Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie最新文献

{"title":"Mental Illness Prevalence Among Ontario Home Care Clients: Variation by Urban/Rural Residence and Deprivation Measures: Prévalence de la maladie mentale chez les clients de soins à domicile en Ontario : variation selon la résidence urbaine/rurale et les mesures de défavorisation.","authors":"Cindy Wang, Ruth Ann Marrie, Jin Luo, James M Bolton, Andrea Gruneir, Erind Dvorani, Karl Everett, Zahra Goodarzi, Ping Li, Liisa Jaakkimainen, Colleen J Maxwell","doi":"10.1177/07067437261468887","DOIUrl":"10.1177/07067437261468887","url":null,"abstract":"<p><p>BackgroundDegree of rurality and neighbourhood deprivation are important factors in understanding variation in mental illness across populations, but epidemiological data on their relevance to mental illness in home care (HC) clients are limited. We estimated the prevalence of several mental illnesses by these characteristics and their interaction effects among HC clients and matched community comparators in Ontario, Canada.MethodWe conducted a repeated cross-sectional study using linked health administrative data. HC recipients aged ≥18 years were matched to community comparators on demographics, dementia, and comorbidity. Within each study sample, prevalence estimates were calculated and compared across urban/rural residence and binary measures of the 4 dimensions of the Canadian Index of Multiple Deprivation (CIMD). Outcomes were derived with validated case definitions for any mental illness, mood/anxiety disorders, depression and anxiety (with/without drug claims), schizophrenia, bipolar disorder, and suicide attempt. Prevalence ratios (PRs: 95% CIs) were estimated with modified Poisson regression models adjusted for relevant covariates.ResultsWe included 479,064 urban- and 72,862 rural-residing HC clients (mean age 73.2 and 72.4 years, respectively). Mental illnesses were less common in rural than urban clients (e.g., any mental illness 31.3% vs. 39.4%), with adjusted PRs between 0.80 and 0.87. Prevalence estimates were significantly higher among clients in areas more marginalized in residential instability and ethno-cultural composition, with more pronounced adjusted PRs for clients in urban than rural settings (e.g., PR [more vs. less marginalized residential instability] for any mental illness: 1.12 (1.12, 1.13) for urban and 1.07 (1.04, 1.10) for rural clients, <i>P</i> < 0.001). In matched community comparators, we observed similar patterns by urban/rural and deprivation measures though mental illness prevalence was significantly lower overall.ConclusionsMental illnesses are common among HC clients and vary regionally. Incorporating geographic and socioeconomic indicators into mental health surveillance systems offers insight into mental health disparities that may warrant more targeted interventions.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261468887"},"PeriodicalIF":4.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"As Psychedelic Treatments Get Leaner, Patients' Social Environments Deserve Attention.","authors":"Edward Jacobs, Ian Roullier, Rosalind Watts, Hattie Wells","doi":"10.1177/07067437261479491","DOIUrl":"10.1177/07067437261479491","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261479491"},"PeriodicalIF":4.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Health Conditions and Substance Use Among Canadian Youth: A Nationally Representative Study: Problèmes de santé chroniques et usage de substances chez les jeunes Canadiens : étude représentative à l'échelle nationale.","authors":"Mark A Ferro, Alex Luther, Danielle Fearon, Joel A Dubin, Laura Duncan, Scott T Leatherdale, Dillon T Browne, Ian Colman","doi":"10.1177/07067437261479115","DOIUrl":"10.1177/07067437261479115","url":null,"abstract":"<p><p>BackgroundThis study compared prevalence of youth substance use by gender and type of chronic health condition (CHC); estimated gender-stratified odds of substance use across CHCs; and, contrasted effect sizes across CHCs and genders.MethodsData come from 13,580 youth 12 to 17 years in the 2019 Canadian Health Survey on Children and Youth (48.7% girls). CHC was categorized as none (38.4%), physical only (39.8%), mental only (2.7%), neurodevelopmental only (6.7%), and multiple CHCs (MCHC; 12.4%). Multiple CHCs was defined as having ≥1 physical condition and ≥1 mental or neurodevelopmental condition. Youth self-reported alcohol, tobacco, e-cigarette, and cannabis use and gender identity (boy/girl; sparse data prevented inclusion of gender-diverse).ResultsOverall, 29.4% of youth used ≥1 substance. Girls were more likely to be occasional or regular consumers of alcohol (26.4% vs. 24.3%; <i>P</i> < 0.01), but boys were more likely to be frequent e-cigarette (7.2% vs. 5.2%; <i>P</i> < 0.01) and cannabis users (3.0% vs. 1.8%; <i>P</i> < 0.01). Prevalence was lowest for youth with no CHC or physical only and highest for youth with mental only or MCHC. Among girls, all CHCs were associated with increased odds of substance use (vs. no CHC; OR = 1.3 to 14.6; <i>P</i> < 0.05); whereas for boys, odds of substance use were increased among mental only, neurodevelopmental only, and MCHC (OR = 1.3 to 6.0; <i>P</i> < 0.05). Effect sizes for MCHC were typically significantly larger compared to physical only, but not when compared to mental or neurodevelopmental only. Effect sizes were also significantly larger for mental only compared to physical only. Associations between CHCs and substance use were typically larger for girls compared to boys.ConclusionsYouth with CHCs, especially mental only, neurodevelopmental only, or MCHC are more likely to report substance use. Gender differences exist; magnitudes of association are larger for girls compared to boys.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261479115"},"PeriodicalIF":4.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Health System Costs for Recipients of Minimally Guided Internet-Based Cognitive Behavioural Therapy (iCBT) and Therapist-Guided CBT in Routine Care: A Cohort Study Using Ontario's Linked Health-Administrative Data: Comparaison des coûts pour le système de santé entre les personnes suivant une thérapie cognitivo-comportementale par Internet (TCCI) avec des orientations minimales et les personnes suivant une TCC menée par un ou une thérapeute en soins courants : étude de cohorte utilisant les données administratives de santé liées en Ontario.","authors":"Evgenia Gatov, Claire De Oliveira, Gillian Strudwick, David Wiljer, Onil Bhattacharyya, Paul Kurdyak","doi":"10.1177/07067437261477547","DOIUrl":"10.1177/07067437261477547","url":null,"abstract":"<p><p>ObjectiveInternet-based Cognitive Behavioural Therapy (iCBT) is a scalable alternative to therapist-guided CBT, requiring fewer therapist resources. We compared health system costs in individuals receiving minimally guided iCBT (self-directed online modules with asynchronous therapist support) to those receiving therapist-guided CBT (scheduled, one-on-one sessions) in Ontario, Canada (January 2020-August 2021).MethodsThis retrospective cohort study leveraged linked health-administrative data to estimate person-centred health system costs, overall and mental health (MH)-related, one- and two-years post-treatment for all major healthcare services (emergency departments, hospitalizations, physician visits, long-term/home care, and outpatient prescription drugs). Generalized linear models were used to examine the effect of treatment modality on costs, adjusting for patient sociodemographic characteristics, clinical factors, and pre-treatment healthcare utilization.ResultsAmong <i>N</i> = 167 individuals enrolled in iCBT and <i>N</i> = 300 receiving CBT, we found that iCBT recipients were more likely to use MH-related acute care and outpatient services (primary care physicians and psychiatrists) following treatment. The average MH-specific costs per person were $1,668 for iCBT (95% CI $0, $7,299) and $979 ($0, $4,821) for standard CBT 1-year post-treatment and $4,086 ($0, $17,049) and $2,023 ($0, $9,027), respectively, 2 years post-treatment. However, following regression adjustment for sociodemographic characteristics, baseline symptoms, and pre-treatment MH-related service use, there were no statistically significant differences in one-year and two-year post-treatment total or MH-related costs between the groups (<i>P</i> > .05). This finding remained robust among individuals meeting criteria for anxiety and depression treatment effectiveness.ConclusionsiCBT may represent a scalable approach to expanding access to MH care without significantly increasing long-term health system costs.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261477547"},"PeriodicalIF":4.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Correlates of Depressive Symptoms in Canada During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis Based on 144 Studies Including 406,043 Participants: Prévalence et corrélats des symptômes dépressifs au Canada pendant la pandémie de COVID-19 : revue systématique et méta-analyse de 144 études comprenant 406 043 participants.","authors":"Jude Mary Cénat, Seyed Mohammad Mahdi Moshirian Farahi, Wina Paul Darius, Malick Marc Ouattara, Salma Ben Messaoud, Zuhra Ahmadzai, Taddele Cherinet Kibret, Patrick R Labelle, Rose Darly Dalexis","doi":"10.1177/07067437261477556","DOIUrl":"https://doi.org/10.1177/07067437261477556","url":null,"abstract":"<p><p>BackgroundThe COVID-19 pandemic and associated public health measures, including lockdowns, school closures, quarantine, and social restrictions, substantially disrupted social and economic life in Canada. These conditions intensified risk factors for depressive symptoms. However, reported prevalence estimates vary widely across studies, highlighting the need for comprehensive syntheses of evidence specific to the Canadian context. The present study aimed to estimate the pooled prevalence of depressive symptoms and examine key demographic, geographic, and methodological sources of variability.MethodsA systematic review and meta-analysis were conducted following a PROSPERO-registered protocol (CRD42024552536). Five databases were searched for studies published since 2020 assessing depressive symptoms in Canada during COVID-19. Methodological quality was evaluated using Joanna Briggs Institute (JBI) appraisal checklists. Random-effects meta-analyses estimated pooled prevalence, with subgroup analyses and meta-regressions.ResultsA total of 144 studies including 406,043 participants were analysed. The pooled prevalence of depressive symptoms in Canada during the COVID-19 pandemic was 31.1% (95% confidence interval [CI], 28.4%-33.9%), with substantial heterogeneity (<i>I</i>² = 99.71). Prevalence was higher among women (29.2% [95% CI, 25.8%-32.7%]) than men (21.1% [95% CI, 18.5%-23.8%]) (<i>p</i> = .0003) and varied significantly across provinces (<i>p</i> = .0001), measurement tools (<i>p</i> < .0001), evaluation periods (<i>p</i> = .017), and study designs (<i>p</i> = .041). No significant publication bias was detected (Egger's test: <i>z</i> = 1.05, <i>p</i> = .295).ConclusionsThese findings underscore the critical need for a comprehensive and coordinated national mental health strategy in Canada. Such a strategy should expand the mental health workforce, implement large-scale promotion and early intervention program across schools, workplaces, and community settings, and provide gender-responsive support. Future research should focus on standardizing depressive assessment measurements and prioritizing studies and interventions targeting healthcare workers, as well as racialized and Indigenous populations, to promote equitable access, strengthen resilience, and enhance preparedness for future public health crises.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261477556"},"PeriodicalIF":4.4,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey of Canadian Psychiatrists' Attitudes Towards Palliative Care Approaches for Severe and Persistent Mental Illness: Enquête sur les attitudes des psychiatres canadiens à l'égard des approches de soins palliatifs pour les troubles mentaux graves et persistants.","authors":"Sarah Levitt, Lucy Panko, Kate Tsiandoulas, Micaela Forte, Lucy Costa, Daniel Z Buchman","doi":"10.1177/07067437261474291","DOIUrl":"10.1177/07067437261474291","url":null,"abstract":"<p><p>BackgroundPalliative psychiatry, which emphasizes improving quality of life and reducing suffering for individuals with severe and persistent mental illness (SPMI), has gained recognition internationally. Canadian psychiatrists' perspectives on palliative psychiatry remain under-explored. We adapted a survey created by Trachsel et al. on the acceptability of palliative psychiatry amongst German-speaking Swiss psychiatrists for the Canadian context to address this gap.MethodWe conducted a cross-sectional survey of Canadian psychiatrists (<i>n</i> = 69). We collected data on demographics, attitudes towards palliative care in psychiatry, and responses to 3 case vignettes describing a patient experiencing anorexia nervosa, schizophrenia, or major depressive disorder, respectively. Additional questions explored participants' views on coercion. Participants could elaborate on their responses to the case vignettes using optional free-text boxes. We analyzed the survey data using descriptive statistics and the qualitative data using structured tabular thematic analysis.ResultsParticipants broadly endorsed treatment goals focused on improving function, reducing suffering, preventing suicide, and maintaining patient autonomy, while placing less emphasis on curative approaches. Participants were divided on whether palliative care relates to end-of-life care. There was strong acceptance for a palliative approach in SPMI care. Attitudes towards prognosis and treatment futility varied by diagnosis amongst the case vignettes. Participants expressed nuanced views on coercion, highlighting ethical tensions when considering interventions contrary to patient preferences. Our qualitative analysis uncovered themes of ethical dimensions, clinical paradigms, characteristics of mental illness, considering comprehensive treatment options, psychosocial factors, and systemic factors in participants' consideration of their responses.ConclusionsThis cohort of Canadian psychiatrists largely endorses the applicability of palliative care approaches within SPMI care. Our findings underscore the need for further research with larger samples to understand potential gaps between theoretical acceptance and practical implementation. Future research should include the perspectives of patients, families, and other interest-holders to guide the potential integration of a palliative care model into psychiatric practice.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261474291"},"PeriodicalIF":4.4,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncertain Benefit and Potential Harms of Serotonergic Antidepressants in Persons With Substance Use Disorder.","authors":"Evan Wood, Jürgen Rehm, Thomas L Perry, David B Menkes, Ginette Poulin, Ronald Lim, David Healy, Bernard Le Foll, Julie Bruneau","doi":"10.1177/07067437261468911","DOIUrl":"10.1177/07067437261468911","url":null,"abstract":"","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261468911"},"PeriodicalIF":4.4,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Characteristics of Long-Stay Forensic Patients With Intellectual and Developmental Disabilities: An Ontario Population-Based Study: Prévalence et caractéristiques des patients hospitalisés pour de longs séjours dans un service médico-légal et présentant des déficiences intellectuelles et développementales : Une étude fondée sur la population de l'Ontario.","authors":"Avra Selick, Lisa Whittingham, Michael A Campitelli, Anjie Huang, Robert Balogh, Elizabeth Lin, Paul Kurdyak, Yona Lunsky","doi":"10.1177/07067437261474298","DOIUrl":"https://doi.org/10.1177/07067437261474298","url":null,"abstract":"<p><p>ObjectivesThis study examined the point prevalence of patients with intellectual and developmental disabilities (IDDs) in Ontario forensic inpatient units and compared the demographic, clinical, and system-level profiles of long-stay forensic patients with and without IDD.MethodThis cross-sectional study utilized Ontario administrative health data held at ICES. All patients over 18 years of age who occupied an Ontario forensic inpatient bed on 30th September 2023 were included in the analysis. Focus was given to patients with a length of stay (LOS) of at least 365 days (i.e., \"long-stay\" patients). Within this group, the prevalence of IDD was assessed, and patients with and without IDD were compared on their demographics, clinical characteristics, LOS, and support needs using standardized differences (StdDiff).ResultsAmong long-stay forensic patients (<i>n</i> = 549), 42.4% had IDD. Long-stay forensic patients with and without IDD had a mean age of 43 years, and the majority of patients in both groups were male (87.6% vs. 90.8%; StdDiff = 0.105). In the 2 years prior to admission, the majority of all long-stay patients were diagnosed with a psychotic disorder, though the proportion was higher among patients without IDD (80.3% vs. 92.1%; StdDiff = 0.348). Long-stay patients with IDD had a substantially longer LOS (mean LOS = 7.2 years vs. 4.9 years; StdDiff = 0.459) and were more likely to be restrained (5.2% vs. 2.2%; StdDiff = 0.156). A higher proportion of long-stay patients with IDD had difficulty with activities of daily living (23.2% vs. 11.7%; StdDiff = 0.306), and severe cognitive impairment (14.6% vs. 6.6%; StdDiff = 0.260).ConclusionsThis study found that almost half of long-stay forensic patients had IDD and this patient group had different demographic and clinical profiles from other patients, which may impact their support needs within the hospital and pose barriers to discharge.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261474298"},"PeriodicalIF":4.4,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Methodological Concerns Regarding a Recent Study on Autism and Gender Diversity in a Canadian Gender Identity Clinic.","authors":"Molly Isabel Pascoe, Jacqueline Vincent, Meng-Chuan Lai, Pushpal Desarkar, Nina Vitopoulos, Yona Lunsky, Kinnon Ross MacKinnon, June Sing Hong Lam","doi":"10.1177/07067437261474299","DOIUrl":"https://doi.org/10.1177/07067437261474299","url":null,"abstract":"<p><p>Plain Language Summary<b>Responding to concerns regarding the methods and findings of a study on autism and gender diversity in Canada</b>Dinu and colleagues wrote a letter to the editor about a recently published study that looked at differences in characteristics between autistic and non-autistic adults who were seen by clinicians at a Canadian gender identity clinic. Dinu and colleagues encouraged interpreting the findings of the original article with caution, because they were concerned about the type of data, the method of analyzing the data, and the interpretations that the authors made. In this response, we address their concerns and clarify the goals and findings of our original study. Like all retrospective chart review studies, our original study has important limitations. We agree that these limitations should be considered when interpreting our findings, but they do not change the main conclusions of the study. Dinu and colleagues interpreted our study as recommending specific approaches to care for autistic adults. Our response clarifies that our study described autistic transgender and gender diverse adults attending an adult gender identity clinic as having substantial mental health needs and did not recommend specific approaches to care. We conclude that further research and service planning are needed to improve access to individualized mental health and gender-related care for autistic transgender and gender-diverse adults.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261474299"},"PeriodicalIF":4.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Heterogeneity and Patterns of Services Utilization of Homeless and at-Risk Youth: Results From the ACCESS-OM-RIPAJ Cohort: Comprendre l'hétérogénéité et les habitudes d'utilisation des services chez les jeunes en situation d'itinérance et à risque : Résultats de la cohorte ACCESS-OM-RIPAJ.","authors":"Giuseppe D'Andrea, Charles Tessier, Diane Aubin, Marie-Eve Dupont, Camille Arbaud, Axel Glaize, Pasquale Bauco, Julie-Marguerite Deschenes, Jai L Shah, Ashok Malla, Srividya N Iyer, Amal Abdel-Baki","doi":"10.1177/07067437261468896","DOIUrl":"https://doi.org/10.1177/07067437261468896","url":null,"abstract":"<p><p>IntroductionHomeless youth experience disproportionately high rates of mental disorders, suicidality, and overdose. Understanding their heterogeneous needs is essential for designing integrated care models. This study examined characteristics, help-seeking reasons, and service use among youth accessing ACCESS Open Minds (ACCESS-OM)-<i>Réseau d'intervention de proximité auprès des jeunes de la rue</i> (RIPAJ), a Montréal-based network serving homeless and at-risk youth.MethodsWe analyzed sociodemographic and clinical data, presenting concerns, and services received by youth referred to ACCESS-OM-RIPAJ (2016-2020). Latent class analysis (LCA) identified clusters based on (1) presenting concerns and (2) service use.ResultsA total of 681 referrals were made to ACCESS-OM-RIPAJ. LCA identified 4 distinct help-seeking clusters: (1) a group characterized by severe material deprivation, including homelessness and unmet basic needs, alongside notable social isolation and higher prevalence of psychotic symptoms, who were more often referred to specialized psychiatric services; (2) a group defined by substance misuse with homelessness and financial instability, with fewer co-occurring concerns, requiring coordination across services; (3) a cluster marked by trauma-related experiences, family difficulties, and suicidality, with less clearly defined service use patterns; and (4) a group characterized by emotional distress, occurring alongside financial precarity and risk of homelessness, who were primarily offered psychological interventions.ConclusionThese findings highlight the heterogeneity of needs among homeless and at-risk youth and the importance of integrated, multi-component mental health programs. Improving access to care across the continuum of needs and presentation severities is essential for preventing adverse outcomes and addressing the cyclical relationship between mental health and homelessness.</p>","PeriodicalId":55283,"journal":{"name":"Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie","volume":" ","pages":"7067437261468896"},"PeriodicalIF":4.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}