ACCESS Open Minds / ACCESS Esprits ouverts

• Register: ISRCTN
• Last refreshed on: 29 November 2021
• Main ID: ISRCTN23349893
• Date of registration: 16/02/2017
• Prospective Registration: No
• Primary sponsor: Canadian Institutes of Health Research
• Public title: ACCESS Open Minds / ACCESS Esprits ouverts
• Scientific title: Developing, implementing and evaluating a model for youth mental health service transformation in Canada: ACCESS Open Minds
• Date of first enrolment: 12/09/2016
• Target sample size: 13760
• Recruitment status: Completed
• URL: https://www.isrctn.com/ISRCTN23349893
• Study type: Interventional
• Study design: Community-led stepped wedge cluster randomised trial (Other)
• Phase: Not Applicable

Countries of recruitment

Canada

Contacts

• Name: Ashok Malla

Key inclusion & exclusion criteria

Inclusion criteria:
Youth:
1. Aged between 11 and 25
2. Seeking, or being referred to, mental health services at one of the twelve sites

Carers:
Family members or identified caregivers of participating youths.

Exclusion criteria:
Youth:
1. Outside the age range of the project (under 11 or over 25)
2. Intellectual disability (IQ<70)
3. History of organic brain damage


Age minimum:
Age maximum:
Gender: Both

Health Condition(s) or Problem(s) studied

Youth mental health care
Mental and Behavioural Disorders
Youth mental health care

Intervention(s)

Each of the 12 ACCESS OM site are transforming their services to meet the new 5 ACCESS OM objectives:
1. Early Identification, to ensure that more youth are referred sooner, through activities such as targeted outreach, community awareness, etc.
2. Rapid and Engaging Access, to offer youth, and those seeking help on their behalf, access to an initial evaluation within 72 hours in a stigma-reducing environment. Key strategies include the addition of a trained clinician (Access Clinician) who serve as a single point of contact and that can be directly accessed by youth in need or those acting on their behalf; who respond in less than 72 hours; who can offer an initial evaluation irrespective of type/severity of mental health problem; and who can, in collaboration with youth and their families/carers, link the young person to needs-appropriate services. Other strategies for rapid access are inclusion of multiple portals for accessing care, including direct walk-in access; and elimination of any referral or administrative requirements.
3. Appropriate care, to offer youth evidence-informed interventions staged by phase of illness and level of care needed (as opposed to only diagnosis-based), with a focus on reducing wait times to meet modified Canadian Psychiatric Association benchmarks (less than 30 days except in urgent cases). Care is provided in strengths-based, youth-friendly, engaging, rights-respecting, non-stigmatizing, and recovery-oriented environments.
4. Continuity of care, to ensure youth are supported through any transitions between services and that these transitions are based on needs and not age. Collaboration between services, stakeholders, sectors, and disciplines are be foste

Primary Outcome(s)

1. Number of referrals from youth (or those seeking help on behalf of youth) at ACCESS OM sites is measured by comparing referral rates before and after transformation using retrospective institutional data and post-transformation data via an online data collection system (DACIMA)
2. Number of youth who receive the offer of an initial evaluation within 72 hours of referral is measured by comparing retrospective data with data collected using the Services and Interventions Documentation Form created by ACCESS OM at baseline and documents the timeline of the youth’s referral and intake as well as communication between the service user and clinician
3. Proportion of youth with a serious mental illness receiving appropriate care in less than 30 days (except for urgent cases) is measured by comparing retrospective data with data collected using the Services and Interventions Documentation Form created by ACCESS OM, which is completed at baseline, 1, 3, 6, 9, 12 and 24 months

Secondary Outcome(s)

1. Number of help-seeking contacts before accessing appropriate mental health care for youth with serious mental illness is measured using institutional data at baseline
2. Levels of satisfaction among youth and their families/carers is measured using the Ontario Perception of Care Tool for Mental Health and Addictions (OPOC-MHA), at 1, 3, 6, 9, 12, and 24 months
3. Clinical, functional and subjective outcomes of youth receiving services at ACCESS OM sites is primarily measured using the Clinical Global Impressions - Youth Mental Health (CGI-YMH), the Social and Occupational Functioning Assessment Scale (SOFAS), Kessler-10 Psychological Distress Scale (K-10), at baseline, 1, 3, 6, 9, 12 and 24 months

Secondary ID(s)

MHB-135810

Source(s) of Monetary Support

Graham Boeckh Foundation, Canadian Institutes of Health Research

Results

• Results available: Yes
• Date Completed: 31/03/2021