New data from a national project led by McGill University researchers shows that redesigning youth mental health services can significantly cut wait times and connect more young people to care.
The ACCESS Open Minds project was launched in 2014 to address gaps in access to quality mental health care, especially for Indigenous, remote and underserved communities. Findings published in Jama Psychiatry provide the first assessment of the program's outcomes across Canada.
"We focused on transforming existing programs in clinics, schools and youth centres to make them more accessible, youth-friendly and culturally appropriate," said lead author Srividya Iyer , Professor in McGill's Department of Psychiatry and Researcher at the Douglas Research Centre.
The program was developed, implemented and evaluated by McGill researchers, in collaboration with colleagues at universities across Canada, as well as youth, families, community organizations and policymakers.
A measurable impact
Access to mental health care typically requires a professional referral, a step the authors say can be slow and discouraging for youth. ACCESS Open Minds removed that barrier by letting youth reach out for help on their own. It also set clear service targets: an evaluation within three days and treatment within 30 days – benchmarks few public services are able to achieve.
Over four years, nearly 8,000 youth ages 11 to 25 were referred across 11 study sites. Most were seen within three days, far faster than the typical wait of between 45 days and more than a year, say the authors. Referrals rose by 10 per cent every six months.
"At our downtown Montreal site for homeless youth, we saw a dramatic increase in the number of young people accessing services. Even with this increased demand, with just two additional staff, we were still able to see the majority of young people within 72 hours," said Iyer, who is also Canada Research Chair in Youth, Mental Health and Learning Health Systems.
The project also involved adjusting workflows, training staff, and improving co-ordination among service providers, largely done using existing resources.
Model has helped shape Quebec's Aire ouverte network
Of the 16 communities served across Canada, five were in Quebec. In the northern region of Nunavik, the team worked with Indigenous youth and Elders to transform a garage into a warm, youth-friendly hub where teens could connect and fix hunting gear.
In downtown Montreal, young people experiencing homelessness received holistic care through partnerships with shelters, soup kitchens, clinics and even a circus.
"We worked with Cirque Hors Piste to develop artistic programs. We wanted to create space for young people to express themselves and show that we care for the whole person, not just their symptoms," Iyer said.
The authors say their model has helped shape Quebec's Aire Ouverte network and similar initiatives across Canada.
They are now exploring ways to address the broader factors affecting mental health.
"From climate anxiety and unaffordable housing to precarious jobs and the impact of AI, the root causes of these challenges must be addressed in our systems," Iyer said.
About the study
" An Approach to Providing Timely Mental Health Services to Diverse Youth Populations " by Srividya Iyer and Ashok Malla et al., was published in JAMA Psychiatry.
ACCESS Open Minds was funded by the Canadian Institutes of Health Research and the Graham Boeckh Foundation as part of Canada's Strategy for Patient-Oriented Research.
