Atlantic Canada Children’s Effective Service Strategies (ACCESS-MH) – Patient Journeys


Children with mental health disorders receive treatment and services through a myriad of service providers including health professionals, educators, social workers, and, in severe cases, the justice system. The provision of care is largely uncoordinated and results in poor outcomes, lengthy queues, and inefficiencies. The aim of the ACCESS-MH research program is to bring together a cross-sectorial and interdisciplinary team of researchers, health care providers, and decision makers from across Atlantic Canada to take a diverse and innovative approach to studying how services are provided to children and youth identified with anxiety, depression, autism spectrum disorders, conduct disorder, and eating disorders. We are documenting and analysing how treatment is received across government sectors including Health, Education, Social Development, Public Safety, and Youth and Family Services.


Patient journeys research is a qualitative, narrative, and descriptive technique that has been used for clinical redesign, using the evidence produced to address obvious shortcomings in the health care delivery system and attempting to increase the evidence base regarding patient experiences with health care. We apply this analytical technique to Atlantic Canada and across sectors to examine interactions with health, public education, and other service providers. We have formally interviewed children/youth, family members, and service providers to map their knowledge of points of access, duplications, barriers/facilitators, and journey through the system as encountered.


The key research objectives of ACCESS-MH are to: (1) document service delivery and care in the four provinces through analysis of administrative datasets and personal patient journeys, and (2) use this information and the technique of operations research to propose more effective approaches to service delivery for the five mental health conditions.

The patient journeys component of the study is guided by the following questions:
1. What are the individual journeys experienced in the mental health system?
2. What does a typical journey look like in each province?
3. What services are these patient populations currently accessing?
4. What services are they accessing through other agencies or providers (e.g., education, social work, private sector providers)?
5. What are the significant barriers/facilitators to accessing these services? Is there duplication in services provided?
6. What services or models of care are perceived as effective/ineffective and why? What is the quality of care experienced or provided?
7. Can the system be re-organized and resources better allocated to improve outcomes and efficiency?


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