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

NCT02836080 | Active Not Recruiting DMC

• 1 other identifier: #012/2016
• Study Type: interventional
• Target: 247
• Locations: 1 country
• Sites: 5

Brief Summary

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.

Conditions

Mental Disorders; Addiction

Keywords

Mental Health; Randomized; Pragmatic; Integrated Collaborative Care; Addiction; Youth

Outcome Measures

Primary Outcomes (1)

• Youth functioning

  Measured using the Columbia Impairment Scale (CIS)

  One year

Secondary Outcomes (9)

• Clinical improvement

  One year

• Problematic substance use

  One year

• Satisfaction with the service models

  One year

• Continuity of care

  One year

• Goal attainment

  One year

Study Arms (2)

Integrated Collaborative Care Team

EXPERIMENTAL

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.

Behavioral: Integrated Collaborative Care Team (ICCT)

Treatment as Usual (TAU)

ACTIVE COMPARATOR

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.

Other: Treatment as Usual (TAU)

Interventions

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.

Treatment as Usual (TAU)

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.

Integrated Collaborative Care Team

Eligibility Criteria

• Age: 14 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

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

Study Sites (5)

North York General Hospital

Toronto, Ontario, M2K 1E1, Canada

Location

Michael Garron Hospital

Toronto, Ontario, M4C 3E7, Canada

Location

Sunnybrook Hospital

Toronto, Ontario, M4N 3M5, Canada

Location

The Hospital for Sick Children

Toronto, Ontario, M5G 1X8, Canada

Location

Centre for Addiction and Mental Health (CAMH)

Toronto, Ontario, M6J 1H4, Canada

Location

Related Publications (4)

• Quinlan-Davidson M, Henderson JL, Szatmari P, Cheung A, Dixon M, Relihan J, Singer D, Hawke LD, Cleverley K. A qualitative study exploring youth's experiences of hospital- and integrated community-based mental health services: the YouthCan IMPACT initiative. BMC Psychiatry. 2025 Nov 12;25(1):1084. doi: 10.1186/s12888-025-07523-7.

  PMID: 41225406 DERIVED

• Henderson J, Szatmari P, Cleverley K, Ma C, Hawke LD, Cheung A, Relihan J, Dixon M, Quinlan-Davidson M, Moretti M, de Oliveira C, Lee A, Courtney DB, O'Brien D, McDonald H, Lemke K, Pignatiello T, Monga S, Kozloff N, Solomon L, Andrade BF, Barwick M, Charach A, Courey L, Darnay K, Kurdyak P, Lin E, Shan D. Integrated Collaborative Care for Youths With Mental Health and Substance Use Challenges: A Randomized Clinical Trial. JAMA Netw Open. 2025 May 1;8(5):e259565. doi: 10.1001/jamanetworkopen.2025.9565.

  PMID: 40358950 DERIVED

• Krause KR, Lee A, Shan D, Cost KT, Hawke LD, Cheung AH, Cleverley K, de Oliveira C, Quinlan-Davidson M, Moretti ME, Henderson JL, Ma C, Szatmari P. Minimally important change on the Columbia Impairment Scale and Strengths and Difficulties Questionnaire in youths seeking mental healthcare. BMJ Ment Health. 2025 Jan 22;28(1):e301425. doi: 10.1136/bmjment-2024-301425.

  PMID: 39848629 DERIVED

• Henderson JL, Cheung A, Cleverley K, Chaim G, Moretti ME, de Oliveira C, Hawke LD, Willan AR, O'Brien D, Heffernan O, Herzog T, Courey L, McDonald H, Grant E, Szatmari P. Integrated collaborative care teams to enhance service delivery to youth with mental health and substance use challenges: protocol for a pragmatic randomised controlled trial. BMJ Open. 2017 Feb 6;7(2):e014080. doi: 10.1136/bmjopen-2016-014080.

  PMID: 28167747 DERIVED

Related Links

• Information about research at the Centre for Addiction and Mental Health, Canada's largest mental health and addiction teaching hospital

MeSH Terms

Conditions

Mental Disorders; Behavior, Addictive; Psychological Well-Being

Interventions

Therapeutics

Condition Hierarchy (Ancestors)

Compulsive Behavior; Impulsive Behavior; Behavior; Personal Satisfaction

Study Officials

• Joanna Henderson, Ph.D., C.Psych

  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

  PRINCIPAL INVESTIGATOR

• Peter Szatmari, MD, FRCPC

  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

  PRINCIPAL INVESTIGATOR

• Amy Cheung, MD, FRCPC

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

  PRINCIPAL INVESTIGATOR

• Kristin Cleverley, RN, Ph.D.

  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

  PRINCIPAL INVESTIGATOR

• Gloria Chaim, M.S.W.

  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

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health; Associate Professor of Psychiatry, University of Toronto

Study Record Dates

• First Submitted: July 14, 2016
• First Posted: July 18, 2016
• Study Start: September 1, 2016
• Primary Completion: April 1, 2021
• Study Completion: April 1, 2026
• Last Updated: March 17, 2026

Record last verified: 2026-03

Locations

CA (5)