Grant: Catalyst Grant: Standards for Children and Youth Mental Health Services

Background: Depressive Disorders in adolescents (ages 13-18 years old; DD-A) are common, and represents important risk of morbidity and mortality, namely by suicide. Our prior published work identified the relevant NICE guideline as uniquely high quality and up-to-date. Integrated Care Pathways (ICPs) are treatment algorithms intended to translate of guideline recommendations (i.e. standard of care) into routine practice. Our group developed an ICP based on the NICE guideline called CARIBOU-2. There are 7 core components: assessment, education, therapy options, medication options, caregiver support, measurement-based care, and graduation. Implementation efforts for CARIBOU-2 are already underway across Ontario. It is not known to what extent mental health centers in other provinces are ready to implement the CARIBOU-2 intervention. We wish to clarify readiness for the CARIBOU-2 pathway implementation process of mental health agencies in Quebec, Alberta and British Columbia. Method: Co-investigators based in Quebec, Alberta and British Columbia will broadly invite administrative staff (directors, managers, lead clinicians and local youth partners) at community-based and academic mental health centers to participate in the study. Consenting participants will receive extensive detailed information about the CARIBOU-2 pathway and each of its components. Structured site-level group interviews will proceed to assess need, fit, capacity, supports, evidence and usability factors for consideration prior to implementation of a complex intervention. Results will be synthesized and summarized across sites using tables and narrative summary. Impact: This study will indicate where efforts to implement CARIBOU-2 across Canada are warranted and set the stage to scale up this complex intervention. Sites that are ready could then initiate processes required to deliver care to DD-A based high quality standards.