We are improving mental health care for young people across Canada.
The McCain Centre drives projects that:
address a pressing mental health and/or substance use challenge affecting children, youth and/or families
engage youth, families and service providers in planning and implementation
involve meaningful collaboration
have a high likelihood of service or system impact
include a robust knowledge translation plan
McCain projects stretch across a number of key research areas, including:
optimizing outcomes through personalized treatment for children and youth
understanding transitions and addressing transition gaps
improving youth access to mental health information, for youth by youth
integrated and stepped models of care.
National Youth Screening Project
The National Youth Screening Project is improving youth-focused, evidence-based care for substance use through collaborative work that included decision-makers, service providers and other stakeholders.
A common screening tool (GAIN-SS) was implemented across 10 Canadian communities to increase knowledge about youth substance use and mental health needs; increase the capacity to provide care; increase early intervention opportunities; and improve pathways to treatment for young people 12 to 24 with substance use and concurrent disorders.
Findings suggest improvements be made in gender-informed and gender-specific services; developmentally informed and responsive services; and trauma-informed and trauma-specific services. Increased capacity for addressing suicide-related concerns is also needed, as are opportunities through which service providers can identify and address co-occurring substance use and mental illnesses.
YouthCan IMPACT is a collaboration between youth, families, community agencies, primary care partners and hospitals in Toronto that is focused on improving the youth mental health and addiction system. Through a one-stop walk-in clinic model, young people access the services they need when they need them, right in their community.
As part of this study, the YouthCan IMPACT team is comparing the approach to hospital outpatient psychiatric services. The study focuses on youth 14 to 18, and recruitment is active at CAMH, SickKids, Michael Garron Hospital, North York General Hospital and Sunnybrook.
A similar approach has been adopted by Youth Wellness Hubs Ontario (YWHO), which provides one-stop services for up to 12,000 young people across the province through 10 sites. YWHO operates under the leadership of Dr. Joanna Henderson, also Director of the McCain Centre.
The YouthCan IMPACT team has also created Building Integrated Service Hub Models for Youth Mental Health and Addictions: The YouthCan IMPACT Experience and Guidebook, a resource for community partners looking to implement mental health care hubs in their community.
The Longitudinal Youth in Transition Study is improving transitions from youth to adult mental health services by creating a better understanding of how young people transition out of mental health services at age 18 — a difficult time in which up to half experience a disruption in their care.
The study examined symptoms, life functioning, service use and readiness to transition out of child and adolescent mental health services. The team is seeking to understand ways of improving continuity of mental health care for youth, and evaluating the impact of co-occurring major life-stage milestones, such as first experiences in the workplace, moving away from home and beginning post-secondary education.
Longitudinal Youth in Transition Study community partners:
The Web Interventions Repository of Evidence (WIRE) is a searchable database of internet-based interventions for substance use that have been evaluated for use with youth 12 to 24. WIRE was created to support informed decision-making among service providers interested in exploring the use of internet-based interventions with this population.
WIRE was built as part of a larger project examining the evidence for internet-based interventions for youth who use substances, funded by Health Canada’s Drug Treatment Funding Program. WIRE summarizes findings from a systematic literature review published since 2005 on internet-based interventions for the target population.
WIRE community partners:
Centre for Addictions Research of British Columbia
Working with youth researchers from the National Youth Action Council, the Wellness Quest team is consulting with young people across Canada on a resource that helps them understand the services available in their communities; and giving youth the means to advocate for the services they feel best suit their needs. This youth-written resource consists of a checklist and a guide. The checklist helps young people identify issues and services most important to them, which they can then share with service providers. The guide explains these issues and services in an engaging, easy-to-navigate format, with youth-friendly language and including questions youth may have for service providers.
Developed by youth for youth, Wellness Quest is aimed at moving young people from the role of patient to partner in their own mental health care. Through the project, a final version of the Wellness Quest resource will be developed that reflects the feedback provided by Canadian youth; the resource will be disseminated to youth across Canada using a strategy identified by participants as most effective for young people; and the research design will position young people as natural leaders, researchers and participants.
Clinical Practice Guidelines for Disruptive Behaviour Disorder
Clinical practice guidelines provide a valuable framework for evidence-based practice, yet few studies assess their quality. Through this project, researchers examined guidelines aimed at assessing, preventing and treating disruptive behaviour, including attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder and aggression in young people. Of the 29 guidelines identified that met inclusion criteria, two that were developed for ADHD and one for contact disorder showed high quality in all three domains.
Findings from this review provide important information for clinicians and organizations wanting to use guidelines to implement best-practice clinical services for children and youth with disruptive behaviour.
Understanding the health care experiences of girls and women on the autism spectrum
Diagnosing autism spectrum disorders (ASD) in females can be challenging because their social behaviours present differently than males. Many girls and women are undiagnosed, misdiagnosed or diagnosed late in life, often leaving their health care needs unrecognized or unmet.
Through this project, researchers set out to better understand the ASD and health care experiences of girls and women. Areas of exploration included how girls and women experience autism and the process of being diagnosed with ASD; how being a girl or a woman with ASD affects access to health care; and how girls and women experience both ASD-specific and general health care.
Preliminary results indicate there are specific presentations of ASD in females compared to males, and that gender-related factors contributed to females being undiagnosed and having unmet health care needs. Key themes included feeling different from others at an early age; being diagnosed with mental health conditions and overlooked for ASD; experiencing exhaustion from managing ASD in daily social life; being socialized differently than boys and men; and lacking access to health, education, employment and social services and supports.
Understanding the health care experiences of girls and women with ASD can inform the development of diagnostic and health care practices tailored to their needs; the training of health professionals; and pathways to improve access to both general health and ASD-specific services and supports.
Co-created with youth, YouthCan IMPACT is offering young people innovative services that are easily accessible and rigorously evaluated. This work is helping build better service models for youth across Ontario’s communities for the future.
Dr. Joanna Henderson, Director of the Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health
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