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.

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.

BackgroundSeventy percent of lifetime cases of mental illness emerge prior to age 24. While early detection and intervention can address approximately 70% of child and youth cases of mental health concerns, the majority of youth with mental health concerns do not receive the services they need.ObjectiveThe objective of this paper is to describe the protocol for optimizing and evaluating Thought Spot, a Web- and mobile-based platform cocreated with end users that is designed to improve the ability of students to access mental health and substance use services.MethodsThis project will be conducted in 2 distinct phases, which will aim to (1) optimize the existing Thought Spot electronic health/mobile health intervention through youth engagement, and (2) evaluate the impact of Thought Spot on self-efficacy for mental health help-seeking and health literacy among university and college students. Phase 1 will utilize participatory action research and participatory design research to cocreate and coproduce solutions with members of our target audience. Phase 2 will consist of a randomized controlled trial to test the hypothesis that the Thought Spot intervention will show improvements in intentions for, and self-efficacy in, help-seeking for mental health concerns.ResultsWe anticipate that enhancements will include (1) user analytics and feedback mechanisms, (2) peer mentorship and/or coaching functionality, (3) crowd-sourcing and data hygiene, and (4) integration of evidence-based consumer health and research information.ConclusionsThis protocol outlines the important next steps in understanding the impact of the Thought Spot platform on the behavior of postsecondary, transition-aged youth students when they seek information and services related to mental health and substance use.

This article describes a two-phase, multi-sectoral project aimed at enhancing youth services addressing substance use in Ontario. In the information gathering phase, a youth-focused website and survey, focus groups, and interviews were used to elicit perspectives from multiple stakeholders. In the implementation phase, capacity-building and consultations on transition-aged youth needs were conducted to inform youth transition-readiness checklists. We discuss the importance of engaging youth as collaborators as well as respondents and the processes used to tailor findings to local contexts for implementation.Keywords: substance use, service system, youth engagement, cross-sectoral collaboration, health equity, knowledge exchange RÉSUMÉCet article décrit un projet multisectoriel à deux volets qui vise à améliorer les services de toxicomanie pour les jeunes Ontariens. Premièrement, un site web et un sondage axés sur les jeunes, des groupes de discussion, et des entrevues étaient employés afin d'obtenir les perspectives de multiples parties prenantes. Ensuite, des initiatives de renforcement de capacité et des consultations sur les besoins de jeunes en transition étaient effectuées afin de développer un inventaire de préparation à la transition. Nous discutons de l'importance d'impliquer les jeunes comme collaborateurs et comme répondants, ainsi que des processus d'adaptation aux contextes locaux d'implantation.Mots clés : usage de substances, système de services, engagement des jeunes, collaboration intersectorielle, équité en santé, échange de connaissances Although experimenting with substances is common, rates of substance use problems increase significantly in adolescence and emerging adulthood (e.g., Boak, Hamilton, Adlaf, & Mann, 2015). Problematic substance use can have long term impacts for youth, and is often complicated by co-occurring mental health concerns, increasing the risk for negative health and life outcomes (Grella, Hser, Joshi, & Rounds-Bryant, 2001;Roberts, Roberts, & Xing, 2007;Storr, Pacek, & Martins, 2012;Vida et al., 2009). Adolescence and emerging adulthood are challenging periods of transition and change; unmet need for mental health and substance use services can interfere with developmentally salient domains including education, work, and relationships (Goodman, Henderson, Peterson-Badali, & Goldstein, 2015;MacLeod & Brownlie, 2014). The continuing low rate of treatment for mental health concerns among children and youth (Auditor General of Ontario, 2008) is just one indicator of the need for system enhancement addressing child and youth mental health difficulties including substance use concerns (Mohajer & Earnest, 2009).A consistent message in Changing Direction, Changing Lives: The Mental Health Strategy for Canada is the need to increase the extent to which services are designed and reviewed by the people who use them (Mental Health Commission of Canada, 2012). Youth perspectives are critical if services are to be developmentally informed and responsive to the differences in...