Young people’s experiences and strategies for improving their awareness and access to mental health and substance use health services
Bibliographic record
Abstract
BACKGROUND: Young people face persistent challenges in accessing mental health and substance use health (MHSU) services, which have been further complicated by the COVID-19 pandemic, and are particularly pronounced among marginalized populations. We sought to understand how young people navigate MHSU services since the pandemic, focusing on their awareness of and access to care. METHODS: Our project uses participatory research approaches and is comprised of two phases. This manuscript describes Phase 1, where five young people participated as research partners, informing study design and implementation. We conducted five virtual focus groups with a larger sample of young people from Ontario with MHSU lived experience, prioritizing participants from underrepresented communities. Focus groups explored their service awareness, access experiences, and improvement suggestions. Discussions were audio-recorded, transcribed, and thematically analyzed. Phase 2 will involve co-designing resources for young people based on Phase 1 findings. RESULTS: Our analysis of forty participants identified six interconnected domain themes (relationships and guidance, preferences and choice, convenience, self-directed information seeking, established sources, and system constraints), and fifteen sub-themes, spanning three dimensions of MHSU services (awareness, access, and improvements). We found that young people relied on informal networks (family/friends) and healthcare providers for MHSU service information and access, with trust being essential. They desired both choice in their provider and delivery method, plus the ability to research options independently before making decisions with others. While they primarily got service information from healthcare providers, online platforms, and community organizations, finding comprehensive, reliable information remained challenging. Barriers such as costs, wait times, location, and discrimination highlighted the need for affordable, accessible, and culturally responsive care to meet their diverse needs. CONCLUSIONS: This study revealed key insights about post-pandemic MHSU service awareness and access for young people. Participants demonstrated desires for both autonomy in service selection and guidance from trusted sources, suggesting a supported decision-making model. Recommended service improvements include centralized information resources, stronger informal referral networks, culturally responsive services and flexible delivery options. Partnership with young people throughout the research process yielded valuable perspectives that enhanced study validity. These findings will inform Phase 2-the co-design of resources addressing the information gaps and structural barriers identified by participants.
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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 | 0.005 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.006 | 0.004 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| 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".