1. ACCESS-Mental Health: Understanding how youth with mental health access services in Atlantics Canada Rick Audas, PhD

2. Atlantic Canada Children’s Effective Service Strategies (ACCES-MH) Examining Barriers and Facilitators in Child and Youth Mental Health in Atlantic Canada Researchers: Dr. Rick Audas (Nominated PI) – Health Economist (MUN) (on leave) Dr. Marshall Godwin (Nominated PI) Family Medicine (MUN) (acting) Dr. Jacques Richard (PI) – Psychologist (UdeM) Dr. Scott Ronis (PI) – Psychologist (UNB) Dr. Kate Tilleczek(PI) – Canada Research Chair (Young Lives) (UPEI & SickKids) Dr. Michael Zhang (PI) – Operations Research Expert (SMU)
The project will include:
Interviewing over 150 individuals: children/youth/parents, service providers (medical & community) to understand child/youth journeys in mental health. Longitudinal follow-up
Analysing large datasets: Using administrative databases in four provinces & Statistics Canada datasets to examine health utilization patterns antecedents and trajectories of affected youth and link to data from various government agencies
Using advanced analytical techniques and computer models to make better decisions

3. What is the project about?
Bring together an inter-sectorial and inter-disciplinary team of decision makers, clinicians, and academic researchers from across Atlantic Canada
Taking a diverse approach to studying several mental health and behavioural conditions.
ASD, Anxiety, Depression, Conduct Disorders and Eating Disorders.
Building on anecdotal evidence that services for children with mental health conditions are lacking, are poorly coordinated and place a tremendous burden on families.

4. Analysis of Large Datasets
Atlantic Canada Children’s Effective Service Strategies (ACCESS-MH) Examining Barriers and Facilitators in Child & Youth Mental Health in Atlantic Canada
Guiding Questions
What services are being accessed?
What journeys are being taken through the system?
What are the barriers and facilitators to access and services?
Which services are effective/ineffective and why?
Can the system be better integrated, coordinated, and funded?
Analysis of Large Datasets
Patient Journeys
Operations Research
Administrative databases in four provinces & Statistics Canada datasets
Health utilization patterns
Antecedents and trajectories of affected youth
Link to data from various government agencies
Interviews & visual methods to understand child/youth journeys in mental health
Interviewing 240 individuals:
Children/youth
Parents
Service providers (medical & community)
Longitudinal follow-up
Using advanced analytical techniques and computer models to make better decisions
Simulation models to capture complex interactions within and between different programs
System and queuing optimization to create efficient/effective solutions

5. Achievements to Date
Completed an environmental scan of current mental health services in Atlantic Canada. Producing an Atlantic Canada map with service providers identified with “hot spots” or links to service providers
Received research ethical approval from 5 universities and several health authorities
Developed qualitative tools for data collection
Designed and delivered training workshop
Partnered with SEAK and ASI to host a symposium on Child and Youth Mental Health entitled: Investing in Child and Youth Mental Health - Mobilizing Atlantic Canadians for a Positive Future.

6. Achievements to Date
Collaborated on a needs assessment for the Autism Society of Newfoundland and Labrador – a significant undertaking involving over 40 interviews with parents, adults with ASD, service providers, educators and policy makers; and four distinct surveys with over 500 responses
Created a website to be used as a resource for youth, parents/caregivers, service providers and researchers. Website (
Building capacity through the training of approximately 30 graduate students, including master’s, PhD and Post docs
Nearing completion of Phase I data collection with over 150 interviews completed
Have built a partnership with the Atlantic Regional Training Centre for Applied Health Services Research (ARTC) to facilitate training and capacity building.

7. Student Thesis Projects
Health Utilization Patterns of Children and Youth with Mental Health Conditions in NL
An Atlantic Canadian Urban and Rural Communities Mixed Methods Comparison: An Examination of the Differences in Self-Perceived and Potential Need for Mental Health Care and Actual Mental Health Service Use Among Youth (Aged ). Results from the Canadian Community Health Survey – Mental Health.
Key Factors Associated with Help- Seeking Behaviours Among Atlantic Canadian Adolescents with Depressive Symptoms
Examination of factors linked to service utilization among Atlantic Canadian Youth with conduct disorders
Youth and Mental Health Access to Primary Care Services in Atlantic Canada: Exploring the relationship(s) between the client/youth and their service provider
Youth Mental Health Access in Atlantic Canada: A critical ethnography of youth diagnosis and treatment with a focus on interpreting psychological disorders within a specific historic and cultural context
Examining the Transitioning of Pediatric Patients with Autism into Adult Care
Access and Barriers to Services for Youth with Anxiety and Depression
Early Diagnosis and Treatment for Autism Spectrum Disorder in Elementary aged children
Barriers and facilitators of access to mental healthcare among incarcerated youths with substance use disorders in New Brunswick
Overview of Emergency Health Services for Children and Youth with Mental Health Conditions
Socio-economic Impact of Children’s Mental Health Conditions on Families in Atlantic
Families Journeys: Exploring Family Perspectives on Access to Mental Health Services for Children and Youth in New Brunswick
Comparative access to youth mental health services across francophone and annglophone communities in Atlantic Canada
Modeling the HR needs for youth with mental health conditions.

8. Work to Come
We are just starting to scratch the surface of what is possible
Working to try to link individuals across datasets (which is starting to happen in NB, hopefully will follow elsewhere)
Longitudinal analysis of qualitative data.
Focus on ‘solutions’ from the OR team – lead by Michael Zhang. Key that these solutions will be data driven, but will also have input from qualitative approaches
Trying to use multiple lenses to study this problem from a variety of perspectives.

9. Outcomes and Expected Impact of Research Program
Short Term
Outcomes
Medium Term
Long Term
Increase
Awareness
Knowledge
Attitudes
Skills
Change Culture
By improving clinical practice attitudes towards children and youth mental health
Change Practice
Implementing best practices in youth and mental health treatment
Increase Dialogue
between all sectors
At the organizational level:
Improve accessibility to treatment and care
Reduce wait times
Increase cost effective programs
At the patient level:
Improve mental health for children and youth in Atlantic Canada
Provide platform for patient voice

10. Main Messages
Children with mental health conditions have a tough time of it
The way services are delivered varies tremendously across the provinces, and quite often within each provinces
There tends to be a lack of services available outside of larger centres
Parents and caregivers play a crucial role in advocating, arranging and coordinating care
Few health service, or other providers/educators take on the coordination role
Often this places an undue amount of stress on families
Can result in both physiological and economic hardship
Concern that care is not being efficiently provided.

11. Future Work
Eager to potentially carry on through the life course and seeing how these youth transition to adulthood
Especially interested in barriers to employment – identified as a key area in the ASNL Needs Assessment
Interested in examining the longer-term impact on families
Extending to other mental health conditions and other forms of disability.

12. Questions?