Background
Recent years have seen growing recognition of the need to provide appropriate, tailored and accessible solutions for children, youth, and young adults in the field of mental health, and that the optimal approach to meeting that need is integrative community care, provided mostly in a service center (hub). This model of care provides services tailored to the unique needs of this population, including mental and physical health services and other community and social services (e.g., social support, support in education, higher education and professional training) at the same location. This model is often referred to as the “one-stop-shop” model.
A survey conducted in 2021 to map the population of children and youth with disabilities in Israel found that about 93,000 children and youth have significant emotional difficulties, including 51,000 whose daily function is affected.[1] These data exclude moderate or minor emotional difficulties, hence the total number of children and youth with emotional difficulties is even higher. Nevertheless, few community services are currently offered for this population.
In order to continue and develop integrative community services for this population, 360° – the National Program for Children and Youth at Risk and the Administration for Individual and Social Services at the Ministry of Welfare and Social Security requested that the Myers-JDC-Brookdale Institute research this field, including the outcomes and the quality of available care services by conducting case studies, constructing a logic model, and measuring outcomes. In addition, it was decided to conduct an international review of the literature on integrative community mental health care for children, youth and young adults. This report presents the international review that was conducted. Additional reports of the case studies, a logic model, and outcomes of available care services will be published later.
Objective
Review integrative community services for children, youth, and young adults with mental health difficulties in selected countries, including operational model, best practices, and outcome indicators, and provide decision makers with a comprehensive and up-to-date overview.
Design
International review of scholarly articles and online publications, such as research reports and information on programs (grey literature) regarding integrative community mental health services provided to children, youth and young adults in the community. The review focuses on several selected countries and on a major service model applied in each: Headspace (Australia), ACCESS Open Minds (Canada), Jigsaw (Ireland), Forward Thinking Birmingham (UK), and Maison des Adolescents (France). The countries were selected based on the presence of a national or central service model and the availability of sufficient information on the service model.
In addition, semi-structured interviews were held with a Canadian researcher of child and youth mental health as well as with an Israeli expert on disability, both of whom have unique knowledge and experience in their respective fields. The information was collected in April-June 2021.
Main Finding
The recent literature suggests there is no single universal model for implementing integrative mental health community care for children, youth and young adults. Rather, we find a variety of models that nevertheless share several key characteristics. These include eligibility criteria (service accessibility and terms of entry), the importance of early intervention, designing the service provision and service space to be youth-friendly, evidence-based treatment models, partnership and collaboration with other services and stakeholders, meeting the needs of young people in the transition to adulthood, and a range of services in different areas, particularly education, welfare and employment, and program measurement and evaluation.
In addition, the literature suggests that there are several different (albeit often complementary) interpretations of the concept of integrative community care: (1) Care provided in a setting that is integral to the community rather than separate therefrom (as in a hospital); (2) Care that integrates services from a variety of areas apart from mental health, including physical health, education, and social and welfare services; (3) Continuity of care and a more fluid transition across various services along the continuum between less and more intensive services, and for different populations with different needs, some of which require more or less comprehensive and intensive solutions.
The models reviewed illustrate the different meanings of integrative community mental healthcare for children, youth and young adults, and serve various populations that have different needs along the continuum of care.
[1] Barlev, L., Namer Furstenberg, R., & Guedj, N. (forthcoming, 2021). Children with Disability in Israel. Myers-JDC-Brookdale Institute (Hebrew).