Integrated care for children and youth through interRAI: Promoting efficiency across mental health care service sectors in Ontario

IntroductionIn Ontario, the mental health care system is overwhelmed by the volume of individuals requiring services and supports. It is estimated that 1 in 5 children and youth will experience a mental health concern, but the majority will not receive the needed treatment. Over the years, a lack of coordination between service sectors has consistently been endorsed as one of the contributors to the mental health care system’s shortcomings. The difficulty in navigating the mental health care system has resulted in a call for the development of a standardized assessment system that will improve efficiency and integration across service sectors.Aims Objectives Theory or MethodsTo address the need for an integrated health information system, interRAI designed psychometrically sound instruments to coordinate the provision of services for infants, toddlers, children and youth. The interRAI mental health suite of instruments supports a life course approach to assessment and care planning.Highlights or Results or Key FindingsA number of characteristics make the interRAI child and youth suite of instruments an integrated health information system including a shared clinical focus and conceptual basis related to care planning, a common language across instruments, and a standardized data collection method. The various instruments have several applications that are made possible through the embedded scales/algorithms, care planning protocols, outcome measures, and quality indicators. This allows for client profiles to be created in a uniform manner through standardized practices across service sectors. The integrated nature of the interRAI assessment system is illustrated with three examples highlighting the prevalence of self-injurious intent, self-injurious behaviours, and depressive symptoms across the suite of instruments. Data was obtained from children and youth seeking mental health services within the Province of Ontario.  ConclusionsThis research depicts the critical utility of interRAI’s assessment system, as it allows us to take an integrated look at important trends and patterns across various service sectors, including the experience of self-injurious intent, self-injurious behaviours, and depressive symptoms among children and youth.Implications for applicability/transferability sustainability and limitations In Ontario, the implementation of the interRAI child and youth suite has been effective in organizing care delivery and is currently being adopted by other provinces. The instruments emphasize a needs-based approach to care, reducing disparity in mental health services.

https://ijic.org/articles/10.5334/ijic.ICIC21196