Beyond Silos: Exploring Service Providers’ Experiences of Integrated Care within Integrated Youth Services

Background: Integrated youth services (IYS) aim to provide low-barrier access to integrated care (e.g., clinical, community, and primary care services) to youth aged 12-25 years to address their youth mental health and substance use (MHSU) needs in a holistic manner. The IYS model in Ontario (Youth Wellness Hubs Ontario, YWHO) provides young people with low-barrier, walk-in access to integrated care. Significant international attention is currently being paid to integrated care approaches within IYS, yet there is no single best practice model or well-defined guidelines for the implementation of integrated care. This study explored YWHO service provider perspectives and experiences with delivering integrated care within IYS.

 

Approach: A convergent parallel mixed methods design assessed attitudes and perspectives of service providers at YWHO using quantitative survey data and qualitative focus group data. The Service Provider Adopter and Innovation Characteristics Questionnaire (SPAICQ) survey measured adopter characteristics (concern; self-efficacy) and innovation characteristics (complexity; compatibility; relative advantage) and descriptive statistics were generated. Focus groups were conducted to explore perspectives related to the perceived benefits of integrated care to youth, and barriers to and facilitators of implementing integrating care in IYS. Focus group findings were analyzed using a thematic approach to analysis.

 

 

Results: Forty-nine service providers completed the SPAICQ and 15 service providers participated in focus groups. SPAICQ findings overall highlight that service providers believe that the provision of integrated care has advantages over traditional youth mental health services, that the integrated and that the service delivery model is compatible with their organization’s values and strategies. Service providers showed high levels of self-efficacy and a high level of confidence in their ability to delivery integrated care. Focus group findings highlight the strengths of integrated care (e,g, stigma reduction, increased service access, reduced fragmentation, empowers youth), and barriers (e.g., adequate physical space, technology, staffing resources, communication and coordination).

Implications: Implementing integrated care holds significant potential for improving mental health and substance use care for youth. IYS models are emerging internationally, but greater evidence on the implementation of those models, including the perspectives of service providers is required to establish and implement the presenting enablers.