Strengthening service integration across the mental health care system: An exploration of service complexity and resource intensity among youth in Ontario
Abstract
The prevalence of mental health disorders among young persons in Canada is high. Approximately 1 in 5 will experience a mental health concern. This estimate does not capture individuals who experience disruptive symptoms but fail to meet diagnostic thresholds. In Canada, the provision of mental health supports is fragmented across service sectors and lacks a standardized governance to identify, prioritize and triage youth in need of assistance. This results in a paucity of information about service users, especially as it relates to autistic youth. This three-paper dissertation utilized multi-sectoral assessment tools to describe treatment-seeking
youth in Ontario, Canada in terms of service complexity and mental health resource intensity. The first paper examined the association between sex, age, caregiver distress, finance, co-occurring conditions, intellectual disability and evaluated health status on mental health service complexity among autistic youth. Results indicated that older youth, females, several co-occurring conditions, no intellectual disability and longer durations of programming resulted in greater service complexity. The second paper explored classes of health risk behaviours related to alcohol and substance use among youth. Three classes of health risk behaviours emerged: (i) non-use, (ii) cannabis use and (iii) polysubstance use. Additionally, sex, age, polyvictimization, a diagnosis of autism spectrum disorder, family functioning, peer conflict and school engagement were associated with class membership. The third paper examined classes of health risk behaviours specifically among autistic youth and their relationships to mental health state indicators and resource intensity. The results indicated three classes of health risk behaviours: (i) recent smoking and substance use, (ii) non-use and (iii) recent cannabis use. Additionally, levels of sleep difficulties and externalizing symptoms differed between classes, whereas communication difficulties and internalizing symptoms did not. Female youth and recent cannabis users required higher mental health resource intensity compared to male peers and non-users. The dissertation concludes by discussing the implications of the overall findings for research and for mental health policy, specifically as it relates to the integration of supports for youth in Ontario, Canada.