Background and objectives: Despite substantial global burden of mental illnesses, there remains limited evidence evaluating the effectiveness of inpatient Models of Care (MOC) for adolescents. This paper compares the effectiveness of an innovative MOC, the Brief Intervention MOC (BIMOC), with the Traditional MOC in the acute adolescent inpatient unit. Comparisons were based on clinical outcome measures and several Key Performance Indicators (KPIs) (Length of Stay, 28-day readmission rate, 7-day follow-up rate, seclusion rate, and self-harm incidents), which were tracked over the subsequent years to evaluate BIMOC’s effectiveness and sustainability. Materials and Methods: A quasi-experimental design was applied. Clinical outcomes were assessed using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Children’s Global Assessment Scale (CGAS).Service-level KPIs were compared across models. Descriptive statistics, paired-samples t-tests, Cohen’s d, and z-tests were used to evaluate changes within models and compare outcomes between models. Results: Within the BIMOC, both acute and crisis subgroups showed substantial improvements, with increased CGAS scores and corresponding reductions in HoNOSCA scores. Overall, both models demonstrated significant improvements; however, effect size analysis indicated greater functional gains under the BIMOC compared with the TMOC, while symptom improvements were comparable between two MOC. KPI data analysis demonstrated sustained improved service performance under the BIMOC compared to the TMOC. Conclusions: The study implies that a structured and integrated inpatient MOC( BIMOC), can deliver comparable clinical outcomes while improving efficiency, safety, and continuity, highlighting its potential as a sustainable solution for high-demand adolescent mental health services.

Early identification of autism spectrum disorder (ASD) is essential for improving developmental outcomes but remains challenging due to diagnostic delays, subjectivity, and resource limitations. Eye-tracking offers objective indices of social attention and could improve access to early screening when deployed on consumer devices at home. This scoping review synthesizes evidence on home-deployable eye-tracking as digital biomarkers for early ASD screening, associated machine learning methods, and feasibility of real-world implementation. Following the Arksey and O’Malley framework and Joanna Briggs Institute (JBI) methodology, reported per PRISMA Extension for Scoping Reviews (PRISMA-ScR), we searched PubMed and Scopus (2015-2025) for English-language human studies using terms for autism, eye-tracking, and home-based assessment. Using a Population, Concept, Context (PCC) framework (Population: infants/ children; Concept: eye-tracking as digital biomarker; Context: home/ clinical settings), two reviewers screened each record and charted data on participant characteristics, stimuli, devices, analytic methods, diagnostic performance, and implementation indicators. Extracted data, including diagnostic performance metrics (PPV, NPV, confidence intervals), study design classifications, validation methods, and biomarker readiness ratings, are provided in full in Supplementary Tables S2–S6. The protocol was preregistered on the Open Science Framework (OSF Registries osf.io/mdz2e/; https://doi.org/10.17605/OSF.IO/MDZ2E). Searches were last executed on 1 August 2025. A process-based estimation approach was used to quantify the EOL carbon footprint of two timber floor systems—Adhesive Screw and Sharp Plate Screw, following ISO 14040/44 standards. Four realistic EOL pathways (landfilling, downcycling, component reuse, and full assembly reuse) were assessed under three recovery-rate scenarios (90

While there are numerous social skills interventions (SSI) designed for pre-schoolers, the evidence supporting their effectiveness for adolescents and young adults remains limited. This study conducted a systematic review and meta-analysis to examine the available evidence on the efficacy of SSIs on core autistic traits among youth diagnosed with autism spectrum disorder aged 12–25 years. Several electronic databases such as APA PsychINFO, Academic Search Complete, CINAHL, Education Source, Psychology and Behavioural Sciences Collection, Education Resources Information Center (ERIC), Pubmed, Ovid MEDLINE, Educational Administration Abstracts and SocINDEX with Full Text, were systematically searched for randomised controlled trials (RCTs) and quasi-controlled studies, with either a waitlist or active control group. The review included 15 (14 RCTs and one quasi-control study) studies (N = 1244). Meta-analysis revealed that participants receiving SSIs resulted in improvements in social skills, based on observation (standardised mean difference (SMD) = 0.49, 95

INTRODUCTION:To explore caregivers' (i) priorities and challenges in seeking and using relevant information and services to support their children's mental health, and (ii) preferences for digital solutions that could meet their needs. METHODS:Semi-structured interviews were conducted with 13 caregivers experiencing adversity. Transcripts were analysed employing framework analysis. RESULTS:When seeking information and support services, caregivers prioritised feeling understood and not being judged. Common challenges were too much or not enough relevant information; lack of time and a 'solution burden' to find support; as well as being unsure how to progress seeking appropriate support. Caregivers used a range of online search strategies to seek information and services to support their child's health needs. They expressed a need for a digital solution that was practical and non-judgemental. CONCLUSIONS:Caregivers often sought information and services online but faced challenges with navigating the abundance of resources. A practical and simple online solution providing the right information and services at the right time is critically needed. SO WHAT:A digital navigation platform providing evidence-based information and services could assist caregivers in navigating the complex process of seeking support for child and family health and wellbeing.

Exposure to intimate partner violence (IPV), posttraumatic stress disorder (PTSD), depressive symptoms, and functional impairment among women of reproductive age are pressing public health and human rights issues in conflict-affected settings. However, to better inform policy and influence positive change, there is a need to understand the trajectories and relationships between these issues over time. We aimed to characterize the trajectories and associations between IPV, depressive symptoms, PTSD, and functional impairment over time among women of reproductive age in conflict-affected, low-resource Timor-Leste. Data are from a prospective cohort study of 854 women, conducted from 2013 to 2020 in Timor-Leste. Participants were assessed at four time points: second trimester of pregnancy (from Weeks 13 to 27) and when the child was 18 months, 36 months, and 60 months old. Latent growth curve modeling and bivariate analyses were used to explore the trajectories and associations. At each wave, PTSD and depressive symptoms were positively correlated with functional impairment and past conflict trauma. IPV was consistently associated with risk of PTSD, depressive symptoms, and impaired functioning among women over time. IPV was reported at a high rate at each time point, whereas PTSD and depressive symptoms improved over time. Findings indicate the need for IPV prevention programs and stronger legal and social sanctions to reduce men's violence. Improvements in women's mental health may be due to the time that has elapsed since conflict trauma or since the birth of the child. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Parent-child behavioral synchrony—the dyad’s moment-to-moment coordination of behavior and emotion—supports children’s socioemotional development, yet most evidence comes from cross-sectional community samples using global indices, limiting clinical insight for heterogeneous conduct problems (CP). This prospective study tested baseline differences and treatment-related change in discrete synchrony facets among clinic-referred children with CP, comparing CP-only, primary callous-unemotional (CU; CU without internalizing problems), and secondary CU (CU with internalizing problems) variants. Mother-child and father-child dyads of N = 234 children aged 2–7 years (74

Introduction Many children and their families, especially those from priority populations, experience barriers to accessing high-quality early childhood health, education, social and legal services. Further, these families are often under-represented in service planning and research; hence innovations are not designed to meet their needs. Our aim is to codesign with families and the wider community, a Strength-based, Tiered, Accessible Resources and Supports for Kids (STARS for Kids) programme to optimise child development, parental mental well-being, and family psychosocial needs in the first 2000 days from pregnancy to start of school.Methods and analysis This study will employ a mixed methods design at three sites: (1) Fairfield, urban multicultural site in South-Western Sydney New South Wales; (2) Taree, a regional town with a large Indigenous community; and (3) The City of Wanneroo, a low socioeconomic area of Western Australia. The codesign process will involve five phases of the design thinking methodology informed by culturally safe, strengths-based, and trauma-informed practices. Codesign will involve families, service providers, and community leaders from priority groups such as multicultural stakeholders from South-Western Sydney and an Aboriginal Community Consultation Group with Biripi Elders and other local Indigenous representatives at Taree. Data collection will include semi-structured interviews, workshops, or focus groups as well as ‘yarning’ for the Aboriginal community. Qualitative data will be thematically analysed using Braun and Clarke’s six-phase method of thematic approach.Trial registration number Australian New Zealand Clinical Trials Registry - ACTRN12624000806561 (This protocol pertains only to the initial codesign phase, during which the STARS for Kids tiered care model will be finalised for subsequent implementation and evaluation in the next trial phase which is outlined in the trial registry).

Neurodevelopment is a dynamic process involving genetic and environmental factors that influence motor, cognitive (e.g., learning, communication), social, adaptive, emotional, and behavioural domains. This systematic review and meta-analysis aimed to estimate the prevalence of NDDs among preschool children of migrants and refugees in high-income Western countries. Five databases, including Medline, Embase, Scopus, CINAHL, and PsycINFO, were searched for eligible studies from inception until October 1, 2025. Three reviewers independently screened and selected studies, extracted data, and assessed the methodological quality. We have used Stata to estimate the weighted pooled prevalence of autism from crosssectional and cohort study data using random-effects meta-analysis with (I²/Q>50

PURPOSE OF REVIEW:High comorbidity rates across neurodevelopmental disorders (NDDs) may suggest shared pathogenic mechanisms rather than independent disease processes. This review synthesizes recent neuroimaging evidence (2024-2025) examining how comorbidity patterns reveal circuit-level convergence across traditional diagnostic boundaries. RECENT FINDINGS:Studies of brain connectivity demonstrate that four core transdiagnostic dimensions of cognitive rigidity, sensory processing, repetitive behaviours, and social-emotional regulation show both circuit convergence and disorder-specific patterns across autism spectrum disorder, attention deficit hyperactivity disorder, obsessive compulsive disorder, Tourette syndrome and anxiety disorders. Analyses of how brain networks change over time clarify inconsistencies in earlier static studies, revealing that temporal network inflexibility predicts symptom severity better than anatomical connectivity alone. Developmental studies suggest circuit dysfunction emerges early (as early as 18 months for sensory processing) and creates cascade effects throughout maturation. Interventions targeting specific brain circuits produce transdiagnostic improvements, validating circuit-based approaches over disorder-specific supports. SUMMARY:Comorbidity patterns provide critical clues to shared pathogenesis, with circuit-level evidence supporting dimensional models over categorical diagnoses. The timing and of circuit dysfunction inform whether patterns reflect shared vulnerabilities, developmental cascades, or independent processes converging on similar phenotypes. These findings suggest that assessments and interventions targeting underlying brain mechanisms may be more effective than traditional categorical diagnosis-based interventions.

Early and accurate detection of Autism Spectrum Disorder (ASD) is critical for enabling timely intervention and support. Recent advances in eye-tracking technologies and deep learning have facilitated objective, scalable approaches for ASD screening using visual attention patterns. In this study, we propose a robust hybrid methodology that extracts deep neural network activations from eye-tracking scanpath images using EfficientNetB0 and leverages these features for classification with a Support Vector Machine (SVM) optimized via grid search. Experiments were conducted on a public scanpath image dataset of 547 samples, encompassing both ASD and Typically Developing (TD) participants. After systematic image preprocessing, augmentation, and feature extraction, the optimized SVM classifier achieved an overall accuracy of 97%, with macro-averaged precision, recall, and F1-score all at 0.97 on the held-out test set. Comparative analysis with prior deep learning and ensemble-based pipelines demonstrates that the proposed approach attains state-of-the-art performance while maintaining computational efficiency and interpretability. These results position our hybrid pipeline as a practical tool for scalable, automated ASD screening from eye-tracking data.

Introduction:Parental quality of life (QoL) and stress are strongly linked to behavioural, emotional, and cognitive differences in autistic children. However, these relationships have rarely been examined with a cross-cultural lens, despite the potential influence of sociocultural contexts on assessment and interpretation. To address this knowledge gap, this study employed multinational data to investigate the cross-cultural associations between emotional/behavioural and cognitive/adaptive differences in autistic children and parental wellbeing. Methods:Data were obtained from 219 autistic children aged up to 18 years across five countries (Australia, Singapore, Hungary, Romania, and the United Kingdom). Standardised instruments were used to assess four key domains of parental QoL, parental stress, child's behavioural/emotional difficulties, and adaptive/cognitive differences. Since different standardised instruments were used across countries, all measures were dichotomised according to established clinical cut-offs for each instrument. Multivariable logistic regression models were used to examine associations between children's autistic difficulties and parental wellbeing accounting for country- and measure-level variations. Results:Across countries, children experiencing higher emotional/behavioural difficulties were significantly associated with lower parental QoL (QoLA Part A: AOR = 0.36, 95% CI 0.11-0.97) and twice higher odds of parental stress (AOR = 2.11, 95% CI 1.08-4.54). However, the association between cognitive/adaptive difficulties and parental QoL and parental stress did not reach statistical significance. Additionally, there were no evidence of country- or measure-level heterogeneity for parental wellbeing outcomes (ICC = 0.00), indicating consistent associations across cultural contexts and assessment tools. Discussion:Emotional and behavioural difficulties in autistic children are significantly associated with poorer parental quality of life and increased stress across diverse cultures, suggesting that the challenges faced by parents are largely universal. These findings highlight the importance of early identification and family-centred, culturally responsive supports to improve wellbeing for both autistic children and their parents.

Children whose primary caregivers experience mental illness and adverse psychosocial complexity are at increased risk of experiencing mental, physical, and relational challenges. Perinatal mental health services have commonly focused on treating the parental mental health problem; however, emerging evidence shows that parental mental health interventions alone are not sufficient to address the complex needs of both caregivers and their children. To address this gap in services, a new, highly specialised program-the Nurturing Connections Program-was implemented across three Australian local health districts within the State of New South Wales. The program is targeted to caregivers of young children referred to mental health services and aims to improve caregiver mental health and psychosocial adversity, child developmental outcomes, and the child-caregiver relationship. This study evaluated caregivers' experiences with, and views of, the program. Twelve caregivers participated in semi-structured, in-depth interviews. A reflexive thematic analysis approach guided data interpretation. Four themes and three subthemes emerged from the data: (1) motivation for attending the program; (2) program components received; (3) post-program outcomes (subthemes: Caregiver-related outcomes, Child-related outcomes, and interpersonal outcomes); and (4) areas for program improvement. This study's findings highlight program benefits, program facilitators and areas for improvement.

Background Mental health challenges are common in autistic individuals but there is limited research, particularly among preschool children. Aims To ascertain the nature and occurrence of mental health challenges in autistic preschool children, as well as their association with autistic traits and cognitive and adaptive functioning. Method We conducted a secondary analysis of data collected from children attending Autism Specific Early Learning and Care Centres across six states in Australia. The primary outcome of mental health challenges was assessed using the Child Behaviour Checklist (CBCL). The severity of autism and autistic traits, such as social communication differences and repetitive behaviours, alongside cognitive and adaptive functioning, were used as exposure variables. Multivariable linear regression analyses examined the associations among mental health challenges, autistic traits, cognitive level and adaptive functioning, and adjusted for key sociodemographic covariates. Results Among 760 children, about 76% scored above the clinical range of CBCL total problem scores. Mental health difficulties were significantly associated with greater severity of autistic traits, social communication differences and repetitive behaviours, and lower verbal developmental functioning and adaptive functioning. Additionally, sociodemographic determinants, such as children who were older, female or with an autistic sibling, were associated with higher risk of mental health difficulties, whereas culturally and linguistically diverse status, higher parental education and family income were protective against mental health challenges. Conclusions Our findings provide useful insights into the high prevalence of mental health difficulties among autistic preschool children, highlighting the significant association with autistic traits, cognitive and adaptive functioning levels and sociodemographic risk factors.

Background:The management of persistent symptoms for long COVID (eg, fatigue, concentration difficulties, sleep difficulties, loss of appetite and taste, depression, and anxiety) has not been widely studied among adolescents and young adults (AYA). This systematic review and meta-analysis aimed to synthesise and review evidence on the effectiveness of non-pharmacological interventions for AYA aged 13-25 years, presenting with long COVID symptoms. Methods:A systematic literature search was conducted in four electronic databases (PubMed, EMBASE, PsycInfo, and ProQuest) in addition to manual searches for studies from January 2020 to May 2025 (PROSPERO: CRD42024516016). The studies were screened for eligibility, and methodological quality was assessed using the Joanne Briggs Institute Critical Appraisal tool by two independent reviewers. Findings were summarised using a narrative synthesis approach, and where possible, a meta-analysis was conducted using a random effects model with standardised mean differences (SMD) and a 95% confidence interval (CI). Results:Of the 325 screened articles, seven studies were included, which discussed six interventions. Three studies reported on the effectiveness of three multidisciplinary rehabilitation programs (eg, neuropsychological rehabilitation program, multidisciplinary post-COVID rehabilitation program, micro-choice-based concentrated group rehabilitation), three on alternative medicine practices (eg, forest bathing, traditional Thai Medicine), and one on mechanical therapy (eg, enhanced external counterpulsation). Findings suggested that interventions, although varied in duration and follow-up, were effective in improving mental health (SMD: 0.64, 95%, p<0.0497). There were also non-statistical improvements in fatigue (SMD: 1.74, 95%, p = 0.1307), quality of life (SMD: -1.34, 95%, p = 0.2787), and cognitive function (SMD: 1.05, p = 0.2989). Conclusion:This review's findings suggest that non-pharmacological interventions may effectively treat neuropsychiatric symptoms of long COVID in AYA, ensuring better outcomes. Nevertheless, further research must be conducted with longer-term follow-up and robust methodology to explore sustained benefits, which may better inform treatment decisions. Trial Registration:This systematic review is registered in Prospero (CRD42024516016).

BACKGROUND AND OBJECTIVE:Autism is highly heterogeneous and reliance on behavioural assessments alone may not provide sufficient insight into the unique characteristics of autistic individuals. Biomarkers, like hair cortisol concentration (HCC), may help unravel mechanisms underlying clinical variation in autism and support diagnostic measures, especially in young children who may not be able to effectively communicate their distress. We examined the relationship between HCC and autistic traits along with commonly co-occurring conditions including sleep disturbances in autistic children compared to non-autistic children. METHODS:We conducted a cross-sectional analysis utilising data from the Australian Autism Biobank comprising clinical and biological samples from Australian children aged 2-17 years. Primary analysis included multivariable linear regression analyses to identify significant associations with HCC after controlling for key sociodemographic covariates, including child's intelligence quotient (IQ). RESULTS:The study included 307 autistic children, 158 non-autistic siblings, and 124 unrelated non-autistic children. The commonly reported co-occurring conditions were global developmental delay (8.5 %), intellectual disability (6.1 %), and otitis media (6.1 %). Higher severity of autistic traits and in particular social affect issues, co-occurring attention-deficit/hyperactivity disorder (ADHD), internalising, and maladaptive behaviours were significantly associated with lower normalised HCC. Higher sleep anxiety and IQ were associated with higher HCC. Regarding sociodemographic factors, older age and higher family income were associated with lower HCC. CONCLUSION:The findings indicate the clinical value of HCC as a viable biomarker to identify subgroups based on co-occurring medical and mental health conditions. Further research to elucidate the link to individual and family/environmental factors as potential sources of stress is needed to offer targeted supports.

Migrant women and children can face significant barriers when accessing child and family health services. Child and family health hubs (hubs) represent a potential solution to simplify pathways between maternity, child, and social care services for migrant populations. However, how these hubs operate specifically for migrants remains underexplored. Our study addresses this gap by exploring what helps and hinders the establishment and delivery of hubs across three different contexts in New South Wales, Australia for migrant populations using a case study approach. While all sites found the hub model appropriate and acceptable, its feasibility varied. Challenges included limited resources, particularly the absence of a dedicated hub coordinator, governance issues, and personnel turnover. Success depended on clear leadership, dedicated coordination, systematic referral pathways, cultural sensitivity, and community engagement. The evidence from this study can be used within other contexts to plan and deliver hubs for migrant and potentially other priority population families with young children.

Families experiencing adversity are disproportionately affected by mental health challenges among both children and caregivers and encounter systemic barriers to accessing, navigating, and benefiting from information, services, and supports. To address these challenges, we developed a digital Child and Family eHub (eHub) through user‑centered design with families experiencing adversity and local service providers. The eHub aimed to improve access and navigation to reliable evidence‑based information and relevant primary health, mental health, and social services. To assess implementation outcomes - acceptability, adoption and appropriateness, of the eHub among caregivers experiencing adversity, and to examine impacts on access to and use of information and services, help‑seeking behavior, and child and caregiver mental health. A mixed‑methods implementation–impact evaluation was conducted with a prospective cohort of caregivers from three Australian communities who accessed the eHub. Caregivers completed surveys at baseline and 6-month follow-up and participated in semi‑structured interviews. eHub analytics captured engagement and satisfaction. Qualitative data were analysed using framework analysis, and quantitative outcomes were examined using logistic and linear regression. Findings were triangulated across data sources. Of 252 caregivers completing the baseline survey, 210 completed the 6 month follow up and 15 participated in interviews. Implementation outcomes indicated high acceptability, adoption, and appropriateness of the eHub. At follow up survey, 80.5% of caregivers reported the information and 71.0% reported the services were useful in meeting their child’s needs; among those reporting usefulness, 81.0% were satisfied with the eHub. Qualitatively, caregivers expressed confidence in the evidence based information. Impact outcomes between baseline and 6 months included reduced use of primary health services and increased use of psychosocial services. The proportion of children receiving services for emotional or behavioural problems declined (32.5% to 26.7%), while the proportion of caregivers reporting that children’s needs were met increased (42.7% to 51.8%). Caregivers reported fewer help seeking barriers, no significant change in psychological distress, and reduced risk of mental health symptoms among children aged 0–2 years (57.1% to 38.9%; OR = 0.48, 95% CI: 0.27–0.84). The eHub was acceptable and appropriate for caregivers experiencing adversity and was associated with meaningful shifts in help seeking, with reduced reliance on primary health care and increased use of psychosocial supports. Caregivers reported better alignment between services received and their child’s needs, alongside reduced service use for emotional and behavioural concerns. Early findings suggest reduced mental health risk among infants and toddlers; however, results should be interpreted cautiously given the modest sample size and follow up duration. ISRCTN Registry ISRCTN49839991 RR2-10.2196/72548

This study investigated whether cognitive, behavioural, and communication differences are associated with emotional dysregulation among preschool-aged autistic children in Australia. Secondary data analysis was undertaken in a sample of autistic preschool children as part of the Autism Subtyping Project, receiving early intensive intervention in six Autism Specific Early Learning and Care Centres (ASELCCs) across the six states in Australia. Multilevel multivariable logistic regression analyses were used to determine associations between sociodemographic factors, autistic traits (adjusted for sociodemographic covariates), and their dysregulation profile. Further, multivariable linear regression analyses were conducted to determine whether dysregulation profile was a significant predictor of changes in autistic traits following intervention. Among the sample of 415 children, 43

BACKGROUND:Clinical and demographic factors influencing prescribed sleep medication use in children and young people (CYP) have been studied inadequately. We aimed to examine the prevalence of prescribed sleep medication use among CYP experiencing mental health crises and its associations with clinical and demographic factors. MATERIALS AND METHODS:Electronic medical records of CYP (n = 201) attending the Macarthur Safeguards Acute Mental Health Crisis Service (referred to as the Safeguards Service) in Sydney, Australia, were reviewed. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. Multivariate logistic regression was used to estimate the Adjusted Odds Ratio (AOR) with 95% confidence intervals, examining the associations between prescribed sleep medication use and clinical and demographic factors. RESULTS:The prevalence of prescribed sleep medication use (e.g., melatonin, benzodiazepines) among CYP was 20.9%. Multivariate regression analysis indicated that CYP's length of stay with the Safeguards Service was positively associated with increased prescribed sleep medication use (AOR = 3.61, 95% CI: 1.19-10.94, p = 0.023). CYP who were diagnosed with trauma-related psychiatric conditions tended to use more prescribed sleep medication use (AOR = 2.81, 95% CI: 1.09-7.19, p < 0.032). Moreover, multiple medication prescriptions (polypharmacy) were strongly associated with increased prescription of SM (AOR = 11.36, 95% CI: 4.46-28.95, p < 0.000). CONCLUSION:Prescribed sleep medication use is significant in CYP experiencing mental health crises. This requires careful consideration due to potential risks, drug interactions, and limited evidence of long-term benefits. There needs to be a focus on addressing the underlying causes of sleep difficulties and exploring adjunct non-pharmacological interventions, especially for those with trauma-related psychiatric conditions, those who tend to have a longer length of stay and are prescribed multiple medications, including for sleep.

BACKGROUND:Over the last two decades, integrated mental health services for youth aged 12-25 have expanded globally to enable young people to access comprehensive age-appropriate care. This study examined the barriers and facilitators of integrated care from the perspective of health practitioners and service providers. METHOD:In total, 45 service managers and practitioners who work with young people aged 12-25 years participated in interviews investigating the barriers and enablers of integrated youth mental health care. Themes were identified through inductive analysis and organised by overarching themes. RESULTS:Five overarching themes were identified: (i) continuity of care, referring to challenges associated with service fragmentation, navigation, and timely access to care; (ii) workforce, referring to challenges impacting staff ability to provide integrated care; (iii) information exchange, referring to areas to improve communication of patient information; (iv) financing, referring to supporting integrated care through core funding; and (v) leadership, referring to system- and service-level priorities impacting service delivery. CONCLUSION:Improving integrated youth mental health care entails a multi-level health system transformation. Strategies to achieve this are discussed in the context of the current results and emerging youth-specific frameworks for strengthening service integration and integrated care.