Parents who contacted 1 of 15 children's mental health agencies in Ontario, Canada reported on where and why they were seeking mental health services for their 4- to 17-year-old children. Parents contacted an average of four agencies (± 1.7; range = 1-14) in the previous year. Approximately one-half of parents were looking for either multiple types of treatment, or help for different problems, across agencies. The complex pattern of help-seeking evidenced in our study likely increases the burden on the mental health care system and on families, and may reduce the likelihood that families will connect with the most appropriate treatment.

Aim: This article describes the development and design of the Youth Wellness Centre (YWC), an innovative, youth-friendly centre providing mental health and addiction services for emerging adults aged 17 to 25 in Hamilton, Canada. We also report on demographic and clinical characteristics of clients to evaluate how the YWC is serving populations at increased risk of developing mental disorders.Methods: Data were extracted from clinic databases for 1520 youth at the YWC between March 2015 and 2018 to report on demographic characteristics, clinical profiles, primary presenting problems, service use and overall satisfaction with services.Results: Marginalized groups, particularly street-involved individuals and LGBTQ+ youth, are highly represented at the YWC, keeping with the centre's mandate of reaching at-risk populations. Youth at the YWC carry significant mental health burdens, with 80.8% having a history of suicidal ideation and 32.8% having a history of a substance use disorder. The primary route of referral is self-referral and the number of new clients has increased by nearly 20% in the first 3 years of operations. Overall satisfaction with the centre is on par with or slightly above provincial averages. Conclusions:The YWC was developed to meet the mental health needs of transition-aged youth in Hamilton by providing early intervention, system navigation and transition services. The success of the YWC in reaching high-risk youth is demonstrated by the significant proportion of clients reporting demographic and clinical risk factors associated with increased risk for development of mental disorders. The increasing referrals to the YWC highlight the ongoing need for similar services.

A substantive literature suggests that anxious people have an attentional bias toward threatening stimuli. To date, however, no systematic review has examined the effects of cognitive behavioral therapy (CBT) for anxiety on attentional bias. A better understanding of the extant literature on CBT and its effect on attentional bias can serve to bridge the gap between experimental research on cognitive bias and the implications for clinical treatment of anxiety disorders. The present review examined studies that measured the effects of CBT on attentional bias. Of the 13 studies reviewed, 10 demonstrated that attentional bias, as assessed by dichotic listening tasks, the emotional Stroop test, or probe detection tasks, was significantly reduced from pretreatment to posttreatment for obsessive-compulsive disorder, spider phobia, social phobia, and generalized anxiety disorder. Methodological issues are considered, and implications for cognitive behavioral treatments of anxiety are discussed.

BackgroundSome children with mental health (MH) problems have been found to receive ongoing care, either continuously or episodically. We sought to replicate patterns of MH service use over extended time periods, and test predictors of these patterns.MethodsLatent class analyses were applied to 4 years of visit data from five MH agencies and nearly 6000 children, 4- to 13-years-old at their first visit.ResultsFive patterns of service use were identified, replicating previous findings. Overall, 14% of cases had two or more episodes of care and 23% were involved for more than 2 years. Most children (53%) were seen for just a few visits within a few months. Two patterns represented cases with two or more episodes of care spanning multiple years. In the two remaining patterns, children tended to have just one episode of care, but the number of sessions and length of involvement varied. Using discriminant function analyses, we were able to predict with just over 50% accuracy children’s pattern of service use. Severe externalizing behaviors, high impairment, and high family burden predicted service use patterns with long durations of involvement and frequent visits.ConclusionsOptimal treatment approaches for children seen for repeated episodes of care or for care lasting multiple years need to be developed. Children with the highest level of need (severe pathology, impairment, and burden) are probably best served by providing high intensity services at the start of care.