghene Evi is a registered social worker and CEO of the Ontario Association of Social Workers.

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