Abstract:Purpose: Developments in the field of early intervention in psychotic disorders have encouraged further examination of and interest in youth mental health incorporating all levels of severity of mental disorders. Methods:The authors have briefly reviewed the relevant current state of knowledge, challenges and the service and research response across four countries (Australia, Ireland, the U.K. and Canada) most active in this field.Results: Here we present information on response to principal challenges associated with improving youth mental services in each country. Australia has developed a model comprised of a distinct front line youth mental health service (Headspace) to be implemented across the country and initially stimulated by success in early intervention in psychosis;in Ireland, Headstrong has been driven primarily through advocacy and philanthropy resulting in front line services (Jigsaw) which are being implemented across different jurisdictions; in the UK a limited regional response has addressed mostly problems with transition from child-adolescent to adult mental health services; and in Canada a national multi-site research initiative involving transformation of youth mental health services has been launched with public and philanthropic funding, with the expectation that results of this study will inform implementation of a transformed model of service across the country including indigenous peoples. Conclusions:There is evidence that several countries are now engaged in transformation of youth mental health services and in evaluation of these initiatives.

In this article we have provided a perspective on the importance and value of youth mental health services for society and argued that advancing youth mental health services should be the number one priority of health services in Canada. Using the age period of 12-25 years for defining youth, we have provided justification for our position based on scientific evidence derived from clinical, epidemiological and neurodevelopmental studies. We have highlighted the early onset of most mental disorders and substance abuse as well as their persistence into later adulthood, the long delays experienced by most help seekers and the consequence of such delays for young people and for society in general. We have also provided a brief review of the current gross inadequacies in access and quality of care available in Canada. We have argued for the need for a different conceptual framework of youth mental disorders as well as for a transformation of the way services are provided in order not only to reduce the unmet needs but also to allow a more meaningful exploration of the nature of such problems presenting in youth and the best way to treat them. We have offered some ideas based on previous work completed in this field as well as current initiatives in Canada and elsewhere. Any transformation of youth mental health services in Canada must take into consideration the significant geographic, cultural and political diversity across the provinces, territories and indigenous peoples across this country.

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