Enhancing youth mental health through measurement-based care: A qualitative study of youth’s experiences across Ontario, Canada

Background: Measurement-based care (MBC) is the systematic use of the same set of measures to track progress in mental health treatment for youth. Service providers and youth collaboratively review results together and make decisions in order to help improve and tailor the care to youth needs. As a standard for integrated youth services, MBC has been shown to empower youth and improve usual care. Although the benefits of MBC are clear, there is limited research on youth’s experience of MBC in mental health service settings. Among youth who have accessed community-based mental health services, the objective of the current study was to explore their perspectives and experiences of MBC across Ontario, Canada.

 

Approach: Youth were purposively sampled from community-based mental health services across Ontario, Canada. They were eligible to participate if they had ever used mental health and substance use services and were between 12 and 25 years of age. n=23 youth were included in focus groups. Focus groups explored benefits, challenges, and strategies to enhance MBC within youth services. Thematic analysis was used. Youth, as research team members, were actively involved in study co-design, implementation, and interpretation of results.

 

Results: Findings indicate that MBC enhances the therapeutic alliance between youth and service providers, helps track treatment progress, and encourages youth agency in their own care. Challenges to MBC include an inability to express feelings and needs through a quantitative measure, filling out several measures without much thought, and encountering questions that trigger negative emotions. Strategies to enhance MBC include integrating qualitative responses, moving beyond standardized assessments, providing time and flexibility for MBC assessment, and fostering choice for youth to tailor or opt-out of MBC assessment.

 

Implications: The study provides an understanding of youth’s experience of MBC and its importance in integrated youth services and community-based mental health settings. Our findings will add to practical solutions to improve and strengthen measurement-based care within these services.