Kyleigh E Schraeder1, Melanie Barwick2,3, John Cairney4, Jeff Carter1,3,5, Paul Kurdyak3,6,7, Richard W J Neufeld1,8, Shannon L Stewart9,10, Jeff St Pierre11, Juliana Tobon12, Evelyn Vingilis13,14, Gregory Zaric14,15, Graham J Reid1,10,13,16. 1. Department of Psychology, Western University, London, Ontario. 2. The Hospital for Sick Children, Toronto, Ontario. 3. Department of Psychiatry, University of Toronto, Toronto, Ontario. 4. Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario. 5. Vanier Children's Services, London, Ontario. 6. Mental Health and Addictions Research Program, Institute for Clinical Evaluative Sciences, Toronto, Ontario. 7. Center for Addiction and Mental Health, Toronto, Ontario. 8. Department of Psychiatry, Western University, London, Ontario. 9. Faculty of Education, Western University, London, Ontario. 10. Children's Health and Therapeutics, Children's Health Research Institute, London, Ontario. 11. Child and Parent Resource Institute, London, Ontario. 12. Department of Psychiatry and Behavioural Sciences, McMaster University, Hamilton, Ontario. 13. Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario. 14. Department of Epidemiology and Biostatistics, Western University, London, Ontario. 15. Department of Management Science, Ivey School of Business, Western University, London, Ontario. 16. Department of Paediatrics, The University of Western Ontario, London, Ontario.
Abstract
OBJECTIVE: About 20-26% of children and youth with a mental health disorder (depending on age and respondent) report receiving services from a community-based Child and Youth Mental Health (CYMH) agency. However, because agencies have an upper age limit of 18-years old, youth requiring ongoing mental health services must "transition" to adult-oriented care. General healthcare providers (e.g., family physicians) likely provide this care. The objective of this study was to compare the likelihood of receiving physician-based mental health services after age 18 between youth who had received community-based mental health services and a matched population sample. METHOD: A longitudinal matched cohort study was conducted in Ontario, Canada. A CYMH cohort that received mental health care at one of five CYMH agencies, aged 7-14 years at their first visit (N=2,822), was compared to age, sex, region-matched controls (N=8,466). RESULTS: CYMH youth were twice as likely as the comparison sample to have a physician-based mental health visit (i.e., by a family physician, pediatrician, psychiatrists) after age 18; median time to first visit was 3.3 years. Having a physician mental health visit before age 18 was associated with a greater likelihood of experiencing the outcome than community-based CYMH services alone. CONCLUSION: Most youth involved in community-based CYMH agencies will re-access services from physicians as adults. Youth receiving mental health services only within community agencies, and not from physicians, may be less likely to receive physician-based mental health services as adults. Collaboration between CYMH agencies and family physicians may be important for youth who require ongoing care into adulthood.
OBJECTIVE: About 20-26% of children and youth with a mental health disorder (depending on age and respondent) report receiving services from a community-based Child and Youth Mental Health (CYMH) agency. However, because agencies have an upper age limit of 18-years old, youth requiring ongoing mental health services must "transition" to adult-oriented care. General healthcare providers (e.g., family physicians) likely provide this care. The objective of this study was to compare the likelihood of receiving physician-based mental health services after age 18 between youth who had received community-based mental health services and a matched population sample. METHOD: A longitudinal matched cohort study was conducted in Ontario, Canada. A CYMH cohort that received mental health care at one of five CYMH agencies, aged 7-14 years at their first visit (N=2,822), was compared to age, sex, region-matched controls (N=8,466). RESULTS: CYMH youth were twice as likely as the comparison sample to have a physician-based mental health visit (i.e., by a family physician, pediatrician, psychiatrists) after age 18; median time to first visit was 3.3 years. Having a physician mental health visit before age 18 was associated with a greater likelihood of experiencing the outcome than community-based CYMH services alone. CONCLUSION: Most youth involved in community-based CYMH agencies will re-access services from physicians as adults. Youth receiving mental health services only within community agencies, and not from physicians, may be less likely to receive physician-based mental health services as adults. Collaboration between CYMH agencies and family physicians may be important for youth who require ongoing care into adulthood.
Keywords:
adolescent; adolescent health services; child; enfant; health services; jeune adulte; mental health services; services de santé; services de santé mentale; services de santé pour adolescent; transition aux soins pour adultes; transition to adult care; young adult
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