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NCT Number: NCT02836080

Integrated Collaborative Care Teams for Youth With Mental Health and/or Addiction Challenges (YouthCan IMPACT)

Among youth, the prevalence of mental health and addiction (MHA) disorders is roughly 20%, yet youth are challenged to access services in a timely fashion. To address MHA system gaps, this study will test the benefits of an Integrated Collaborative Care Team (ICCT) model for at-risk youth with MHA challenges. In partnership with community agencies, adolescent psychiatry hospital departments, and family health teams, investigators have developed an innovative model of service provision involving rapid access to MHA services. This model will be implemented and compared to the usual treatment youth receive in hospital-based, outpatient, mental health clinics in Toronto. A rapid, systematic, approach to MHA services geared to need in a youth-friendly environment is expected to result in better MHA outcomes for youth. Moreover, the ICCT approach is expected to decrease service wait-times, be more youth- and family-centred, and be more cost-effective.

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This study is active but is not currently recruiting participants.

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Key information

Conditions

Mental Disorders Addiction Behavior Behavior, Addictive Compulsive Behavior Impulsive Behavior Personal Satisfaction Psychological Well-Being

Age range

14 year–18 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada

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About this study

This study is a pragmatic randomized control trial (RCT) with random allocation occurring within each hospital site to either treatment as usual (TAU) (4 out-patient hospital sites) or treatment at one of 3 community-based Integrated Collaborative Care Teams (ICCTs). A total of 500 youth aged 14-18 with mental health and/or addictions (MHA) concerns, referred for out-patient services at one of four local hospitals, will be randomized to receive ICCT care versus TAU. For each youth, a primary caregiver will also be recruited into the study, if available.

With wide inclusion criteria and a design meant to emulate a "real world" setting, this study will rigorously evaluate a service delivery model composed of multiple interventions for youth presenting with a broad range of MHA problems. The ICCT is expected to result in better MHA outcomes, show better performance indicators, and be more cost-effective than TAU.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Provision of informed consent
  • Aged 14 - 17 years 11 months
  • New referrals to one of the four participating hospitals for out-patient MHA services
  • Among the population regularly accepted for out-patient services at that hospital

Exclusion criteria

  • Referral for specialty forensic or firesetting treatment
  • Moderate to severe intellectual disability or autism without MHA problems
  • Primary diagnosis of an eating disorder
  • Active psychosis or imminent risk of self-harm requiring immediate intervention
  • Inability to read and write English or to consent to the study

Treatment and study plan

Integrated Collaborative Care Team (ICCT)

Behavioral

An integrated, collaborative pathway of needs-based services. ICCTs will offer a wide variety of services, including Solution-Focused Brief Therapy (SFBT) on a scheduled and walk-in basis, care navigators, various clinician-guided interventions, psychiatry, nurse practitioner services, access to primary care, and peer support, all co-located in youth-friendly, community-based clinics. For each intervention, standardized intervention protocols will be used.

Treatment as usual (TAU)

Other

Standard out-patient treatment provided at each participating hospital site. This typically entails referral to a psychiatrist at the participating hospital, who will provide assessment and treatment, with referral to appropriate services, guided by local treatment protocols.

Primary outcomes

  1. Youth functioning

    Time frame: One year

    Measured using the Columbia Impairment Scale (CIS)

Secondary outcomes

  1. Clinical improvement

    Time frame: One year

    Measured using Strengths and Difficulties Questionnaire

  2. Problematic substance use

    Time frame: One year

    Assessed using the GAIN Short Screener and the substance use table of the Adolescent Alcohol and Drug Involvement Scale

  3. Satisfaction with the service models

    Time frame: One year

    Assessed using the Ontario Perception of Care Tool for Mental Health and Addictions

  4. Continuity of care

    Time frame: One year

    Measured using the Continuity of Care in Children's Mental Health questionnaire

  5. Goal attainment

    Time frame: One year

    Measured using a custom form indicating goals established by the youth and caregiver at intake, followed by a rating of goal attainment

  6. Client empowerment and engagement

    Time frame: One year

    Measured using the Family Empowerment Scale for caregivers, and the Youth Efficacy/Empowerment Scale for youth

  7. Caregiver burden

    Time frame: One year

    Measured using the Burden Assessment Scale

  8. Quality-adjusted life years (QALYs)

    Time frame: One year

    Measured using the Assessment of Quality of Life-6D (AQOL-6D)

  9. Cost-effective analysis (CEA) and a cost-utility analysis (CUA)

    Time frame: One year

    Incremental costs of ICCT compared to TAU (treatment as usual) in improving health outcomes

Sponsors and collaborators

Lead sponsor

Centre for Addiction and Mental Health

Other

Collaborators

  • Delisle Youth Services
  • East Metro Youth Services
  • Graham Boeckh Foundation
  • Institute for Clinical Evaluative Sciences
  • LOFT Community Services
  • Medical Psychiatry Alliance
  • South East Toronto Family Health Team
  • The Anne Johnston Health Station
  • The Ontario Spor Support Unit
  • The Sashbear Foundation

Registry information

Official study title

Integrated Collaborative Care Teams to Enhance Service Delivery to Youth With Mental Health and Substance Use Challenges: Protocol for a Pragmatic Randomized-controlled Trial

Important dates

Study start
2016
Primary completion
2021
Study completion
2026
First posted
Jul 18, 2016
Registry last updated
Mar 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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