Program manager perspectives on the service system to meet the needs of youth with concurrent disorders: findings from a Canadian national survey

Abstract

BackgroundConcurrent mental health and substance use issues are a serious problem for adolescents and transition-aged youth. Service providers across sectors must be involved in informing system change to meet youth needs. This study examines stakeholder perspectives on services for youth with concurrent disorders including 1) clinical issues in youth services; 2) priority system issues; and 3) optimal knowledge translation strategies to enhance researcher-stakeholder communication.MethodsA database of youth clinical services across Canada was developed. Program managers (n = 481) at cross-sectoral (mental health, addictions, justice, child welfare, advocacy, and outreach) youth-serving (aged 12–24) programs were invited to complete an online survey; 232 responded. Survey questions concerned youth needs, program characteristics, priorities for service system enhancement; and usual and preferred knowledge translation methods.ResultsAcross service sectors, the mean estimated proportion of youth using services with concurrent mental health and substance use problems was 55 %. Program managers reported routine screening for mental health and substance use concerns (66 %), referring to other agencies to meet the concurrent disorder needs of youth (54 %), offering specific programming for concurrent disorders (42 %), and program evaluation (48 %). Notably, mental health programs were significantly less likely to offer concurrent disorders services than addictions programs. Where services do exist, most are targeted at youth aged 12–18 years, with fewer services available for transition-aged youth. Endorsement of various system change goals exceeded 80 %, with a particular emphasis on improving access to services (49 %), ensuring a continuum of services for varying levels of severity (37 %), and improved integration across sectors (36 %). Preferred knowledge exchange methods were workshops and websites for receiving information; and focus groups or surveys, rather than intensive participation on research teams, to inform research.ConclusionsThere is a high need to build capacity across most sectors for meeting the needs of youth with co-occurring mental health and substance use problems, especially for transition-aged youth. In addition, limits in program evaluation should be addressed. Innovative knowledge exchange strategies are needed to better meet the needs of youth with concurrent disorders. Although service providers expressed readiness to participate in service enhancement and knowledge translation activities, effective, feasible approaches must integrate strategies likely to result in desired clinical outcomes, given clinical workload challenges.

Enhancing prevention and intervention for youth concurrent mental health and substance use disorders: The Research and Action for Teens study

“…However, expanded awareness about youth CDs and CD‐informed approaches to meet the needs of youth with CDs are still needed in child and adolescent mental health agencies, youth addiction services and other health and social services. Because of the degree of overlap between mental health and substance‐related concerns among youth, effective collaboration is essential across sectors and developmental stages (Chaim & Henderson, ; Chaim et al, ; Henderson et al, ). This set of studies provides insight into a range of approaches that can be used to address this continuing practice gap.…”

“…Additionally, capacity‐building training was provided on youth CDs and the use of screening tools. Service providers were surveyed about their use and perception of the GAIN‐SS implementation, and on their attitudes and knowledge about youth CDs, before and after capacity‐building training (Henderson et al, ). However, due to the extent of staff turnover and a lack of overlap in the samples before and after training, change attributable to the training could not be directly assessed.…”

Service provision for depressed children and youth: a survey of the scope and nature of services in Ontario

“…Consistent with the sampling methods of previous studies by members of the project team [36, 37], we created a comprehensive province-wide database of mental health and other cross-sectoral agencies who provide any depression-related services to children and/or youth up to 25 years of age. To our knowledge, this database is the first such comprehensive list of depression services across sectors for children and youth (including TAY) compiled in Ontario.…”

“…The survey covered four domains: (1) treatment (psychosocial interventions and client characteristics); (2) service use patterns; (3) service system functioning; and (4) research priorities. This survey used a measure adapted from surveys previously developed by team members [36, 37]. Prior to launch, consultations on survey content and process were held with a Toronto-based cross-sectoral group of child and youth mental health and substance use service providers who meet monthly to share information on projects related to service system enhancement, and a national youth engagement group that focuses on youth mental health and related services.…”

Service provision for depressed children and youth: a survey of the scope and nature of services in Ontario.

“…Consistent with the sampling methods of previous studies by members of the project team [36,37], we created a comprehensive province-wide database of mental health and other cross-sectoral agencies who provide any depression-related services to children and/or youth up to 25 years of age.…”