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A groundbreaking program aimed at improving access to mental health services for children and adolescents in Canada has demonstrated significant progress, according to a new study.
The initiative, known as ACCESS Open Minds (ACCESS-OM), is based on five key principles: early identification, rapid access, appropriate care, seamless transitions for individuals aged 11 to 25, and active youth and family engagement. The program is designed to be adaptable to local conditions, allowing it to be effectively implemented across diverse urban, rural, and Indigenous communities in Canada.
The findings of this study were published online on February 26 in JAMA Psychiatry.
Measuring Success
The research was led by Dr. Srividya N. Iyer, Canada Research Chair in Youth, Mental Health, and Learning Health Systems at McGill University. It involved 4519 youths aged 11-25 from 11 sites across Canada. The study examined three key measures of effectiveness:
- Increase in youth referrals
- Timeliness of evaluations (within 72 hours of referral)
- Time taken to receive services (within 30 days of the first appointment)
The results showed that every six-month period following the program’s implementation saw a 10% increase in referral rates. Additionally, the time taken to offer an evaluation and deliver services decreased by 3% per six-month period.
During the first year, 48% of youths were offered an appointment within 72 hours, rising to 62% in year two and 64% in year three. Similarly, the probability of receiving services within 30 days grew from 85% in year one to 89% in year three. However, individuals with moderate to severe mental health conditions faced 14% longer delays for appointments and 11% longer wait times for services.
Addressing Long Wait Times
ACCESS-OM is a research network funded by the Canadian Institutes of Health Research and the Graham Boeckh Foundation to bridge gaps in youth mental health services. Before this program, wait times across Canada ranged from 45 days to 18 months, often leaving emergency departments as the only alternative for immediate care.
The study emphasized the importance of diverse representation, incorporating rural, urban, Indigenous, and multilingual communities. The program also facilitated access for traditionally underserved groups, including LGBTQ+, racial and ethnic minorities, and economically disadvantaged youths.
However, primary and community healthcare settings were found to be inadequately equipped to handle severe mental health cases, leading to longer delays. Researchers suggest further studies to address this issue.
Innovative Solutions
A key innovation in the program is the use of an open referral system, allowing young individuals to seek services through family members, teachers, counselors, or self-referral. Instead of meeting a psychiatrist first, youths are initially assessed by trained professionals, reducing the burden on psychiatrists, who are in limited supply.
The program is publicly funded through Canada’s healthcare system, a factor that may contribute to its success but could limit its application in countries without universal healthcare.
Dr. Louise Gallagher, chief of the Child and Youth Mental Health Collaborative at the Hospital for Sick Children in Toronto, highlighted the program’s efficiency in providing faster access to care. However, she noted that despite progress, specialist shortages still present a challenge.
While ACCESS-OM has made great strides, the study calls for additional research to ensure that all youth, especially those with more severe conditions, receive timely and appropriate care.
Disclaimer
This article is based on research findings and does not constitute medical advice. Readers seeking mental health support should consult healthcare professionals or appropriate services in their region.
