Integrated Collaborative Care for Youth Mental Health and Addiction

Not currently recruiting at 4 trial locations

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Centre for Addiction and Mental Health

Disqualifiers: Forensic treatment, Intellectual disability, Autism, Eating disorder, Psychosis, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new method to help young people with mental health and addiction issues access care more quickly and effectively. It employs an Integrated Collaborative Care Team (ICCT) model, which unites various healthcare providers to deliver rapid, coordinated support in community settings. Researchers will compare this approach to the usual treatment provided at hospital outpatient clinics in Toronto, which may include medications such as Methadone, Buprenorphine, or Naltrexone. Young people aged 14 to 17, recently referred for outpatient mental health or addiction services and not experiencing certain issues like active psychosis, might be suitable for this trial. As an unphased trial, this study offers a unique opportunity to contribute to innovative care solutions for young people.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that the Integrated Collaborative Care Team model is safe for youth mental health and addiction?

Research has shown that the Integrated Collaborative Care Team (ICCT) model is safe and well-received. Studies have found that young people in the ICCT program have experienced improvements in mental health and substance use. This indicates that the approach not only aids mental health issues but is also generally safe for participants. No major reports of unexpected negative effects have emerged, suggesting that the ICCT model is a safe option for youth needing mental health and addiction support. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Integrated Collaborative Care Team (ICCT) approach for youth mental health and addiction because it brings care directly into the community. Unlike traditional treatments that often require visiting outpatient hospital settings, ICCTs are embedded in local neighborhoods, making it easier for young people to access the help they need. This approach also involves a variety of service providers working together to deliver personalized, evidence-based care in a stepped-care model, which means that treatment can be adjusted based on the individual needs of each patient. This community-focused and coordinated care model aims to improve outcomes by making mental health services more accessible and tailored to young people.

What evidence suggests that this trial's treatments could be effective for youth mental health and addiction?

Research has shown that the Integrated Collaborative Care Team (ICCT) model, one of the treatment arms in this trial, improves mental health and substance use outcomes for young people. Studies have found that youth in the ICCT group receive services faster and experience meaningful improvements in their mental health and daily lives. Although clinical results between ICCT and the Treatment as Usual (TAU) arm are similar, the ICCT approach reduces wait times for services more effectively. Additionally, young people in the ICCT program use fewer psychiatric resources, which can streamline the care process and potentially reduce costs. These benefits make ICCT a promising option for addressing mental health and addiction issues among youth. ^{1 6 7 8 9}

Who Is on the Research Team?

Gloria Chaim, M.S.W.

Principal Investigator

Associate Director, Child Youth and Family Services; Head, Community Engagement and Partnership, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, CAMH; Assistant Professor, Dept. of Psychiatry, University of Toronto

Joanna Henderson, Ph.D., C.Psych

Principal Investigator

Director, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health; Clinician Scientist, Centre for Addiction and Mental Health; Associate Professor, Dept. of Psychiatry, University of Toronto

Kristin Cleverley, RN, Ph.D.

Principal Investigator

CAMH Chair in Mental Health Nursing Research; Assistant Professor, University of Toronto; Clinician-Scientist, Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health

Amy Cheung, MD, FRCPC

Principal Investigator

Associate Scientist, Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute; Associate Professor, Department of Psychiatry, University of Toronto

Peter Szatmari, MD, FRCPC

Principal Investigator

Chief, Child and Youth Mental Health Collaborative, The Hospital for Sick Children and Centre for Addiction and Mental Health; Professor and Head of the Division of Child and Youth Mental Health, University of Toronto

Are You a Good Fit for This Trial?

This trial is for youth aged 14-17 with mental health and addiction challenges seeking outpatient services in Toronto. They must consent to the study, be new referrals to participating hospitals, and able to read/write English. Those with active psychosis, immediate self-harm risk, or needing specialty treatments are excluded.

Inclusion Criteria

Provision of informed consent

Among the population regularly accepted for out-patient services at that hospital

I am between 14 and 17 years old.

Exclusion Criteria

You currently have severe mental health problems or are at high risk of hurting yourself, needing immediate help.

Inability to read and write English or to consent to the study

You have a significant intellectual disability or autism, but you don't have any mental health problems.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either Integrated Collaborative Care Team (ICCT) services or Treatment as Usual (TAU) for mental health and/or addiction challenges

12 months

Regular visits as per treatment protocol

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Integrated Collaborative Care Team (ICCT)
• Treatment as Usual (TAU)

Trial Overview The study compares usual hospital treatment (TAU) against a new model called Integrated Collaborative Care Team (ICCT), which offers rapid access to mental health and addiction services in a youth-friendly environment. The goal is better outcomes and more efficient care.

How Is the Trial Designed?

Group I: Integrated Collaborative Care Team Experimental Treatment 1 Intervention

Integrated Collaborative Care Team (ICCTs) are housed in the local community to improve youth access, in three neighborhoods across Toronto (East Metro Youth Services \[EMYS\]-Scarborough, EMYS-Southeast Toronto, and Delisle Youth Services-Central Toronto). Each ICCT will include a variety of service providers and coordinated patient care delivering evidence-informed interventions in a stepped-care model.

Group II: Treatment as Usual (TAU) Active Control 1 Intervention

The comparator arm consists of out-patient TAU in a hospital setting and will occur at one of four outpatient hospital sites across Toronto. Partners include the following four hospitals: Hospital for Sick Children (SickKids), the Centre for Addiction and Mental Health (CAMH), Michael Garron Hospital (formerly the Toronto East General Hospital), and Sunnybrook Hospital.

Who Is Running the Clinical Trial?

Centre for Addiction and Mental Health

Lead Sponsor

Trials

388

Recruited

84,200+

Institute for Clinical Evaluative Sciences

Collaborator

Trials

37

Recruited

2,509,000+

The Anne Johnston Health Station

Collaborator

Trials

1

Recruited

250+

Medical Psychiatry Alliance

Collaborator

Trials

4

Recruited

5,700+

The Ontario Spor Support Unit

Collaborator

Trials

6

Recruited

508,000+

The Sashbear Foundation

Collaborator

Trials

3

Recruited

610+

South East Toronto Family Health Team

Collaborator

Trials

1

Recruited

250+

Delisle Youth Services

Collaborator

Trials

1

Recruited

250+

LOFT Community Services

Collaborator

Trials

4

Recruited

490+

East Metro Youth Services

Collaborator

Trials

2

Recruited

280+

Published Research Related to This Trial

Collaborative care strategies effectively integrate mental health interventions into trauma care, showing promise in reducing symptoms of PTSD and alcohol use among injured patients, based on initial randomized clinical trials.

These interventions can be feasibly implemented in trauma centers, linking immediate care to outpatient services, which may enhance the overall quality of mental health care for trauma victims.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Collaborative care interventions in general trauma patients. Petrie, M., Zatzick, D.[2023]

An Integrated Care Pathway (ICP) for treating adolescents with Major Depressive Disorder (MDD-A) was developed based on high-quality clinical guidelines, ensuring that treatment reflects the best available evidence.

The ICP includes multi-family psychoeducation, a 16-session Group Cognitive Behaviour Therapy, and regular team reviews, aiming to improve treatment consistency and outcomes for adolescents with depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Way through the woods: Development of an integrated care pathway for adolescents with depression. Courtney, D., Bennett, K., Henderson, J., et al.[2021]

The integrated mental health intervention, doctor-office collaborative care (DOCC), showed significant improvements in service use, behavioral and emotional problems, and overall clinical response compared to enhanced usual care (EUC) in a study involving 78 children aged 5-12 years.

Parents and pediatricians reported high satisfaction with the DOCC model, indicating its feasibility and effectiveness in addressing common mental health issues in primary care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Doctor-office collaborative care for pediatric behavioral problems: a preliminary clinical trial. Kolko, DJ., Campo, JV., Kilbourne, AM., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12076176/

Integrated Collaborative Care for Youths With Mental Health ... These results suggest that the ICCT model is associated with improved youth functioning and mental health and substance use outcomes that are no ...

2. camh.ca camh.ca/en/camh-news-and-stories/new-study-shows-integrated-collaborative-care-helps-youth-access-supports-faster

New study shows integrated collaborative care helps youth ... Results showed that while youth in both groups experienced meaningful improvements in mental health and functioning, those in the ICCT group ...

3. bmjopen.bmj.com bmjopen.bmj.com/content/7/2/e014080

Integrated collaborative care teams to enhance service ... This study tests the benefits of an Integrated Collaborative Care Team (ICCT) model for youth with MHA challenges.

4. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40358950/?utm_source=SimplePie&utm_medium=rss&utm_campaign=pubmed-2&utm_content=1pq-4TZ0w1pIimA2HHLJZYTkSjaU335U-aRSFRxJ31Blahz9sN&fc=20220524061305&ff=20250513143441&v=2.18.0.post9+e462414

Integrated Collaborative Care for Youths With Mental ... The ICCT model, compared to TAU, showed no clinical difference, but ICCT youths accessed services sooner, used fewer psychiatric resources, and ...

5. psychiatryadvisor.com psychiatryadvisor.com/news/community-care-speeds-access-youth-mental-health/

Community Care Speeds Access in Youth Mental Health ICCT improved care, service access speed, and substance use outcomes, though there was no significant difference between ICCT and TAU ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5293997/

Integrated collaborative care teams to enhance service ... This study tests the benefits of an Integrated Collaborative Care Team (ICCT) model for youth with MHA challenges.

7. withpower.com withpower.com/trial/phase-mental-disorders-8-2016-b186b

Integrated Collaborative Care for Youth Mental Health and ... Research suggests that the Integrated Collaborative Care Team (ICCT) model can improve mental health and addiction outcomes for youth by providing faster access ...

8. youthhubs.ca youthhubs.ca/news-new-study-shows-integrated-collaborative-care-helps-youth-access-mental-health-and-substance

NEWS: New study shows integrated collaborative care ... Results showed that while youth in both groups experienced meaningful improvements in mental health and functioning, those in the ICCT group ...

9. researchgate.net researchgate.net/publication/313414391_Integrated_collaborative_care_teams_to_enhance_service_delivery_to_youth_with_mental_health_and_substance_use_challenges_Protocol_for_a_pragmatic_randomised_controlled_trial

Protocol for a pragmatic randomised controlled trial This study tests the benefits of an Integrated Collaborative Care Team (ICCT) model for youth with MHA challenges.