More Than Half of Canadian Youth Sought Mental Health Care Over 15 Years, Study Finds

More than half of young people in British Columbia aged 10 to 24 had a new health contact for a mental disorder between 2008 and 2022, according to a population-based analysis of provincial administrative health records published in BMC Psychiatry. The study, led by Kirsten Marchand of the Centre for Health Services and Policy Research at the University of British Columbia, followed an open cohort of 597,273 youth registered with the provincial public insurance program and traced how often they newly sought care for five major categories of mental disorder over fifteen years.

The researchers drew on retrospective administrative health data, the coded records of physician visits, hospital stays, and other billable encounters that health systems generate as a byproduct of care. Using diagnostic codes from the ICD-9 and ICD-10 classifications, the team identified new health contacts for five diagnostic outcomes: combined mood and anxiety disorders, conduct disorders, substance use disorders, schizophrenia and other psychotic disorders, and attention deficit hyperactivity disorders. Because the cohort was open, young people entered and exited the study as they aged into and out of the 10-to-24 window, allowing the investigators to capture successive generations of youth across the full study period.

The headline finding is stark: 52.4 percent of the cohort, or 313,183 individuals, had at least one new health contact for one of the five mental disorder categories during the observation window. Mood and anxiety disorders, analyzed together as a combined outcome, dominated the picture. They were the most frequent reason for a new mental health contact overall, and they most often appeared as a single disorder diagnosis, meaning the young person’s contact was coded to this category alone rather than alongside another psychiatric diagnosis.

The less frequent diagnostic categories told a different and clinically important story. Conduct disorders, substance use disorders, and schizophrenia and other psychotic disorders occurred less often in the cohort, but when they did appear, they frequently followed a co-occurring diagnosis pattern, in which the same young person registered new health contacts for multiple disorder categories. To characterize this overlap quantitatively, the researchers calculated pairwise correlations among disorders classified under the co-occurring pattern, measuring how strongly the presence of one diagnosis predicted the presence of another within individual care histories.

This distinction between single and co-occurring patterns matters for how services are organized. A young person whose contact involves only a mood or anxiety diagnosis may be well served by a streamlined pathway focused on that category, whereas a young person with co-occurring conduct, substance use, or psychotic diagnoses typically requires coordinated care across multiple specialties. The finding that complexity concentrates in the less common but more severe diagnostic categories suggests that a minority of youth account for a disproportionate share of service needs, a pattern familiar from health services research on other chronic conditions.

To test whether demand was genuinely rising rather than merely reflecting population growth, the team calculated crude three-year repeated cross-sectional trends in the incidence rates of new mental disorder health contacts, essentially taking repeated snapshots of new-case rates across the study period and plotting them over time. They then applied multivariate Poisson regression, a statistical model suited to count outcomes such as the number of new health contacts, to estimate the age- and sex-adjusted risk of a new mental disorder contact across the fifteen-year span. Adjusting for age and sex is critical in this population because the probability of a first mental health contact varies sharply across adolescence and young adulthood and differs between males and females; the adjusted analysis isolates the underlying temporal trend from these demographic drivers.

Both the crude incidence rates and the adjusted risk estimates pointed in the same direction: upward. New health contacts for mental disorders among youth increased during the study period, and the increase persisted after accounting for changes in the age and sex composition of the cohort. The authors interpret this as evidence of growing demand for mental health care services among youth engaging with both outpatient and inpatient settings, and they conclude that targeted services and greater resources may be needed to meet this rising demand.

The study also cross-tabulated the mental disorder outcomes by key demographic characteristics, including age, biological sex, and geography, providing a granular map of who was seeking care and where. This demographic breakdown matters for service planning in a province as geographically varied as British Columbia, where youth in urban centers such as Vancouver and those in remote and rural regions face very different access landscapes. The administrative data covered everyone eligible for, registered with, and in contact with the provincial public insurance program, giving the analysis near-complete population coverage rather than the convenience samples that limit many mental health surveys.

Several technical caveats are worth keeping in view. Administrative health data capture contacts that generate billing records, so encounters with counselors, school-based services, or unbillable community supports may not appear in the dataset. Diagnostic codes reflect what clinicians recorded at the time of the contact, and coding practices can shift over the fifteen-year window, particularly around the transition between ICD-9 and ICD-10. Rising incidence could partly reflect increased willingness to seek care, expanded service capacity, or greater clinician recognition of mental disorders, in addition to any true increase in underlying morbidity. The study design cannot disentangle these explanations definitively, which the authors acknowledge by framing their conclusions around demand for services rather than disease frequency alone.

Even with those caveats, the scale of the finding is difficult to dismiss. That more than half of a full provincial cohort of youth aged 10 to 24 registered a new mental disorder contact within fifteen years underscores how central mental health has become to adolescent and young adult medicine. The research was funded by an operating grant from the Canadian Institutes of Health Research, with additional support for individual investigators from Michael Smith Health Research BC and the Canada Research Chairs program, and it was approved by the Providence Health Care and University of British Columbia Research Ethics Board. As health systems plan for the coming decade, the study’s central message is that the wave of youth mental health need is not a projection but a documented, fifteen-year trend written into the care records of more than half a million young people.

Subject of Research: Population-based trends in youth mental disorder health contacts in British Columbia, Canada

Article Title: Patterns of health contacts for mental disorders among youth: a population-based administrative health data study in British Columbia, Canada (2008 to 2022)

Article References: Marchand, K., Liu, G., Hastings, K. G., Edwards, J., Gadermann, A., Samji, H., Wide, J., Mathias, S., Sutherland, J. M., & Barbic, S. (2026). Patterns of health contacts for mental disorders among youth: a population-based administrative health data study in British Columbia, Canada (2008 to 2022). BMC Psychiatry. https://doi.org/10.1186/s12888-026-08578-w

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08578-w

Keywords: youth mental health, administrative health data, British Columbia, mood and anxiety disorders, co-occurring disorders, incidence trends, Poisson regression, health services research, substance use disorders, psychotic disorders, adolescents, young adults