The stories are sadly, maddeningly familiar.
A murder committed by a young man or woman with a history of violent behaviour.
A teen slipping through the cracks from the occasional skipped class to living on the street.
An infant or toddler coming into harm's way from parents who themselves suffered childhood abuse.
Each time, people wonder what might have been done.
At the Children's Health Policy Centre at British Columbia's Simon Fraser University, Charlotte Waddell and a team of colleagues are studying and developing strategies to help prevent such tragedies where they often begin: in childhood, including infancy and before birth.
"I really have become increasingly convinced over the years that we have to start very, very early and we have to try to lower those numbers [of children not getting adequate or any treatment]," she says.
A big part of that work is the B.C. Healthy Connections Project, or BCHCP, a five-year program that will implement and evaluate Canada's first Nurse Family Partnership, a series of pre- and post-birth home visits for young mothers and their children up to the age of two. The program in the United States has a track record that includes reduced childhood injuries, kids who are more prepared for school and improved pre-natal health.
Dr. Waddell was named the Canada Research Chair in Children's Health Policy in 2008. Her appointment was renewed this year for another five years.
In that role, she is part of a group effort to improve mental health treatment for youth up to the age of 18 and to prevent some problems before they start.
About 13 per cent of children in Canada – roughly 700,000 – have clinically significant disorders, from anxiety and depression to substance abuse and behaviour problems. Of those, 69 per cent, or nearly half a million, receive no specialized mental health services.
The dismal statistics reflect a lack of both resources and awareness, Dr. Waddell says.
"Mental health problems are invisible. We might notice it when a kid is acting out, but we don't really notice it when a child is becoming depressed or anxious. Families don't really know what's going on when this kind of problem starts to emerge," she says.
"But at the same time, we have not ever adequately funded children's mental health services in Canada – not in B.C., not anywhere – so there are tremendous shortages for kids to be able to access services."
Research indicates that early treatment can stave off issues such as anxiety or bullying.
"There is lots of strong research evidence that if we intervene really early in life, we can do a great deal to prevent some of these really common disorders," Dr. Waddell says.
She describes herself as working in two laboratories. One is the political realm, where she and colleagues – using research data as their bargaining chips – work with policy-makers, primarily at the provincial level, to develop treatment and prevention programs.
Her other laboratory is part-time work at a Victoria clinic for street kids, most of whom have been in child protection and youth justice systems. Through that work, she has seen how the mix of abuse and neglect can cause behavioural problems ranging from minor vandalism to threats of bullying to murder.
Through programs such as the BCHCP and other research, she and her colleagues hope to shape public policies that focus on early treatment and intervention.
"I've got thousands of stories from those children and those are the people I feel really accountable to. They tell me the same stories over and over again. Of experiencing abuse and neglect, of moving into multiple foster homes. Being moved in and out of their communities. Not having basic needs like stability, let alone long-term parenting – not having those things that I think most Canadians would say all kids should have."