Integration of Services in Child and Youth Mental Health: A Case Study
Bibliographic record
Abstract
Background: Although approximately one in five children and youth in Canada deal with mental health issues, only a third access specialized care. Difficulties accessing and navigating the health care system are commonly reported. Integration holds promise as a mechanism to address care access and system navigation issues. Objectives: This dissertation aims to explore integration in child and youth mental health care by: identifying components of integration that improve outcomes for children and youth; describing how mental health services for children and youth are integrated and identifying factors that influence integration in Ontario, Canada; and refining an integration framework that can function as a guide for integration in child and youth mental health care settings. Methods: A multi-methods framework was utilized. A scoping review methodology was used to examine the international literature to identify components of integration. A case study methodology was used to examine integration in child and youth mental health care settings in Ontario, Canada. The case study included interviews with 33 key informants from the child and youth services, education and health sectors as well as a review of relevant government documents. A comparative mapping methodology was used to assess congruence of an integration framework with the international literature and the case study results. Results: Several common structural, infrastructure, and operational components were reported in the integration literature. While many of these components aligned with shared mental models (SSMs) of integration, SMMs were not commonly acknowledged in the literature. Additionally, the language describing integration in the child and youth literature differs from the health care literature. Numerous facilitators and barriers influence the integration of child and youth mental health care in Ontario, however two critical features: the absence of guidance in government policies and poor system-level planning are of importance as they demonstrate the lack of a system level shared mental model of integration. Conclusions: The absence of consistent system-level planning and inadequate guidance from policy documents are obstacles that need to be addressed to optimize integration planning and implementation. Addressing these issues may also influence the development of a system level SMM of integration.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.006 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.023 | 0.007 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.009 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 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".