Integrated Collaborative Care for Youth Mental Health and Addiction

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

247 Participants Needed

Trial Summary

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 data supports the effectiveness of the Integrated Collaborative Care Team (ICCT) treatment for youth mental health and addiction?

Research suggests that the Integrated Collaborative Care Team (ICCT) model can improve mental health and addiction outcomes for youth by providing faster access to care, being more youth-friendly, and reducing costs. This approach is expected to enhance service delivery and address gaps in mental health and addiction care for young people. ^{1 2 3 4 5}

Is Integrated Collaborative Care for Youth Mental Health and Addiction safe?

The research does not provide specific safety data for Integrated Collaborative Care for Youth Mental Health and Addiction, but it highlights the importance of coordinated care for youth with mental health and substance use challenges, suggesting a focus on improving outcomes and reducing service wait-times. ^{1 2 3 6 7}

How is the Integrated Collaborative Care Team (ICCT) treatment different from other treatments for youth mental health and addiction?

The Integrated Collaborative Care Team (ICCT) treatment is unique because it uses a rapid, stepped-care approach tailored to the needs of youth, aiming to improve mental health and addiction outcomes while reducing wait times and being more youth- and family-friendly. This model integrates various care providers to deliver coordinated and cost-effective services, addressing gaps in the current mental health and addiction care systems for young people. ^{1 2 3 7 8}

What is the purpose of this trial?

This trial tests a new way of providing mental health and addiction services for young people aged 14-18. The Integrated Collaborative Care Team (ICCT) model involves a team of healthcare providers working together to offer fast and personalized care. The goal is to improve mental health outcomes, reduce waiting times, and be more cost-effective compared to usual treatments.

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

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Integrated collaborative care teams to enhance service delivery to youth with mental health and substance use challenges: protocol for a pragmatic randomised controlled trial. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Essential components of integrated care for youth with mental health and addiction needs: protocol for a scoping review. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Integrated Care for Pediatric Substance Abuse. [2017]

4. United States pubmed.ncbi.nlm.nih.gov

Doctor-office collaborative care for pediatric behavioral problems: a preliminary clinical trial. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Enhanced Child Psychiatry Access and Engagement via Integrated Care: A Collaborative Practice Model With Pediatrics. [2019]

6. Australia pubmed.ncbi.nlm.nih.gov

A Way through the woods: Development of an integrated care pathway for adolescents with depression. [2021]

7. England pubmed.ncbi.nlm.nih.gov

Supporting the need for an integrated system of care for youth with co-occurring traumatic stress and substance abuse problems. [2012]

8. United States pubmed.ncbi.nlm.nih.gov

Collaborative care interventions in general trauma patients. [2023]