Residential Treatment: Working Towards a New System Framework for Children and Youth with Severe Mental Health Needs


Since 2015, CMHO has been leading an in-depth policy initiative bringing together service providers and system stakeholders, including associations, children, youth and families to consider solutions to the complex challenges facing the child and youth residential treatment sector.

Residential treatment is an out-of-home intervention where children and youth with complex mental health needs receive intensive clinical treatment, careful 24-hour supervision, family therapy, and support for daily activities such as school, recreation and socializing.

Ontario’s residential treatment system has evolved over decades in the absence of a provincial strategy or service plan. This has resulted in a series of challenges, including: residential service providers being forced to close beds due to chronic underfunding; in-patient hospitalization rates rising due to lack of residential treatment programs; children and youth accessing high-cost programs outside the province due to insufficient capacity at home; and Northern children and youth being required to access treatment too far from home.


This report presents timely and solutions-oriented recommendations based on in-depth consultation across many groups of stakeholders. In particular, it examines the need to:

- differentiate services based on the needs of the children, youth and families with a proposed provincial system design framework for residential services;
- scale-up investment in existing community-based residential treatment programs for those with the most complex mental health issues, to meet the demand for services; and
- spread the development of new, intensive non-residential programs demonstrating strong outcomes through investment and removal of the barriers to re-purposing existing funding.

Specifically, the following policy and program elements were identified through CMHO’s work as being critical to the design and function of our future model of care for children, youth and families with highly complex needs:

1. Using standardized mental health assessments to deliver stronger outcomes
2. Providing intensive residential treatment that matches the needs of children and youth
3. Building intensive alternatives to residential treatment
4. Building after-care programs as a key component of intensive programs – residential and non-residential


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