Background
Objectives
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How and to what extent does ACCESS Open Minds work to identify youth in need and improve their access to high-quality mental healthcare?
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Among which youth groups and in which contexts is the transformation most and least beneficial?
Primary objectives
Secondary objectives
Methods
Setting/sites
Site (prominent languages of the milieu) | Province | Youth Population1 | Target N of youth expected to consent to research2 | Notable features of youth population, if any | Service system features |
---|---|---|---|---|---|
URBAN SITES | |||||
PEER Saint John (English) | New Brunswick | 11,085 | 277 | Many low socio-economic status, many NEET3 | Mental health day-treatment centre |
Dorval-Lachine- Lasalle (French, English) | Québec | 18,530 | 864 | 28% speak languages other than English/French | Primary care centre offering health and social services to specified geographic catchment |
RIPAJ-Montréal Homeless Youth Network* (French, English) | Québec | 1000* | 93 | Homeless, many NEET | Network of community organisations; and primary and tertiary public health and social service settings |
Parc-Extension (English, French) | Québec | 5065 | 236 | Large numbers (over 60%) are visible minority and immigrant | Primary care centre offering health and social services to specified geographic catchment |
Edmonton (English) | Alberta | 17,010 | 700 | Many homeless, Many NEET | Governed by single authority that provides health care to entire province |
University of Alberta* (English) | Alberta | 8000 | 329 | First year university students | Student services at the university |
SEMI-URBAN / RURAL | |||||
Caraquet, Acadian Peninsula (French) | New Brunswick | 555 | 39 | Mobile team and community centre | |
Chatham-Kent (English) | Ontario | 17,355 | 865 | Also serves two neighboring First-Nation communities | Community-based youth services hub; Key partners are public health and addictions program and a community mental health organization. |
INDIGENOUS / REMOTE | |||||
Eskasoni First Nation (Mi’kmaq, English) | Nova Scotia | 1025 | – | Mental health centre (division of health centre) accountable to the Band Council | |
Elsipogtog First Nation (Mi’kmaq, English) | New Brunswick | 839 | – | Health centre and youth space accountable to the Band Council | |
Cree Nation of Mistissini (Cree, English) | Québec | 1015 | – | Network of services funded by Cree Health Board and local Band Council | |
Puvirnituq (Inuktitut, English) | Québec | 535 | – | Remote, Northern | Lay health workers in collaboration with Saqijuq, a community youth diversion initiative |
Sturgeon Lake First Nation (Plains Cree, English) | Saskatchewan | 350 | – | Youth Space with mobile ACCESS clinician services | |
Ulukhaktok (Inuvialuit, English) | Northwest Territories | 105 | – | Remote, Northern | Lay health workers in collaboration with Inuvialuit Regional Corporation4 |
Study intervention
Study design
Instrument | Informant(s) | Key construct | Subscales | Measurement time(s)a |
---|---|---|---|---|
Description of participant sample
| ||||
Customized ACCESS OM sociodemographic questionnaire | Youth; Clinician; Administrative records | Sociodemographic characteristics | None | Intake, Months 3, 6, 9, 12 and 34/end of services |
Custom checklist | Youth, Clinician | Presenting concerns | None | Intake |
GAIN-SSx | Clinician-administered youth report | Clinical symptoms | Internalising problems, externalizing problems, substance use disorders, crime/violence | Intake, Months 3, 12 and 24/end of services |
Columbia-Suicide Severity Rating Scale (C-SSRS): Screenerx | Clinician | Suicidal ideation and behavior over past month plus one item re past suicidal behavior | None | Intake, Months 1, 3, 6, 9, 12 and 24/end of services |
Service-level improvements
| ||||
Customized services forms | Clinician; Administrative records | Number of referrals (Hyp. 1); Number offered evaluation 72 h after referral request (Hyp 2); Number offered appropriate treatment within 30 days after completion of initial evaluation (Hyp. 3) | None | Intake, Month 1; Services forms repeated at months 1, 3, 6, 9, 12, and 24 or at end of services to document services needed and offered |
CCHS-MH 2012 questions related to services sought and received | Clinician-interview with youth and/or family/carer, plus any available records | Number of help-seeking contacts made for problems with mental health/substance use and whether or not services were received in previous 12 months (Hyp. 4) | None; can examine type of contacts (formal, informal, etc.) | Intake |
Clinical improvements
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Kessler-10 Psychological Distress Scale (K-10) | Youth | Unidimensional factor of distress as being linked to mental ill-health and varied diagnoses (Hyp. 5) | Cut-offs based on overall score (e.g., mild distress) | Intake, Months 1, 3, 6, 9, and 12 |
Clinical Global Impression of Severity (CGI)x | Clinician | Clinician’s rating of severity of youth’s presenting problem over time (Hyp. 5) | None | Intake, Months 1, 3, 6, 9, 12 and 24/end of services |
Self-rated health and self-rated mental health (SRH-MH) | Youth | Self-assessment of health and mental health, each on a single 5-item Likert scale (Hyp. 5) | None | Intake, Months 1, 3, 6, 9, and 12 |
Functional improvements
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Social and Occupational Functioning Assessment Scale (SOFAS)x | Clinician | Social and vocational functioning on a 0 to 100 scale (Hyp. 5) | None | Intake, Months 1, 3, 6, 9, 12 and 24/end of services |
Subjective/Well-being improvements
| ||||
Goals tool inspired by the Goals-based Outcome (GBO) tool*x | Youth | Self-rated progress on 3 chosen goals (Hyp. 5) | None | Intake, Months 3, 6, 12 and 24/end of services |
Outcome Rating Scale (ORS)x | Youth | Overall outcome/ functioning/ well-being (Hyp. 5) | None; Items related to overall; individual; interpersonal; and social outcomes can be examined separately | Intake, Months 6, 12 and 24/end of services |
World Health Organisation Quality of Life – Brief (WHOQOL)* | Youth | Self-assessment of quality of life (Hyp.5) | Four domains: physical health, psychological health, social relationships, and environment | Intake, Months 6, 12 and 24/end of services |
Service experiences
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OPOCx | Youth, family | Satisfaction (Hyp. 6) | Access to service, services provided, participation/ rights, therapists/support workers/staff, environment, discharge, recovery outcome, service quality | Months 1, 3, 6, 9, 12 and 24/end of services |
Session Rating Scale (SRS)x | Youth | Working Alliance (Hyp. 6) | None; Items related to relationship; goals or topic; approach or method; and overall can be examined separately | Intake, Months 6, 12 and 24/end of services |
Youth Efficacy/Empowerment Scale (YES)* | Youth | Empowerment | Self, services, system | Intake, Months 3, 6, 9, 12 and 24/end of services |