Collaborative youth mental health service users, immigration, poverty, and family environment.

BACKGROUND: This article examines the association between immigration, poverty and family environment, and the emotional and behavioral problems reported by youth and their family receiving mental health (MH) services within a collaborative care model in a multiethnic neighborhood. METHOD: Participants in this study were 140 parent-child dyads that are part of an ongoing longitudinal project looking at the association between individual, familial, social and organizational factors, and outcomes of youth receiving MH services in local health and social service organizations in the Montreal area. Measures included in this study were collected at the initial phase of the longitudinal project (Time 0). Parents completed a sociodemographic questionnaire and the Family Environment Scale (FES), and both parents and children completed the Strength and Difficulties questionnaire (SDQ). RESULTS: Results suggest that the family environment, especially family conflicts, has a significant role in the MH problems of children seeking help in collaborative MH services. In this specific population, results also show a trend, but not a statistically significant association, between poverty or immigration and emotional and behavioral problems. They suggest as well that boys show more MH problems, although this could be a contamination effect (parents' perspective). CONCLUSIONS: The results support the importance of interventions that not only target the child symptomatology but also address family dynamics, especially conflicts. Collaborative care models may be particularly well suited to allow for a coherent consideration of family environmental factors in youth mental health and to support primary care settings in addressing these issues.

[Youth mental health at the cross roads of service organization]. / La santé mentale jeunesse: un domaine à la croisée des chemins.

The importance of children and youth mental health is increasingly recognized. This rapidly developing field cannot be conceptualized as an extension of adult services to a younger age group and its developmental and organizational specificities are the object of debate. Reviewing recent literature in this domain and some preliminary information about the Quebec Mental Health Plan implementation, this paper addresses some of the questions which structure this debate in Quebec.Quebec mental health plan has put at the forefront collaboration among disciplines and partnership among institutions. In spite of having produced significant improvement in the field, discontinuities in services, which interfere with an ecosystemic model of care, persist. Recent studies suggest that the organisational climate which surrounds youth mental health services has a direct impact on the quality of services and on youth health outcomes. A flexible management structure, which engages clinicians and health workers, favors empowerment, minimizes work stress and facilitates partnership, is needed to foster successful interdisciplinary and intersectorial collaboration. This collaboration is the cornerstone of youth mental health services.

Perception of Interprofessional Collaboration and Co-Location of Specialists and Primary Care Teams in Youth Mental Health.

OBJECTIVES: Interprofessional collaboration is a cornerstone of youth mental health collaborative care models. This article presents quantitative results from a mixed-methods study. It analyses the organizational predictors of the perception of interprofessional collaboration of professionals comparing two models of services within recently constituted youth mental health collaborative care teams. METHODS: Professionals (n=104) belonging to six health and social services institutions completed an online survey measuring their perceptions of interprofessional collaboration through a validated questionnaire, the PINCOM-Q. RESULTS: Results suggest that the integrated model of collaborative care in which specialized resources are co-located with the primary care teams is the main significant predictor of positive perception of interprofessional collaborations in the youth mental health team. CONCLUSION: More research on the relation between service delivery models and interprofessional relations could help support the successful implementation of collaborative care in youth mental health.

OBJECTIF: La collaboration interprofessionnelle est un pilier des modèles de soins en collaboration en santé mentale des adolescents. Cet article présente les résultats quantitatifs d'une étude à méthodes mixtes. Il analyse les prédicteurs organisationnels de la perception de la collaboration interprofessionnelle de professionnels en comparant deux modèles de services au sein d'équipes de soins en collaboration récemment constituées en santé mentale des adolescents. MÉTHODE: Les professionnels (n = 104) qui appartenaient à six institutions de services sociaux et de santé ont répondu à un sondage en ligne mesurant leurs perceptions de la collaboration interprofessionnelle à l'aide d'un questionnaire validé, le PINCOM-Q. RÉSULTATS: Les résultats suggèrent que le modèle intégré des soins en collaboration dans lequel les ressources spécialisées cohabitent avec les équipes des soins de première ligne est le principal prédicteur significatif de la perception positive des collaborations interprofessionnelles dans l'équipe de santé mentale des adolescents. CONCLUSION: Plus de recherche sur la relation entre les modèles de prestation des services et les relations interprofessionnelles pourrait contribuer à soutenir la réussite de la mise en oeuvre des soins en collaboration en santé mentale des adolescents.