Money, case complexity, and wait lists: perspectives on problems and solutions at children's mental health centers in Ontario.

Senior managers of children's mental health centers across Ontario, Canada were interviewed regarding the challenges and solutions of access and delivery of care. The central challenges--funding, case complexity, waitlists, staffing, and system integration--revealed a complex interplay between the policies and financing of children's mental health services and the provision of clinical services at the agency level and within the community. The desire for integration and collaboration was countered by competition for funding and service demands. A need for policies that allow for local solutions while providing leadership for sustained improvements in the ease and timeliness of access to care and effective clinical services emerged.