Fostering Accessibility to Mental Health Services for Youth Experiencing Homelessness in Montreal, Canada

A Historical Cohort Comparison Study

Bibliographic Data

ID19273296
AuthorsAmal Abdel‐Baki (0000-0003-3333-9652, Douglas Mental Health University Institute), Giuseppe D’Andrea (0000-0001-7014-645X, Douglas Mental Health University Institute), Charles Tessier (McGill University Health Centre), David Aubin (0000-0002-5903-3283, Douglas Mental Health University Institute), Diane Aubin (Douglas Mental Health University Institute), Nora Morrison (0009-0007-4492-823X, Douglas Mental Health University Institute), Marie‐Ève Dupont (Douglas Mental Health University Institute), Marie-Ève Dupont (University of Montréal Hospital Research Centre (CRCHUM), QC, Canada), Camille Arbaud (Douglas Mental Health University Institute), Pasquale Bauco (Douglas Mental Health University Institute), Jai Shah (0000-0002-7549-6990, Douglas Mental Health University Institute), Ashok Malla (0000-0002-5863-4191, Douglas Mental Health University Institute), Srividya N Iyer (0000-0001-5367-9086, Douglas Mental Health University Institute)
Year2026
Pages207640261446109-207640261446109
Publication date2026-05-13
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Social Psychiatry (JOURNAL)
Journal identifiersISSN: 0020-7640 • E-ISSN: 1741-2854
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/00207640261446109
PMID42126077
OpenAlexW7161034578
LanguageEN
References cited34

BACKGROUND: (RIPAJ) was established in Montréal in 2003 through collaboration between community and governmental health organizations. In 2016, RIPAJ joined the national Adolescent/Young Adult Connections to Community-driven Early Strengths-based Stigma-free services-Open Minds (ACCESS-OM) initiative, aiming to enhance mental healthcare accessibility for youth experiencing homelessness. AIMS: This study evaluates the impact of this integrated approach on referral trends and wait times before and during ACCESS-OM RIPAJ implementation. METHOD: Monthly referrals and wait times for first appointment were recorded for a historical cohort (2014-2015) and the ACCESS-OM RIPAJ period (2016-2020). We used Poisson and Cox regression models to analyze trends in referral rates and wait times, with 2014 as reference period. Seasonality was controlled by incorporating calendar month in the models. Additional Cox regressions examined individual-level sociodemographic and clinical factors associated with post-implementation wait times. RESULTS: We analyzed 158 referrals for 2014 to 2015 and 681 for 2016 to 2020. Monthly referrals increased significantly, peaking at 2.5 times the 2014 level. Wait times remained stable, with 73.5% evaluated within 72 hr. The hazard ratio for wait times during the peak period was 0.87 (95% CI [0.63, 1.20]) indicating no significant change despite the surge in referrals. Older age and self-referral were associated with reduced wait times. CONCLUSIONS: This collaborative model successfully increased mental healthcare utilization among youth experiencing homelessness, providing valuable insights for addressing the unmet needs of this vulnerable population and potentially reducing homelessness perpetuation

Cohort · Cohort study · Mental health · Mental healthcare · Poisson regression · Population · Proportional hazards model · Referral · Homelessness and Social Issues · Intimate Partner and Family Violence · Psychiatric care and mental health services

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