McGill University reform youth mental health care in Canada

Researchers at McGill University have unveiled new data from the ACCESS Open Minds project, demonstrating that redesigning youth mental health services can drastically reduce wait times and improve access to care for young individuals across Canada. Initiated in 2014, ACCESS Open Minds aims to bridge the gaps in mental health care, particularly for Indigenous, remote, and underserved populations.

Findings published in JAMA Psychiatry offer the first comprehensive evaluation of the program’s outcomes nationwide. Lead author Srividya Iyer, a professor in McGill’s Department of Psychiatry and researcher at the Douglas Research Centre, explained the project’s focus on enhancing existing services in clinics, schools, and youth centers to ensure they are accessible, youth-friendly, and culturally sensitive.

Traditionally, accessing mental health care involves a lengthy referral process, which can deter young people from seeking help. ACCESS Open Minds eliminated this barrier by allowing youth to seek assistance independently. The program established specific service metrics, including an evaluation within three days and treatment initiation within 30 days—targets that most public services struggle to meet. Over four years, nearly 8,000 youths aged 11 to 25 were referred across 11 study sites, with the majority receiving evaluations within three days, a sharp contrast to the usual wait time of 45 days to over a year. The referral rate increased by 10 percent every six months.

Iyer noted a remarkable rise in service utilization at their downtown Montreal site for homeless youth. Despite the influx of new clients, the team managed to provide timely services, with most young people seen within 72 hours, thanks to just two additional staff members. The project involved refining workflows, providing staff training, and enhancing coordination among service providers, primarily using existing resources.

ACCESS Open Minds operated in 16 communities across Canada, including five in Quebec. In Nunavik, the team collaborated with Indigenous youth and Elders to convert a garage into a welcoming hub where young people could engage and repair hunting gear. In downtown Montreal, services for homeless youth included holistic care through partnerships with shelters, soup kitchens, clinics, and even a circus. Iyer highlighted a collaboration with Cirque Hors Piste to create artistic programs, emphasizing the importance of addressing the whole person rather than just their symptoms.

The ACCESS Open Minds model has influenced Quebec’s Aire Ouverte network and similar initiatives across Canada. The researchers are now investigating how to tackle broader issues impacting mental health, such as climate anxiety, housing affordability, job security, and the effects of artificial intelligence.

The study titled “An Approach to Providing Timely Mental Health Services to Diverse Youth Populations” by Srividya Iyer and Ashok Malla et al., was published in JAMA Psychiatry. The ACCESS Open Minds initiative received funding from the Canadian Institutes of Health Research and the Graham Boeckh Foundation as part of Canada’s Strategy for Patient-Oriented Research.