Developing Service Standards for Youth with Complex Mental Illness

While most service standards in youth mental health have been based on mental health diagnoses, "complexity" may be a useful construct, describing a group of youth requiring more intensive care with multiple components. However, there are no agreed upon service standards for youth with complex mental health needs. The first required steps are to achieve a consensus definition of "complexity" and consistent approach to its measurement with the help of youth and family members with lived experience. In Phase I, we plan to identify relevant literature to date in a scoping review. We will gather an Expert Advisory Committee of knowledgeable Canadians (e.g., youth, family members, service providers, administrators, policymakers, and researchers) to support a "Delphi" survey, which is a way of proposing elements of the definition and getting agreement. In Phase II, we will conduct a scoping review to identify measurement tools/approaches designed to capture the "complexity" construct (as defined from Phase I). A consensus definition of "complexity" in youth mental health and way of measuring it can support a "learning health system" that helps direct resources to young people with the highest need, addressing health inequities, and improving service delivery in specialized mental health and substance use health settings. It can also guide the development of specific interventions that target youth with the highest need, forming the basis for treatment standards to improve outcomes in this key population.