Notes

Curbing Dependability, Interoperability as well as Protection of Cell Health Alternatives.
These strategies and principles may be applicable to other scenarios where rapid research or system transformation would benefit from youth engagement, such as time-limited child research by trainees (e.g., dissertations) or natural disasters.
To describe political advocacy and scientific debate about headspace, a non-governmental organisational (NGO) substantially funded by the Australian federal government that has significantly impacted the youth mental healthcare landscape. IOX1 Access Open Minds is a Canadian clinical research initiative for youth mental health partially based on headspace. Lessons from the Australian experience may thus prove useful for Canadian stakeholders.

The Australian healthcare system, mental health policy and governance for youth mental healthcare are contextually described. The structure and promulgation of the headspace NGO is detailed, as a parallel provider of primary mental healthcare outside of existing public and private mental health services. A review of the existing research on the evaluation of headspace was conducted.

Headspace has expanded rapidly due to successful political advocacy on behalf of the youth early intervention model, with limited coordination in terms of governance, planning and implementaefore further adoption by governments.
This manuscript serves to provide an overview of the methods of the Multimorbidity in Children and Youth across the Life-course (MY LIFE) study, profile sample characteristics of the cohort, and provide baseline estimates of multimorbidity to foster collaboration with clinical and research colleagues across Canada.

MY LIFE is comprised of 263 children (2-16 years) with a physical illness recruited from McMaster Children's Hospital, their primary caregiving parent, and their closest-aged sibling. Participants are followed with data collection at recruitment, 6, 12, and 24 months which includes structured interviews, self-reported measures, and biological samples and occur in a private research office or at participants' homes. Post-COVID-19, data collection transitioned to mail and telephone surveys.

At recruitment, children were 9.4 (4.2) years of age and 52.7% were male. The mean duration of their physical illness was 4.5 (4.1) years; 25% represent incident cases (duration <1 year). Most (69.7%) hadications for the generalizability of findings.
There is a dearth of Canadian-based literature on children referred to treatment services following maltreatment exposure. In order to inform assessment, intervention, and program development to improve outcomes, insight into the demographics and mental health needs of this population is required.

A retrospective file review of 176 children and youth who were referred for assessment and treatment at a mental health partner agency within a Canadian Child Advocacy Centre was conducted from January 2016 to June 2017. A standardized protocol was developed to extract data on family and child demographic characteristics, type of maltreatment, other adversity exposure, presenting concerns of the child, and mental health service utilization.

The majority of children were female (66.5%), 4.5% were 0 to <5 years, 66.5% were 5 to <13 years, and 29.0% were 13 to <18 years of age. More than half of the children (53.4%) had multiple forms of maltreatment, with 67% exposed to sexual abuse. Exposure to other forms of adversity was also common, including domestic violence (53.4%) and parental mental health difficulties (52.3%). Most children had more than five presenting concerns at the time of referral, and most went on to receive intervention services. Sixty-nine percent of families had not previously received child mental health treatment, although 41.5% had prior child welfare involvement. Thirty percent of families ended treatment prematurely.

The current study illustrates the complex profile and mental health needs of children referred for treatment following maltreatment exposure. Results may have implications for clinical care improvement that support maltreated children.
The current study illustrates the complex profile and mental health needs of children referred for treatment following maltreatment exposure. Results may have implications for clinical care improvement that support maltreated children.
There is increasing interest in the identification of mental disorders among youth through routine screening in integrated health services. One tool currently being used in Canada is the Global Appraisal of Individual Needs Short Screener (GAIN-SS). The aims of this study were to (1) estimate the internal consistency of the GAIN-SS and its internalizing disorder screener (IDScr) (2) examine concurrent validity of the GAIN-SS and IDScr in an integrated youth health service centre, and (3) identify clinical cut-points for youth aged 17-24 years.

Participants [n=201, gender=44% women, median age 21 (min,max 17,24) years] were recruited from an integrated youth health service in Vancouver, British Columbia. Participants completed the GAIN-SS and three reference measures Kessler Psychological Distress Scale (K10), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder Scale (GAD-7). Cronbach's alpha, sensitivity, and specificity of the GAIN-SS and IDScr were examined using the K-10, PHQ-9 and GAD-7 as reference measures. Receiver operator characteristic curves were generated to identify optimal cut-points for the GAIN-SS and IDScr.

A cut-point of seven for the GAIN-SS optimized sensitivity (90%) and specificity (42%) with Cronbach's alpha of 0.91. A similar pattern of results was found for the IDScr and the reference measures it was tested against.

The results indicate that the GAIN-SS and IDScr have acceptable sensitivity but poor specificity that could be improved via the optimal cut-points identified in this study. This low specificity may be acceptable within an integrated youth health service that provides follow-up diagnostic assessments by a clinician.
The results indicate that the GAIN-SS and IDScr have acceptable sensitivity but poor specificity that could be improved via the optimal cut-points identified in this study. This low specificity may be acceptable within an integrated youth health service that provides follow-up diagnostic assessments by a clinician.
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