Measuring Patient Oriented Outcomes in Children and Youth With Mental Health Concerns: Albertan Key Informant Perspectives

Mental health concerns among children and youth in Alberta are increasing while poor mental health remains as one of the largest threats to childhood in Alberta. In Canada, mental illness impacts 1 in 4 youth. Demands for mental health services have steadily increased over the past 10 years. To address the child and youth mental health crisis, strategic coordinating and monitoring of child and youth mental health service outcomes are important. This information can inform planning, funding allocation and evaluation. Mental health services were already in crisis when the COVID-19 pandemic hit. The pandemic has only exacerbated the issue, particularly among youth. Delivering supports and services that meet the needs of youth is critical. A better understanding of the efficiency and effectiveness of mental health services is required. Patient-oriented outcome measures are important for gathering information that can incorporate the patient’s own perspectives of their outcomes during treatment. Such measures can inform equitable distribution of funds and efficiency of systems planning. Despite patient-oriented research being a national priority, Canada does not have a policy directing how to conduct patient-oriented research; thus, provinces are creating their own. Alberta lacks a unified approach, resulting in various tools and measures being used, which, has led to issues tracking patient outcomes, identifying trends and referring patients to services. Strategic guidance and policy regarding how to measure and track outcome measures are needed to gather consistent data and provide better services. A lack of consistent data from patient’s perspectives impacts ability to make evidence informed, value-based decisions when allocating funds. Policy related to youth mental health in Alberta is present in many ministries; however, no overarching cross-ministry strategy exists. This communiqueÌ presents three findings from key informants who are knowledgeable about Alberta’s youth mental health services and patient-oriented outcome measures. 1. Measure what matters: A lack of provincial consistency for measuring child and youth mental health outcomes was identified. A provincial strategy to improve measurement and monitoring of youth mental health is required. This needs to be a multi-ministry strategy that specifically considers children and youth. Key actions include the measurement of patient-reported outcomes more uniformly and addressing cross- ministry fragmentation in the child and youth mental health sector. Inconsistent or a lack of data being collected across Alberta has created inefficiencies, including the inability to identify trends and compare outcomes across jurisdictions. 2. Bridge the equity gap: Equity gaps in the mental health sector exist for marginalized children and youth, which have grown during the COVID-19 pandemic. Barriers to access services are greater for marginalized children and youth and many have fallen through the cracks throughout the pandemic. It is critical to ensure children and youth have access to resources that meet their needs and that mental health services are monitoring their outcomes during their treatment. Guidelines on how to measure and monitor patient-oriented outcomes are recommended. 3. The need for a cross-ministry youth mental health strategy. The absence of a youth inclusive mental health strategy impacts the implementation of patient-oriented outcome measures for children and youth in Alberta. Without co-ordinated action to improve service delivery and monitoring, there is increased risk of long-term adverse impacts on child and youth mental health. Equity deserving groups must be part of the design and implementation of the provincial strategy to allocate resources appropriately. One in four children in Canada are impacted by mental illness. It is critical for the Alberta government to measure what matters and provide strategic guidance to improve equity and efficiency of youth mental health services delivery.