Understanding the integrated system of care for child and youth mental health
Supporting student mental health is a shared responsibility. Schools, community mental health organizations, families and health partners each have an important role in promoting well-being and ensuring students have access to the right support at the right time.
The integrated system of care
Ontario’s vision for school mental health, outlined in Right Time, Right Care, calls for a coordinated, equitable and identity-affirming system where students move smoothly between levels of care at school and in their community. With strong collaboration across sectors, disciplines and organizations, it is possible for every child and young person to have access to meaningful, timely and culturally responsive support.
Understanding ‘who does what’ within the system of care is an important part of the Right Time, Right Care vision. Broadly speaking, school settings are designed especially for mental health promotion, prevention and early intervention services. Community mental health settings offer more intensive therapeutic supports for children and youth with identified mental health or substance use health disorders. Hospitals and residential care settings offer highly specialized and intensive services for young people with significant complex needs.
Ensuring that there are no gaps between services offered in each setting is at the heart of the integrated system of care model described in Right Time, Right Care. Leaders in each setting work together to develop protocols for service navigation so that children, youth and families experience seamless care.
The graphic includes an upright triangle and an inverted triangle. Each triangle is divided into three sections.
The upright triangle on the left is labelled school-based mental health and includes:
- A large bottom section in green labeled first tier mental health promotion
- A slightly smaller blue section in the middle labelled second tier targeted prevention and brief services
- A small purple section at the point labelled tier three specialized consultation and assessment, family caregiver support, and therapy services
The inverted triangle is labelled community-based mental health services and is to the right of the upright triangle.
- Its point is a blue section and aligns with the middle blue area of the first triangle, which is labelled second tier. There are arrows between the sections of both triangles to depict how someone can move between the services available at tier two in school or the community.
- The section above the point is purple and larger. It aligns with the small tier 3 purple section on the first triangle. Again, arrows between the sections depict movement or collaboration between school and community services.
- Lastly, a large orange section is labelled fourth tier Intensive services: community-based and in-home treatment or in-patient/live-in treatment.
This graphic depiction of the aspirational service system suggests:
- School systems, shown in the triangle on the left, work together within this tiered framework, focusing on everyday wellness, teaching about mental health and noticing early signs of concern (green segment). They provide prevention and early intervention services (blue segment) and support students as they connect them to assessment and therapy services in the community and/or more intensive or specialized help when needed (purple segment). To learn more see: Every Student, Every School
- Community-based mental health agencies offer some brief services (blue segment) but focus primarily on assessment and therapy services (purple segment) and more intensive and specialized supports (orange segment) to ensure that children and young people receive the right support at the right time in the right place.
- Together, schools and community agencies form the basis for an integrated system of care. This means students can move smoothly between different levels of care, whether it’s promotion, prevention, early intervention or more intensive treatment, without facing barriers.
- Other service providers are also essential to this system of care, including public health, cultural, community and faith organizations, hospitals and helplines.
- Commitments to Truth and Reconciliation and equity are foundational. Services recognize and respond to the lived experiences of every student.
- Families and caregivers are active partners, helping to guide services and ensuring that supports reflect the student’s strengths, culture and needs.
Why this is important
An integrated system of care helps to clarify relative roles, identify and fill service gaps, communicate clear pathways to and from care and strengthen access to responsive services.
- Collaboration reduces confusion and helps students move easily between different levels of support.
- Shared accountability across education, health and community systems ensures that no student falls through the cracks.
- Identity-affirming partnerships recognize and respect the cultural and lived experiences that shape well-being.
- Trust and communication between educators, families and service providers build confidence and trust for students seeking help.
This connected approach makes mental health support stronger, more accessible and more equitable for every student in every Ontario school.
Building strong partnerships
Mentally healthy schools and systems collaborate by:
- establishing clear referral pathways and communication protocols between schools and community partners
- building shared professional learning opportunities to align understanding and approaches
- engaging families and caregivers as partners in planning and decision-making
- embedding equity and reconciliation commitments into processes
- regularly reviewing data and feedback to identify gaps and improve coordination
Effective partnerships are built on shared vision, respect and continuous reflection, ensuring the system evolves with the needs of students and communities.