Transitioning from Children's Mental Health to Adult Care: Stakeholder Perspectives and Tracking Service Use into Adulthood
Bibliographic record
Abstract
Transitioning youth from Children’s Mental Health (CMH) services to adult care poses a major challenge for our mental health and health care systems. This dissertation used a mixed-methods approach to explore the challenges of caring for youth with ongoing mental health problems into young adulthood. A Grounded Theory qualitative study consisted of interviews with youth (i.e., ages 12 to 15) treated in CMH, their parents, CMH providers, and family physicians. Using administrative health record and CMH data in the province of Ontario, a complementary quantitative study examined the likelihood of receiving mental health services within the medical sector after the age of transfer (18 years old).\nIn Chapter 2, perceptions from youth and their parents revealed that common CMH disorders were viewed as long-lasting, but not necessarily persistent problems over time. Parents feared their children would disengage from needed mental health services after CMH treatment. Chapters 3 and 4 shed light on provider perspectives, specifically those of CMH providers and family physicians. The consensus view of participating youth, parents, CMH providers, and family physicians themselves was that family physicians were “out of the loop” or not involved with a youth’s mental health care.\nChapter 5 presents the first longitudinal, case-control study in Canada to focus on the problem of transition to mental health adult care. Two key findings were: (1) youth treated in CMH were more likely than the general population to have a mental health visit in the medical system during and after CMH treatment; (2) most factors that significantly predicted having a mental health related visit in the medical system after age 18 were related to prior service utilization in either CMH or the medical system. Overall, youth treated in CMH continued to receive mental health services in the medical sector as young adults.\nThe combined findings presented across this dissertation revealed two common themes. First, the ongoing mental health needs of some children and youth are unlikely to be met within the CMH system. Second, there is uncertainty about the role of family physicians in caring for youth who are treated in CMH. Implications for policy and practice are discussed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".