Mothers and fathers sang a song of their choice, once to their infant and once as if to their infant (simulated). The pitch of songs was higher and the tempo slower for infant-directed than for simulated versions. Listeners varying in child-care experience, musical background, and cultural origin reliably identified which of the two versions was infant-directed (Experiment 1). Identification accuracy was enhanced by musical training, knowledge of the singers' language and culture, and by greater pitch and tempo differences between versions. Other adult listeners who rated the singer's emotional engagement assigned significantly higher ratings to infant-directed than to simulated versions (Experiment 2). Differences in pitch and tempo between both versions predicted emotional engagement ratings. Finally, rating differences between infant-directed and simulated versions were highly correlated with identification accuracy.
BackgroundBy integrating Youth–Adult Partnerships (Y‐APs) in organizational decision making and programming in health‐care settings, youth can be engaged in decisions that affect them in a way that draws on their unique skills and expertise. Despite challenges, Y‐APs can have many benefits for youth and adults alike, as well as for the programmes and initiatives that they undertake together.ObjectiveThis article describes the development, implementation and success of a Y‐AP initiative at the McCain Centre at the Centre for Addiction and Mental Health, a large urban hospital.MethodThe McCain Y‐AP implementation model was developed based on the existing literature, guided by the team's progressive experience. The development and implementation procedure is described, with indicators of the model's success and recommendations for organizations interested integrating youth engagement.ResultsThe McCain Y‐AP has integrated youth into a wide range of mental health and substance use‐related initiatives, including research projects, conferences and educational presentations. The model of youth engagement is flexible to include varying degrees of involvement, allowing youth to contribute in ways that fit their availability, interest and skills. Youth satisfaction has been strong and both the youth and adult partners have learned from the experience.DiscussionThrough the McCain Y‐AP initiative, youth engagement has helped advance numerous initiatives in a variety of ways. Flexible engagement, multifaceted mentorship, reciprocal learning and authentic decision making have led to a successful partnership that has provided opportunities for growth for all those involved. Health‐care organizations interested in engaging youth can learn from the McCain Y‐AP experience to guide their engagement initiatives and maximize success.
Objectives: The current novel coronavirus disease of 2019 (COVID-19) pandemic presents a time-sensitive opportunity to rapidly enhance our knowledge about the impacts of public health crises on youth mental health, substance use, and well-being. This study examines youth mental health and substance use during the pandemic period. Methods: A cross-sectional survey was conducted with 622 youth participants across existing clinical and community cohorts. Using the National Institute of Mental Health-developed CRISIS tool and other measures, participants reported on the impacts of COVID-19 on their mental health, substance use, and other constructs. Results: Reports of prepandemic mental health compared to intrapandemic mental health show a statistically significant deterioration of mental health across clinical and community samples ( P < 0.001), with greater deterioration in the community sample. A total of 68.4% of youth in the clinical sample and 39.9% in the community sample met screening criteria for an internalizing disorder. Substance use declined in both clinical and community samples ( P < 0.001), although 23.2% of youth in the clinical sample and 3.0% in the community sample met screening criteria for a substance use disorder. Participants across samples report substantial mental health service disruptions (48.7% and 10.8%) and unmet support needs (44.1% and 16.2%). Participants report some positive impacts, are using a variety of coping strategies to manage their wellness, and shared a variety of ideas of strategies to support youth during the pandemic. Conclusions: Among youth with histories of mental health concerns, the pandemic context poses a significant risk for exacerbation of need. In addition, youth may experience the onset of new difficulties. We call on service planners to attend to youth mental health during COVID-19 by bolstering the accessibility of services. Moreover, there is an urgent need to engage young people as coresearchers to understand and address the impacts of the pandemic and the short, medium, and long terms.
Background Community-based, integrated youth service hubs have the potential to address some of the longstanding issues with mental health services for youth, including problems with access and system fragmentation. Better understanding of these approaches, particularly efforts to create a single point of entry to comprehensive, evidence-based services through youth service hubs, is needed to help guide future implementation and evaluation. This scoping review identifies the key principles and characteristics of these models of care, as well as the state of the literature, particularly with regard to implementation and replicability. Method Electronic databases and grey literature sources were searched for material from 2001 to 2019, with diverse search terms capturing the concept of “integrated” or “one-stop shop” youth mental health services. Title/abstract and full text review were conducted, as well as additional focused searching. After screening 4891 texts at the title/abstract level and 496 at the full-text level, 110 documents were included for data extraction. Results Several integrated care hub models for youth mental health services and related frameworks were identified internationally, largely in high-income countries. Common principles included an emphasis on rapid access to care and early intervention, youth and family engagement, youth-friendly settings and services, evidence-informed approaches, and partnerships and collaboration. Program characteristics also revealed similarities (e.g., providing evidence-informed or evidence-based services in youth-friendly spaces), with some differences (e.g., care coordination methods, types of service providers), potentially attributable to lack of available information about key ingredients. Outcome research was limited, with few rigorous evaluations of youth outcomes. Moreover, sufficient information for replication, community evaluation of feasibility or actual implementation was rarely provided. Conclusion Internationally, integrated youth service hubs were found to share common key principles, while providing comprehensive services to youth with mental health difficulties. There is a great need for common language and measurement framework to facilitate replication, rigorous evaluation of outcomes, knowledge exchange, and dissemination of findings.
ContextEngaging youth as partners in academic research projects offers many benefits for the youth and the research team. However, it is not always clear to researchers how to engage youth effectively to optimize the experience and maximize the impact.ObjectiveThis article provides practical recommendations to help researchers engage youth in meaningful ways in academic research, from initial planning to project completion. These general recommendations can be applied to all types of research methodologies, from community action‐based research to highly technical designs.ResultsYouth can and do provide valuable input into academic research projects when their contributions are authentically valued, their roles are clearly defined, communication is clear, and their needs are taken into account. Researchers should be aware of the risk of tokenizing the youth they engage and work proactively to take their feedback into account in a genuine way. Some adaptations to regular research procedures are recommended to improve the success of the youth engagement initiative.ConclusionsBy following these guidelines, academic researchers can make youth engagement a key tenet of their youth‐oriented research initiatives, increasing the feasibility, youth‐friendliness and ecological validity of their work and ultimately improve the value and impact of the results their research produces.
Objective: The coronavirus 2019 (COVID-19) pandemic is raising concerns about mental health across the population. Because transgender and gender-diverse youth have particular mental health vulnerabilities, this study examines their mental health challenges during the early stages of the pandemic. Method: A cross-sectional survey was conducted in the early COVID-19 pandemic period, which included 29 transgender and gender-diverse youth and 593 cisgender youth. Descriptive statistics, Fisher’s exact tests, and logistic regression analyses were conducted to understand the differential impact of COVID-19 on mental health and related constructs. Results: Results show that transgender and gender diverse youth are more greatly affected by mental health challenges during the COVID-19 pandemic than cisgender youth (p = .001). They report more mental health and substance use service disruptions (p < .001) and less social support from their families (p = .007) compared with cisgender youth. A large proportion (63.0%) report unmet needs for mental health and substance use during the early pandemic period, compared with 27.9% of cisgender youth (p = .008). Conclusions: Transgender and gender-diverse youth constitute a vulnerable population during the COVID-19 pandemic and are experiencing substantial mental health impacts, in conjunction with high levels of service disruption and less support from family members. Researchers and service planners are encouraged to engage directly with transgender and gender diverse youth to understand how their support needs evolve over the course of the pandemic and how services can be adapted to meet their needs.
IntroductionAmong youth, the prevalence of mental health and addiction (MHA) disorders is roughly 20%, yet youth are challenged to access evidence-based services in a timely fashion. To address MHA system gaps, this study tests the benefits of an Integrated Collaborative Care Team (ICCT) model for youth with MHA challenges. A rapid, stepped-care approach geared to need in a youth-friendly environment is expected to result in better youth MHA outcomes. Moreover, the ICCT approach is expected to decrease service wait-times, be more youth-friendly and family-friendly, and be more cost-effective, providing substantial public health benefits.Methods and analysisIn partnership with four community agencies, four adolescent psychiatry hospital departments, youth and family members with lived experience of MHA service use, and other stakeholders, we have developed an innovative model of collaborative, community-based service provision involving rapid access to needs-based MHA services. A total of 500 youth presenting for hospital-based, outpatient psychiatric service will be randomised to ICCT services or hospital-based treatment as usual, following a pragmatic randomised controlled trial design. The primary outcome variable will be the youth's functioning, assessed at intake, 6 months and 12 months. Secondary outcomes will include clinical change, youth/family satisfaction and perception of care, empowerment, engagement and the incremental cost-effectiveness ratio (ICER). Intent-to-treat analyses will be used on repeated-measures data, along with cost-effectiveness and cost-utility analyses, to determine intervention effectiveness.Ethics and disseminationResearch Ethics Board approval has been received from the Centre for Addiction and Mental Health, as well as institutional ethical approval from participating community sites. This study will be conducted according to Good Clinical Practice guidelines. Participants will provide informed consent prior to study participation and data confidentiality will be ensured. A data safety monitoring panel will monitor the study. Results will be disseminated through community and peer-reviewed academic channels.Trial registration numberClinicaltrials.gov NCT02836080.
Background There are increasing calls to make mental health and substance use services youth friendly, with hopes of improving service uptake, engagement and satisfaction. However, youth-friendliness in this area has not been clearly defined and there is a lack of information about the characteristics that make such services youth friendly. The purpose of this scoping review was to examine the literature available on youth-friendly mental health and substance use services in order to identify the characteristics, outline the expected impacts, and establish a definition. Methods A scoping review of seven databases and grey literature sources was conducted. Twenty-eight documents were retained as relevant to the research questions. Relevant data from these documents was extracted, analyzed and presented to stakeholders, including youth, caregivers and service providers to validate and refine the results. Results Youth-friendly mental health and substance use services include integrated, inclusive, confidential and safe organization and policy characteristics; bright, comfortable, environment with informational materials; welcoming and genuine service providers with appropriate communication and counselling skills; an accessible location; minimal wait times; and individualized and innovative approaches. All areas in which youth friendliness should be implemented in a mental health and substance use service organization had a core value of youth voice. Conclusion Improving the youth friendliness of mental health and substance use services includes incorporating youth voice in organization, policy, environment, service providers, and treatment services, and has implications for treatment uptake, engagement and satisfaction. Further research is required to determine the impact of youth friendliness in such services. Electronic supplementary material The online version of this article (10.1186/s12913-019-4066-5) contains supplementary material, which is available to authorized users.
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