Skip to main content
×
×
Home

Transforming youth mental health: a Canadian perspective

  • S. N. Iyer (a1) (a2) (a3), P. Boksa (a1) (a4), S. Lal (a2) (a5), J. Shah (a1) (a2), G. Marandola (a3), G. Jordan (a1) (a2), M. Doyle (a1) (a3), R. Joober (a1) (a2) and A. K. Malla (a1) (a2) (a3)...
Abstract

In most mental illnesses, onset occurs before the age of 25 and the earliest stages are critical. The youth bear a large share of the burden of disease associated with mental illnesses. Yet, Canadian youths with mental health difficulties face delayed detection; long waiting lists; inaccessible, unengaging services; abrupt transitions between services; and, especially in remoter regions, even a complete lack of services. Responding to this crisis, the Canadian Institutes of Health Research announced a 5-year grant that was awarded to ACCESS, a pan-Canadian network of youths, families, clinicians, researchers, policymakers, community organisations and Indigenous communities. Using strategies developed collaboratively by all stakeholders, ACCESS will execute a youth mental healthcare transformation via early detection, rapid access and appropriate, high-quality care. The project includes an innovative, mixed-methods service research component. Similar in many respects to other national youth mental health initiatives, ACCESS also exhibits important differences of scale, scope and approach.

Copyright
Corresponding author
*Address for correspondence: S. N. Iyer, Ph.D., Douglas Mental Health University Institute, ACCESS-Canada, 6625 Boulevard LaSalle, Montreal, QC H4H 1R3, Canada. (Email: srividya.iyer@douglas.mcgill.ca)
References
Hide All
Adelson, N (2005). The embodiment of inequity: health disparities in Aboriginal Canada. Canadian Journal of Public Health/Revue Canadienne de Sante'e Publique 96, S45S61.
Anderson, KK, Fuhrer, R, Abrahamowicz, M, Malla, AK (2012). The incidence of first episode schizophrenia spectrum psychosis in adolescents and youth adults in Montreal an estimate from an administrative claims database. Canadian Journal of Psychiatry 57, 626633.
Anderson, KK, Fuhrer, R, Malla, AK (2010). The pathways to mental health care of first-episode psychosis patients: a systematic review. Psychological Medicine 40, 15851597.
Anderson, KK, Fuhrer, R, Malla, AK (2013). ‘There are too many steps before you get to where you need to be’: help-seeking by patients with first-episode psychosis. Journal of Mental Health 22, 384395.
Andersson, N (2011). Proof of impact and pipeline planning: directions and challenges for social audit in the health sector. BMC Health Services Research 11, S16.
Armbruster, P, Fallon, T (1994). Clinical, sociodemographic, and systems risk factors for attrition in a children's mental health clinic. American Journal of Orthopsychiatry 64, 577585.
Barnett, H, Lapsley, H (2006). Journeys of despair, journeys of hope. Mental Health Comission: Wellington.
Baumbusch, JL, Kirkham, SR, Khan, KB, McDonald, H, Semeniuk, P, Tan, E, Anderson, JM (2008). Pursuing common agendas: a collaborative model for knowledge translation between research and practice in clinical settings. Research in Nursing & Health 31, 130140.
Boivin, J-F, Roy, É, Haley, N, du Fort, GG (2005). The health of street youth: a Canadian perspective. Canadian Journal of Public Health/Revue Canadienne de Sante'e Publique 96, 432437.
Boydell, KM, Pong, R, Volpe, T, Tilleczek, K, Wilson, E, Lemieux, S (2006). Family perspectives on pathways to mental health care for children and youth in rural communities. The Journal of Rural Health 22, 182188.
Canadian Institute for Health Information (2012). Health Care in Canada, 2012: A Focus on Wait Times. Ottawa, ON: CIHI.
Canadian Institutes of Health Research (CIHR) (2011). Canada's Strategy for Patient-Oriented Research: Improving health outcomes through evidence-informed care. Ottawa, ON: CIHR.
Canadian Institutes of Health Research (CIHR) (2012). Guide to Knowledge Translation Planning at CIHR: Integrated and End-of-Grant Approaches. Ottawa, ON: CIHR.
Cheung, AH, Dewa, CS (2007). Mental health service use among adolescents and young adults with major depressive disorder and suicidality. Canadian Journal of Psychiatry/Revue canadienne de psychiatrie 52, 228232.
Chong, S-A, Mythily, S, Verma, S (2005). Reducing the duration of untreated psychosis and changing help-seeking behaviour in Singapore. Social Psychiatry and Psychiatric Epidemiology 40, 619621.
Clark, C, Taplin, D (2012). Theory of Change Basics: A primer on Theory of Change. Actknowledge: New York.
Dreischulte, T, Grant, A, Donnan, P, Guthrie, B (2013). Pro’s and con’s of the stepped wedge design in cluster randomised trials of quality improvement interventions: two current examples. Trials 14, O87.
Edlund, MJ, Wang, PS, Berglund, PA, Katz, SJ, Lin, E, Kessler, RC (2002). Dropping out of mental health treatment: patterns and predictors among epidemiological survey respondents in the United States and Ontario. American Journal of Psychiatry 159, 845851.
Freeman, JG, King, MA, Pickett, W, Craig, W, Elgar, F, Janssen, I, Klinger, D (2011). The Health of Canada's Young People: A Mental Health Focus. Public Health Agency of Canada: Ottawa, ON.
Gessessew, A, Barnabas, GA, Prata, N, Weidert, K (2011). Task shifting and sharing in Tigray, Ethiopia, to achieve comprehensive emergency obstetric care. International Journal of Gynecology & Obstetrics 113, 2831.
Greenberg, MT, Domitrovich, C, Bumbarger, B (2001). The prevention of mental disorders in school aged children: current state of the field. Prevention & Treatment 4, 162.
Gulliver, A, Griffiths, KM, Christensen, H (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 10, 113113.
Handa, ML (1986). Peace paradigm: transcending liberal and Marxian paradigms. International Symposium on Science, Technology and Development, New Delhi, India, 20–25 March 1987.
Hussey, MA, Hughes, JP (2007). Design and analysis of stepped wedge cluster randomized trials. Contemperory Clinical Trials 28, 182191.
Iyer, SN, Malla, A (2014). Early intervention in psychosis: concepts, current knowledge and future directions. Santé Mentale au Quebec (in press) 39, 201230.
Joa, I, Johannessen, JO, Auestad, B, Friis, S, McGlashan, T, Melle, I, Opjordsmoen, S, Simonsen, E, Vaglum, P, Larsen, TK (2008). The key to reducing duration of untreated first psychosis: information campaigns. Schizophrenia Bulletin 34, 466472.
Johannessen, JO, McGlashan, TH, Larsen, TK, Horneland, M, Joa, I, Mardal, S, Kvebæk, R, Friis, S, Melle, I, Opjordsmoen, S (2001). Early detection strategies for untreated first-episode psychosis. Schizophrenia Research 51, 3946.
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593602.
Kids Help Phone. KidsHelpPhone.ca. Being There for Kids (http://org.kidshelpphone.ca/en). Accessed 10 November 2014.
Kirmayer, LJ, Brass, GM, Tait, CL (2000). The mental health of Aboriginal peoples: transformations of identity and community. The Canadian Journal of Psychiatry/La Revue canadienne de psychiatrie 45, 607616.
Kowalewski, K, McLennan, J, McGrath, P (2011). A preliminary investigation of wait times for child and adolescent mental health services in Canada. Journal of the Canadian Academy of Child and Adolescent Psychiatry 20, 112119.
Kuhn, TS (2012). The Structure of Scientific Revolutions: 50th Anniversary Edition. University of Chicago Press: Chicago, IL.
Leamy, M, Bird, V, Le Boutillier, C, Williams, J, Slade, M (2011). Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. The British Journal of Psychiatry 199, 445452.
Lester, H, Birchwood, M, Freemantle, N, Michail, M, Tait, L (2009). REDIRECT: cluster randomised controlled trial of GP training in first-episode psychosis. British Journal of General Practice 59, e183e190.
Lieske, J, Swearer, S, Berry, B (2013). Mental health and rural schools: an integrated approach with primary care. In Handbook of Culturally Responsive School Mental Health (ed. C. S. Clauss-Ehlers, Z. N. Serpell and M. D. Weist), pp. 147155. Springer: New York.
Lomas, J (1991). Words without action – the production, dissemination, and impact of consensus recommendations. Annual Review of Public Health 12, 4165.
Malla, A, Norman, R, McLean, T, Scholten, D, Townsend, L (2003). A Canadian programme for early intervention in non‐affective psychotic disorders. Australian and New Zealand Journal of Psychiatry 37, 407413.
Malla, A, Norman, R, Scholten, D, Manchanda, R, McLean, T (2005a). A community intervention for early identification of First Episode Psychosis. Social Psychiatry and Psychiatric Epidemiology 40, 337344.
Malla, A, Norman, RM, Joober, R (2005b). First-episode psychosis, early intervention, and outcome: what have we learned? Canadian Journal of Psychiatry 50, 881891.
McGorry, P, Bates, T, Birchwood, M (2013). Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. British Journal of Psychiatry. Supplement 54, s30s35.
McGorry, PD, Edwards, J, Mihalopoulos, C, Harrigan, SM, Jackson, HJ (1996). EPPIC: an evolving system of early detection and optimal management. Schizophrenia Bulletin 22, 305.
McGorry, PD, Hickie, IB, Yung, AR, Pantelis, C, Jackson, HJ (2006). Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. The Australian and New Zealand Journal of Psychiatry 40, 616622.
McGorry, PD, Purcell, R, Hickie, IB, Jorm, AF (2007a). Investing in youth mental health is a best buy. Medical Journal of Australia 187, S5S7.
McGorry, PD, Purcell, R, Hickie, IB, Yung, AR, Pantelis, C, Jackson, HJ (2007b). Clinical staging a heuristic model for psychiatry and youth mental health. The Medical Journal of Australia 187, s40s42.
McGorry, PD, Tanti, C, Stokes, R, Hickie, IB, Carnell, K, Littlefield, LK, Moran, J (2007c). Headspace: Australia’s National Youth Mental Health Foundation – where young minds come first. The Medical Journal of Australia 187, S68S70.
McGorry, PD, Yung, AR (2003). Early intervention in psychosis: an overdue reform. Australian and New Zealand Journal of Psychiatry 37, 393398.
McGorry, PD, Yung, AR, Phillips, LJ, Yuen, HP, Francey, S, Cosgrave, EM, Germano, D, Bravin, J, McDonald, T, Blair, A, Adlard, S, Jackson, H (2002). Randomized controlled trial of interventions designed to reduce the risk of progression to first-episode psychosis in a clinical sample with subthreshold symptoms. Archives of General Psychiatry 59, 921928.
McGrath, PJ, Lingley-Pottie, P, Emberly, DJ, Thurston, C, McLean, C (2009). Integrated knowledge translation in mental health: family help as an example. Journal of the Canadian Academy of Child and Adolescent Psychiatry 18, 3037.
Melle, I, Larsen, TK, Haahr, U, Friis, S, Johannessen, JO, Opjordsmoen, S, Simonsen, E, Rund, BR, Vaglum, P, McGlashan, T (2004). Reducing the duration of untreated first-episode psychosis: effects on clinical presentation. Archives of General Psychiatry 61, 143150.
Mental Health Comission of Canada (2013). Making the case for investing in Mental Health in Canada. Calgary, AB: Mental Health Commission of Canada.
Patton, GC, Coffey, C, Romaniuk, H, Mackinnon, A, Carlin, JB, Degenhardt, L, Olsson, CA, Moran, P (2014). The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study. The Lancet 383, 14041411.
Power, P, Iacoponi, E, Reynolds, N, Fisher, H, Russell, M, Garety, PA, McGuire, PK, Craig, T (2007). The Lambeth Early Onset Crisis Assessment Team Study: general practitioner education and access to an early detection team in first-episode psychosis. The British Journal of Psychiatry 191, s133s139.
Reid, G, Brown, J (2008). Money, case complexity, and wait lists: perspectives on problems and solutions at children's mental health centers in Ontario. Journal of Behavioral Health Services and Research 35, 334346.
Reid, G, Cunningham, C, Tobon, J, Evans, B, Stewart, M, Brown, J, Lent, B, Neufeld, R, Vingilis, E, Zaric, G, Shanley, D (2011). Help-seeking for children with mental health problems: parents' efforts and experiences. Administration and Policy in Mental Health 38, 384397.
Renwick, L, Gavin, B, McGlade, N, Lacey, P, Goggins, R, Jackson, D, Turner, N, Foley, S, McWilliams, S, Behan, C (2008). Early intervention service for psychosis: views from primary care. Early Intervention in Psychiatry 2, 285290.
Rossler, W, Salize, HJ, van Os, J, Riecher-Rossler, A (2005). Size of burden of schizophrenia and psychotic disorders. European Neuropsychopharmacology 15, 399409.
Scott, E, Naismith, S, Whitwell, B, Hamilton, B, Chudleigh, C, Hickie, I (2009). Delivering youth-specific mental health services: the advantages of a collaborative, multi-disciplinary system. Australasian Psychiatry 17, 189194.
Scott, J, Leboyer, M, Hickie, I, Berk, M, Kapczinski, F, Frank, E, Kupfer, D, McGorry, P (2013). Clinical staging in psychiatry: a cross-cutting model of diagnosis with heuristic and practical value. The British Journal of Psychiatry 202, 243245.
Sherman, M, Barnum, D, Buhman-Wiggs, A, Nyberg, E (2009). Clinical intake of child and adolescent consumers in a rural community mental health center: does wait-time predict attendance? Community Mental Health Journal 45, 7884.
Singh, SP (2010). Early intervention in psychosis. British Journal of Psychiatry 196, 343345.
Singh, SP, Paul, M, Ford, T, Kramer, T, Weaver, T, McLaren, S, Hovish, K, Islam, Z, Belling, R, White, S (2010). Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study. British Journal of Psychiatry 197, 305312.
Stephens, T, Joubert, N (2001). The economic burden of mental health problems in Canada. Chronic Diseases in Canada 22, 1823.
Transformational Research in Adolescent Mental Health (TRAM) (2014). Phase III: call for full applications. http://tramcan.ca/. Accessed 10 February 2015.
Vallerand, IA, McLennan, JD (2013). Child and adolescent mental health service management strategies that may influence wait times. Journal of the Canadian Academy of Child and Adolescent Psychiatry 22, 159.
Vohringer, PA, Jimenez, MI, Igor, MA, Fores, GA, Correa, MO, Sullivan, MC, Holtzman, NS, Whitham, EA, Barroilhet, SA, Alvear, K, Logvinenko, T, Kent, DM, Ghaemi, NS (2013). Detecting mood disorder in resource-limited primary care settings: comparison of a self-administered screening tool to general practitioner assessment. Journal of Medical Screening 20, 118124.
Walsh, A, Ndubani, P, Simbaya, J, Dicker, P, Brugha, R (2010). Task sharing in Zambia: HIV service scale-up compounds the human resource crisis. BMC Health Services Research 10, 272.
Wang, J (2007). Mental health treatment dropout and its correlates in a general population sample. Medical Care 45, 224229.
Wang, PS, Berglund, P, Olfson, M, Pincus, HA, Wells, KB, Kessler, RC (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 603613.
Williams, M, Latta, J, Conversano, P (2008). Eliminating the wait for mental health services. Journal of Behavioral Health Services and Research 35, 107114.
Windell, D, Norman, R, Malla, AK (2012). The personal meaning of recovery among individuals treated for a first episode of psychosis. Psychiatric Services 63, 548553.
World Health Organization (2007). Treat Train Retain. Task shifting: Global Recommendations and Guidelines. WHO: Geneva.
Wright, A, McGorry, PD, Harris, MG, Jorm, AF, Pennell, K (2006). Development and evaluation of a youth mental health community awareness campaign – The Compass Strategy. BMC Public Health 6, 215.
Yap, MBH, Reavley, N, Jorm, AF (2013). Where would young people seek help for mental disorders and what stops them? Findings from an Australian national survey. Journal of Affective Disoders 147, 255261.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Irish Journal of Psychological Medicine
  • ISSN: 0790-9667
  • EISSN: 2051-6967
  • URL: /core/journals/irish-journal-of-psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed