Literature Collection

BACKGROUND: Early onset of mental health disorders is common, but many cases remain undetected and untreated, highlighting the need for early intervention. In Canada, youth mental health services face challenges, including fragmentation and resource limitations. Integrated youth services (IYS) aim to address these gaps for individuals aged 12-24 years. Mobile health (mHealth) programs, like Foundry Virtual BC, offer potential solutions, yet their integration and sustainability within IYS require further exploration. OBJECTIVE: This study examined interest-holder perspectives on creating a sustainable, youth-centred mHealth system to improve mental health outcomes. The research focused on three questions: (a) How do users, service providers, and nonclinical staff perceive mHealth's effectiveness and impact? (b) What are the barriers and facilitators to mHealth integration within the Foundry IYS network? and (c) What strategies support the sustainability of mHealth services? METHODS: A qualitative study using semi-structured interviews was conducted with 23 interest-holders, including youth users, service providers, and nonclinical staff from the Foundry network. Participants were recruited via social media and snowball sampling. Thematic analysis identified key themes and subthemes. RESULTS: Three themes emerged regarding mHealth perceptions: (a) its own value, (b) its potential to address barriers to in-person care, and (c) its inherent limitations. Barriers and facilitators of mHealth integration were categorized into three domains: (a) design characteristics (e.g., app usability and content quality), (b) individual youth factors (e.g., privacy concern and inner struggle), and (c) external factors (e.g., safe space and support from peers). Sustainability was linked to service quality and external support. CONCLUSION: This study highlights the complexity of mHealth integration within an IYS network. Interest-holders emphasized addressing user motivations, privacy, and accessibility while advocating for co-design approaches to ensure mHealth meets diverse youth needs. Future research should focus on underrepresented groups to promote equity and improve mental health outcomes through sustainable mHealth solutions.

The COVID-19 pandemic struck in the midst of an ongoing opioid epidemic. To offset disruption to life-saving treatment for opioid use disorder (OUD), several federal agencies granted exemptions to existing federal regulations. This included loosening restrictions on medications for OUD (MOUD), including methadone and buprenorphine. In this commentary, we briefly review policy and practice guidelines for treating OUD prior to the onset of the COVID-19 pandemic. We then outline specific MOUD treatment policy and practice exemptions that went into effect in February and March 2020, and discuss the ways in which these unprecedented changes have dramatically changed MOUD treatment. Given the unprecedented nature of these changes, and unknown outcomes to date, we advocate for a data-driven approach to guide future policy and practice recommendations regarding MOUD. We outline several critical clinical, research, and policy questions that can inform MOUD treatment in a post-COVID-19 era.