5.54 Exploring Youth’s Mental Health and Addiction Service Experiences and Preferences Through Participatory Action Research

Youth with vulnerabilities, diverse identities, and backgrounds experience greater barriers to mental health and addiction (MHA) care. During the COVID-19 pandemic, the MHA services that were available, and how they were delivered, changed significantly. These changes helped to bridge service access for some youth, but widened the gap for others, all while raising new service possibilities and preferences. Therefore, our objectives were to update our understanding of youth’s awareness of and access to MHA services before and since the pandemic, and how these varied on dimensions of equity and diversity. We applied a participatory action research (PAR) approach to a qualitative study design. We used social media to recruit and enroll diverse and marginalized youth who were 12 to 25 years old, living in Ontario, and had lived MHA experience. We co-designed a structured focus group guide with 4 youth partners to understand youth’s awareness and access to MHA services, before and since the pandemic, and their suggested improvements. Two coders conducted thematic analysis using NVivo and, with regular team discussions, identified and developed emergent themes. We conducted 5 virtual focus groups with 40 participants during December 2022. Participants had a mean age of 21.2 years (SD 1.88) and were purposively selected to vary in self-reported demographics (15% were gender-diverse; 80% were BIPOC; 28.9% found it difficult to afford their basic needs) and MHA characteristics (77.5% had a current MHA concern; 80.5% were interested in or had sought services). Based on thematic analysis, youth reported that since the pandemic: 1) accessing healthcare provider–based services was their primary means of support; 2) their preferences for how services were delivered (in-person/virtual) shifted; 3) the availability of virtual services increased for those living in rural areas; and 4) the relationship with their provider was a key consideration for service access, which was influenced by providers’ demographics, communication, and training. Youth identified a need to increase their awareness of and access to diverse providers and services, the equity and diversity training providers receive, and the strategies available to support youth in identifying and accessing services and providers with characteristics important to them.