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Cited by 14Psychiatric care and mental health servicesMental Health Treatment and AccessAdolescent and Pediatric Healthcare

Service providers endorse integrated services model for youth with mental health and substance use challenges: findings from a discrete choice experiment

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Hawke, Lisa D., Thabane, Lehana, Iyer, Srividya N., Jaouich, Alexia, Reaume-Zimmer, Paula, Henderson, Joanna·2021·BMC Health Services Research
DOI 10.1186/s12913-021-07038-3PMC PMC8487137
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Abstract

Background: Given high rates of mental health and substance challenges among youth and substantial system access barriers, system innovation is required. Integrated youth services (IYS) models aim to transform youth mental health and substance use services by creating integrative, collaborative models of care in youth-friendly settings. This study examines service provider perspectives on the key service components to include in IYS models. Method: A discrete choice experiment modeled service provider preferences for the service components of IYSs. The sample includes 388 service provider/agency leader participants (age 18+) from youth-serving organizations in Ontario. Importance scores and utility values were calculated for 12 attributes represented by four levels each. Latent class analysis identified subgroups of participants with different preferences. Results: The majority of participants were direct service providers working in larger organizations in the mental health and/or substance use sectors in large urban centers. Participants strongly endorsed service models that provide rapid access to the widest variety of culturally sensitive service options, with supplementary e-health services, in youth-focused community settings with evening and weekend hours. They prefer caregiver involvement in youth services and treatment decisions and support youth and family engagement. Latent class analyses reveal three segments of service providers: a Youth-Focused Service Accessibility segment representing 62.1% (241/388) of participants, a Service Options segment representing 27.6% (107/388) of participants, and a Caregiver Integration segment representing 10.3% (40/388) of participants. Within these segments, the degree of prioritization of the various service components differ; however, the overall endorsement of the service components remains largely consistent across classes for most attributes. The segments did not differ based on demographic or agency characteristics. Conclusions: The core characteristics of IYS settings for youth with mental health and substance use challenges, i.e., rapid access to a wide range of youth-oriented services, are strong priorities of service providers and youth-serving agency leaders. These findings confirm that youth-oriented service providers endorse the importance and relevance of IYS models as a whole; strong service provider buy-in to the model is expected to facilitate development, implementation and scaling of IYS models. Hearing stakeholder perspectives, including those of service providers, youth, and caregivers, is essential to developing, effectively implementing, and scaling effective youth services.

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  • Young people and service providers have endorsed an integrated service model for youth mental health.

    “Young people and service providers have endorsed an integrated service model for youth mental health. 284,285”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [284]

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References 36 · Cited by 14

Research works printed but not linked: 28

  1. [2]Kessler RC Amminger GP Aguilar-Gaxiola S Alonso J Lee S Ustun TB Age of onset of mental disorders: a review of recent literature Curr Opin Psychiatry 2007 20 4 359 364 10.1097/YCO.0b013e32816ebc8c 17551351 PMC1925038 · DOI · Paper page
  2. [3]Morningstar ME Trainor AA Murray A Examining outcomes associated with adult life engagement for young adults with high incidence disabilities J Vocat Rehabil 2015 43 3 195 208 10.3233/JVR-150769 · DOI
  3. [4]Wagner M Newman L Longitudinal transition outcomes of youth with emotional disturbances Psychiat Rehab J 2012 35 3 199 208 10.2975/35.3.2012.199.208 22246118 · DOI
  4. [7]Brown A Rice SM Rickwood DJ Parker AG Systematic review of barriers and facilitators to accessing and engaging with mental health care among at-risk young people Asia Pac Psychiatry 2016 8 1 3 22 10.1111/appy.12199 26238088 · DOI · Paper page
  5. [10]Paul M Street C Wheeler N Singh SP Transition to adult services for young people with mental health needs: a systematic review Clin Child Psychol Psychiatry 2015 20 3 436 457 10.1177/1359104514526603 24711585 · DOI
  6. [11]MacDonald K Fainman-Adelman N Anderson KK Iyer SN Pathways to mental health services for young people: a systematic review Soc Psychiatry Psychiatr Epidemiol 2018 53 10 1005 1038 10.1007/s00127-018-1578-y 30136192 PMC6182505 · DOI
  7. [12]Costello EJ, He J-p, Sampson NA, Kessler RC, Merikangas KR. Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey-Adolescent. Psychiatric services (Washington, DC). 2014;65(3):359–66. PMC4123755 24233052
  8. [13]Watson P Mehra K Hawke LD Henderson J Service provision for depressed children and youth: a survey of the scope and nature of services in Ontario BMC Health Serv Res 2019 19 1 947 10.1186/s12913-019-4784-8 31818284 PMC6902427 · DOI
  9. [14]Johnson E Mellor D Brann P Factors associated with dropout and diagnosis in child and adolescent mental health services Aust N Z J Psychiatry 2009 43 5 431 437 10.1080/00048670902817687 19373704 · DOI
  10. [17]Illback RJ Bates T Hodges C Galligan K Smith P Sanders D Jigsaw: engaging communities in the development and implementation of youth mental health services and supports in the Republic of Ireland J Ment Health 2010 19 5 422 435 10.3109/09638231003728141 20836689 · DOI · Paper page
  11. [18]Henderson J, Cheung A, Cleverley K, Chaim G, Moretti ME, de Oliveira C, et al. Integrated collaborative care teams to enhance service delivery to youth with mental health and substance use challenges: protocol for a pragmatic randomised controlled trial. BMJ Open. 2017;7(2). PMC5293997 28167747
  12. [20]Reaume-Zimmer P Chandrasena R Malla A Joober R Boksa P Shah JL Iyer SN Lal S Transforming youth mental health care in a semi-urban and rural region of Canada: a service description of ACCESS open minds Chatham-Kent Early Interv Psychiatry 2019 13 S1 48 55 10.1111/eip.12818 31243909 PMC6771628 · DOI
  13. [21]Halsall T Manion I Iyer SN Mathias S Purcell R Henderson J Trends in mental health system transformation: integrating youth services within the Canadian context Healthc Manag Forum 2019 32 2 51 55 10.1177/0840470418808815 30799661 · DOI
  14. [22]McGihon R Hawke LD Chaim G Henderson J Cross-sectoral integration in youth-focused health and social services in Canada: a social network analysis BMC Health Serv Res 2018 18 1 901 10.1186/s12913-018-3742-1 30486805 PMC6264042 · DOI
  15. [23]Albers B Mildon R Lyon AR Shlonsky A Implementation frameworks in child, youth and family services – results from a scoping review Child Youth Serv Rev 2017 81 101 116 10.1016/j.childyouth.2017.07.003 · DOI
  16. [24]Mitchell PF Evidence-based practice in real-world services for young people with complex needs: new opportunities suggested by recent implementation science Child Youth Serv Rev 2011 33 2 207 216 10.1016/j.childyouth.2010.10.003 · DOI · Paper page
  17. [25]Brownlie EB Chaim G Heffernan O Herzog T Henderson J Youth services system review: moving from knowledge gathering to implementation through collaboration, youth engagement, and exploring local community needs Can J Commun Mental Health 2017 36 2 133 149 10.7870/cjcmh-2017-018 · DOI
  18. [26]Harkness J Patient involvement: a vital principle for patient-centred health care World Hosp Health Serv 2005 41 2 12 16 16104453
  19. [27]Settipani C, Cleverley K, Hawke LD, Cheung A, Szatmari P, Henderson J. Key components and characteristics of integrated care hubs for youth mental health and addiction: A scoping review. submitted manuscript.
  20. [28]Henderson J, Hawke LD, Iyer S, Hayes E, Darnay K, Mathias S, Thabane L. Youth perspectives on integrated youth services: A discrete choice conjoint experiment. Canadian Journal of Psychiatry. In press. PMC9234900 34874207
  21. [29]Hawke LD, Thabane, L, Wilkins L, Mathias S, Iyer S, Henderson J. Don’t forget the caregivers! A discrete choice experiment examining caregiver views of integrated youth services, The Patient – Patient Oriented Outcomes Research. 2021. 10.1007/s40271-021-00510-6. PMC8046579 33855684 · DOI
  22. [32]Harris PA Taylor R Thielke R Payne J Gonzalez N Conde JG Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support J Biomed Inform 2009 42 2 377 381 10.1016/j.jbi.2008.08.010 18929686 PMC2700030 · DOI · Paper page
  23. [36]Damschroder LJ Aron DC Keith RE Kirsh SR Alexander JA Lowery JC Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science Implement Sci 2009 4 1 50 10.1186/1748-5908-4-50 19664226 PMC2736161 · DOI · Paper page
  24. [37]Hickey G McGilloway S O'Brien M Leckey Y Devlin M Donnelly M Strengthening stakeholder buy-in and engagement for successful exploration and installation: a case study of the development of an area-wide, evidence-based prevention and early intervention strategy Child Youth Serv Rev 2018 91 185 195 10.1016/j.childyouth.2018.06.008 · DOI
  25. [38]Henderson J Hess M Mehra K Hawke LD From planning to implementation of the YouthCan IMPACT project: a formative evaluation J Behav Health Serv Res 2020 47 2 216 229 10.1007/s11414-019-09658-4 31342279 PMC7231799 · DOI
  26. [39]Bannon WM McKay MM Are barriers to service and parental preference match for service related to urban child mental health service use? Fam Soc 2005 86 1 30 34 10.1606/1044-3894.1874 · DOI
  27. [40]Mehra K, Hawke LD, Watson P, Leroux E, Henderson J. Youth psychotherapy seeking behavior: A concurrent mixed methods study. submitted manuscript. PMC8315215 34381509
  28. [41]Mehra K, Hawke LD, Watson P, Sheikhan NY, Leroux E, Henderson J. Youth psychotherapy seeking behavior: a concurrent mixed methods study, J Can Acad Child Adolesc Psychiatry. 2021;30(3):165–76. PMC8315215 34381509

Authors
Hawke, L. D., Thabane, L., Iyer, S. N., Jaouich, A., Reaume-Zimmer, P., & Henderson, J.
Affiliations
  • Centre for Addiction and Mental Health (CA)
  • McMaster University (CA)
  • Douglas Mental Health University Institute (CA)
Corresponding author
  • Hawke, Lisa D.
  • Henderson, Joanna
ORCID
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2021-10-01
Volume
21
Issue
1
Pages
1035-1035
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/s12913-021-07038-3
PMC
PMC8487137
OpenAlex
W3203573991
Cited by
14
References
36
Citations by year
2026: 1 · 2025: 4 · 2024: 6 · 2023: 1 · 2022: 1 · 2021: 1
FWCI
1.53
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • TSpace (University of Toronto) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • eScholarship@McGill (McGill) (submittedVersion, cc-by)
Funders
  • Centre for Addiction and Mental Health
  • Canadian Institutes of Health Research
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 › Speech and Hearing › Adolescent and Pediatric Healthcare
Keywords
integrated youth services, youth mental health, adolescent substance use, service components, caregiver involvement, family involvement, e-health services, latent class segmentation, youth-serving organizations, Ontario
MeSH terms
Adolescent, Humans, Mental Health, Mental Health Services, Ontario, Adolescent Health Services, Substance-Related Disorders

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