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Cited by 107Psychiatric care and mental health servicesMental Health Treatment and AccessMental Health and Patient Involvement

Canadian response to need for transformation of youth mental health services: ACCESS Open Minds (Esprits ouverts)

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Malla, Ashok, Iyer, Srividya, Shah, Jai, Joober, Ridha, Boksa, Patricia, Lal, Shalini, Fuhrer, Rebecca, Andersson, Neil +17 more·2019·Early Intervention in Psychiatry
DOI 10.1111/eip.12772PMC PMC6563151
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Abstract

Aim: Youth mental health is of paramount significance to society globally. Given early onset of mental disorders and the inadequate access to appropriate services, a meaningful service transformation, based on globally recognized principles, is necessary. The aim of this paper is to describe a national Canadian project designed to achieve transformation of mental health services and to evaluate the impact of such transformation on individual and system related outcomes. Method: We describe a model for transformation of services for youth with mental health and substance abuse problems across 14 geographically, linguistically and culturally diverse sites, including large and small urban, rural, First Nations and Inuit communities as well as homeless youth and a post‐secondary educational setting. The principles guiding service transformation and objectives are identical across all sites but the method to achieve them varies depending on prevailing resources, culture, geography and the population to be served and how each community can best utilize the extra resources for transformation. Results: Each site is engaged in community mapping of services followed by training, active stakeholder engagement with youth and families, early case identification initiatives, providing rapid access (within 72 hours) to an assessment of the presenting problems, facilitating connection to an appropriate service within 30 days (if required) with no transition based on age within the 11 to 25 age group and a structured evaluation to track outcomes over the period of the study. Conclusions: Service transformation that is likely to achieve substantial change involves very detailed and carefully orchestrated processes guided by a set of values, principles, clear objectives, training and evaluation. The evidence gathered from this project can form the basis for scaling up youth mental health services in Canada across a variety of environments.

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Crossref · 10.1111/eip.12772

Cites

45 of 45 references verified0 citation errors · 0 not checkable

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  • In ACCESS Open Minds Canada, significant increases occurred over time in referred or help-seeking youth and reductions in delays to evaluation and services received.

    “as hypothesised, significant increases occurred over time in referred or help-seeking youth and reductions in delays to evaluation and services received”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [291]

    The Objectives of service transformation section names increasing the number of youth seeking services and offering assessment within 72 hours and appropriate care within 30 days as ACCESS Open Minds goals. The Abstract Results section describes sites implementing these measures, but the copy does not report significant increases in referrals or help-seeking, or measured reductions in delays over time. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • In ACCESS Open Minds Canada, 64% of young people have moderate to severe mental health problems at entry.

    “64% of young people have moderate to severe mental health problems at entry”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [291]

    The ‘Model of service transformation within ACCESS OM’ section describes how young people are classified as having a moderate to severe mental health problem at initial assessment. It does not report that 64% meet that classification at entry, so the claimed proportion is unsupported. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Other jurisdictions have implemented variations of similar integrated youth mental health care models, adapted to local need as well as cultural, workforce, and financial factors.

    “Other jurisdictions-notably, Ireland, 289 Canada, 290-292 the UK, 293,294 Denmark, Singapore, 295 the USA, the Netherlands, 296 Japan, 297 South Korea, 298 Israel, 299 Hong Kong, 300 Iceland, France, 301 and New Zealand 302 -have implemented variations of similar models, which have been adapted to meet local need as well as cultural, workforce, and financial factors (panel”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [291]

  • In ACCESS Open Minds Canada, post-treatment, significant reductions occurred in distress and the severity of mental health problems.

    “post-treatment: significant reductions occurred in distress and the severity of mental health problems”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [291]

    The 'Model of service transformation within ACCESS OM' section describes measuring distress and clinical severity, but does not report post-treatment changes. It says outcome analyses will be reported in future publications. Searches for post-treatment reductions and follow-up outcomes found no result supporting the claimed significant reductions. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Cites

Flagged first, then by citations

2 of the 47 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. O'Brien, A., Fahmy, R., & Singh, S. P. (2009). Disengagement from mental health services. Social Psychiatry and Psychiatric Epidemiology, 44(7), 558– 568. 19037573

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Authors
Malla, A., Iyer, S., Shah, J., Joober, R., Boksa, P., Lal, S., Fuhrer, R., Andersson, N., Abdel‐Baki, A., Hutt‐MacLeod, D., Beaton, A., Reaume‐Zimmer, P., Chisholm‐Nelson, J., Rousseau, C., Chandrasena, R., Bourque, J., Aubin, D., Levasseur, M. A., Winkelmann, I., Etter, M., Kelland, J., Tait, C., Torrie, J., Vallianatos, H., & the ACCESS Open Minds Youth Mental Health Network
Affiliations
  • Douglas Mental Health University Institute (CA)
  • Université de Moncton (CA)
  • Western University (CA)
  • Alberta Health Services (CA)
  • University of Alberta (CA)
Corresponding author
Malla, Ashok
ORCID
Venue
Early Intervention in Psychiatry
Publisher
Wiley
Published
2018-12-16
Volume
13
Issue
3
Pages
697-706
ISSN
  • 1751-7885 (ISSN-L)
  • 1751-7893
DOI
10.1111/eip.12772
PMC
PMC6563151
OpenAlex
W2904478670
Cited by
107
References
47
Citations by year
2026: 10 · 2025: 11 · 2024: 13 · 2023: 13 · 2022: 12 · 2021: 15 · 2020: 14 · 2019: 18 · 2018: 1
FWCI
14.10
Type
journal article
Language
en
Open access
Licence
Locations
  • Early Intervention in Psychiatry (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • eScholarship@McGill (McGill) (submittedVersion, cc-by-nc-nd)
Funders
Canadian Institutes of Health Research (01308‐000)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
Keywords
child and adolescent mental health services, service transformation, stakeholder engagement, homelessness, substance abuse, Canada
MeSH terms
Adolescent, Mental Disorders, Canada, Child, Delivery of Health Care, Female, Health Services Accessibility, Health Services Needs and Demand, Humans, Male, Mental Health Services, Outcome and Process Assessment, Health Care, Substance-Related Disorders, Young Adult

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