Ontario's $68 Million Decision in 1993: Sending 700 Children to the US for Psychiatric Care

In 1993, Ontario faced a critical challenge in providing psychiatric care for children. The province spent $68 million to send 700 children to the United States for treatment. This decision highlighted significant shortages in local mental health facilities and raised questions about the state of psychiatric care in Ontario at the time. Understanding this event sheds light on the complexities of healthcare planning and the importance of accessible mental health services for young patients.

!Eye-level view of a psychiatric hospital building exterior in Ontario

Background on Psychiatric Care in Ontario in the Early 1990s

In the early 1990s, Ontario’s mental health system struggled to meet the growing demand for child psychiatric services. Facilities were overcrowded, and wait times for treatment extended dangerously long. This shortage forced health officials to look beyond provincial borders for solutions.

• Limited local resources: Many hospitals lacked specialized units for children with complex psychiatric needs.

• Rising demand: Increasing awareness of mental health issues led to more children being referred for treatment.

• Budget constraints: Funding for mental health was limited, making expansion difficult.

  
  

The shortage created a gap between the number of children needing care and the available treatment options within Ontario.

Why Ontario Chose to Send Children to the US

Sending children to the United States was a costly but necessary measure. The decision was driven by several factors:

• Immediate access to care: US facilities had the capacity and specialized programs Ontario lacked.

• Quality of treatment: Some American hospitals offered advanced psychiatric therapies not yet available locally.

• Avoiding long wait times: Delays in treatment could worsen children’s conditions, so timely care was critical.

  
  

The $68 million spent covered hospital stays, travel, and related expenses for 700 children over a period of time. This investment reflected the urgency of addressing the mental health crisis despite the high cost.

Impact on Children and Families

The decision to send children out of province had mixed effects on patients and their families.

Positive outcomes

• Children received specialized care that improved their mental health.

• Access to advanced treatments helped some children recover more quickly.

• Families saw their children receive attention that was otherwise unavailable.

  
  

Challenges faced

• Separation from family and community caused emotional strain.

• Travel and distance made family visits difficult.

• Cultural and systemic differences in care sometimes complicated treatment.

  
  

Families often had to balance relief that their child was receiving care with the hardship of being far from home.

Lessons Learned from the 1993 Experience

Ontario’s experience in 1993 offers important lessons for healthcare planners and policymakers:

• Invest in local capacity: Building more child psychiatric facilities within Ontario reduces reliance on external options.

• Plan for demand growth: Mental health needs can increase rapidly; systems must be flexible and scalable.

• Support families: Providing resources and support for families during treatment improves outcomes.

• Collaborate across borders: While local care is ideal, partnerships with other regions can be valuable in emergencies.

  
  

These lessons have influenced how Ontario and other provinces approach mental health services today.

Progress Since 1993 in Ontario’s Child Psychiatric Care

Since the 1990s, Ontario has made strides in improving mental health services for children:

• New facilities: Several specialized psychiatric units for children have opened.

• Community programs: Increased focus on outpatient and community-based care reduces hospital stays.

• Early intervention: Programs targeting early signs of mental illness help prevent severe cases.

• Funding increases: More government investment supports expanded services and staff training.

  
  

Despite progress, challenges remain in ensuring timely access and meeting the diverse needs of children across the province.

What This Means for Mental Health Care Today

Ontario’s 1993 decision underscores the importance of a strong mental health system for children. Mental health affects every aspect of a child’s life, including education, relationships, and future well-being. Ensuring access to quality care requires:

• Ongoing investment in facilities and trained professionals.

• Reducing stigma so families seek help early.

• Integrating services across health, education, and social sectors.

• Monitoring outcomes to improve programs continuously.

  
  

The $68 million spent in 1993 was a significant expense, but it highlighted gaps that needed urgent attention. Today, the goal is to provide care close to home whenever possible.