We know who is at risk, but we wait anyway

Children with disabilities are experiencing a mental health crisis and Manitoba’s systems are waiting for them to really struggle before they respond.

Across Canada, children with disabilities experience far higher rates of mental health challenges than their peers. Nearly three-quarters of children and youth with disabilities experience elevated mental health challenges. More than one-third score in the “very high” mental health difficulty category, a rate nearly 10 times higher than among children without disabilities.

Between 30 to 50 per cent of children with neurodevelopmental disabilities are diagnosed with mental health conditions, compared to eight to 18 per cent among typically developing children. This includes children with autism, ADHD, FASD, intellectual disabilities, learning disabilities and communication disorders.

Children who struggle with communication, sensory regulation, mobility, executive functioning, or social interaction are often excluded long before systems recognize the emotional consequences of that exclusion. Loneliness and exclusion are not side issues — they are public health issues for children with disabilities.

Families describe the disconnect between recognizing a child’s mental health needs and receiving care like a broken bridge. They chase referrals, sit on waitlists, repeat their stories to different providers and pay privately when they can’t wait any longer. One parent put it plainly: “It’s not accurate to say that we haven’t received any services, but it’s accurate to say that we haven’t received any meaningful services.”

Therapeutic approaches require adaptation and services lack the resources or training to provide neuro-affirming care. However, a meta-analysis of 31 studies found that autistic individuals have over three times the risk of self-injury, suicidal ideation, suicide attempts and suicide death compared to non-autistic individuals. One in four autistic youth experience suicidal thoughts and 8.3 per cent attempt suicide. The distress is real and urgent. Yet families are too often forced to seek care outside their communities, facing longer delays and added strain. This system causes harm. Children cannot wait for these life-saving supports. Their lives may depend on it.

Warning signs emerge early in childhood.

A 2025 Manitoba population-based study followed 42,766 children using linked health and education data. It found that children with special health needs were dramatically more likely to experience mental health challenges and that warning signs were visible as early as kindergarten.

Children showing behavioural impairments in kindergarten were three times more likely to receive a mental health diagnosis later in life. The odds of experiencing mental health challenges were nearly double for children with emotional impairments and more than 60 per cent for children with learning impairments. By age 16, 41 per cent of children with special health needs were diagnosed with a mental health disorder, compared to 22 per cent of children without special health needs.

Schools are increasingly becoming the front line of youth mental health care without the staffing or integrated supports needed to respond. Teachers identify distress, behavioural struggles, developmental concerns and the need for assessment years before many families receive meaningful help.

Despite their needs, schools often lack psychologists, counsellors, specialized staff and direct pathways into accessible mental health services.

Meanwhile, families are left to navigate separate systems for education, health care, psychiatry, disability services and community supports. Each system may see part of the child, but no system is being responsible for the whole child.

Social determinants of health play a role. Children with special health needs are disproportionately affected by poverty, live in lower-income neighbourhoods, face immigration-related barriers and navigate inadequate access to services. Those most likely to need support are least likely to access it.

These gaps are not just service failures; they are violations of the United Nations Convention on the Rights of the Child and the Convention on the Rights of Persons with Disabilities which state: children with disabilities have the right to health, inclusion, education, participation, dignity and supports that allow them to develop to their fullest potential.

Manitoba’s systems need to stop treating mental health support for neurodivergent children as a crisis response. Children need early, school-based, integrated supports that encompass the whole child. They have a right to accessible classrooms, adapted therapeutic care, caregiver support and meaningful participation in decisions that affect them.

We know who is at risk. We know how the warning signs appear. We know that disability, exclusion and mental health risks intersect. Yet, Manitoba’s systems remain fragmented and crisis-driven, forcing too many neurodivergent children to deteriorate before receiving care.

Manitoba must do better for neurodivergent children and youth.

Sherry Gott is the Manitoba Advocate for Children and Youth.