Youth-developed Recommendations on Public Health Planning for Future Pandemics or Public Health Emergencies: A National Delphi Study (preprint)

Background. In Canada, multiple studies reported an increase in youth-reported anxiety, depression, and substance use over the course of the COVID-19 pandemic. As the country has decreased restrictions, it is important to consider public health planning for future pandemics and emergencies, in light of the associated youth mental health and substance use burden. To prevent youth from falling further behind, we need to focus on public health planning recommendations to optimize Canada’s future response. The objective of the study was to generate concrete, youth-derived recommendations for government, policymakers, and service planners to support public health planning for the next pandemic or public health emergency. Methods. Using a virtual, modified Delphi, Youth Delphi Expert Panel Members rated recommendation items over three rounds, with the option to create their own recommendations items. “Consensus” was defined a priori if ≥ 70% of the entire group, or subgroups of youth (e.g., age, race/ethnicity, gender and sexual identities), rated items at a 6 or 7 (on a 7-point Likert scale). Items that did not achieve consensus were dropped in subsequent rounds. Content analysis was used for qualitative responses in Rounds 1 and 2. Youth were engaged as members of an expert advisory committee throughout the design, implementation, and interpretation of findings. Results. A total of n=40 youth participated in Round 1 with good retention (>95%) in subsequent rounds. Youth endorsed eleven recommendations to support public health planning for the next pandemic or public health emergency. Youth prioritized easily accessible, clear, and understandable information about pandemics; and equitably and efficiently distributed vaccines. They also prioritized increased awareness of timely and accessible mental health and substance use services in schools, workplaces and communities; greater investment in free or inexpensive MHSU services; and health professionals and scientists leading pandemic-related policy decisions. Conclusions. For Canada to move forward in a relevant, efficient, and ethically sound manner, decisions must be guided by the population that these decisions affect. These recommendations can be used to guide Canada’s strategies and policies to prepare for future public health emergencies and pandemics, prioritizing the needs of youth, families/caregivers, and communities.

Going Virtual: Youth Attitudes Toward and Experiences of Virtual Mental Health and Substance use Services During the COVID-19 Pandemic (preprint)

Background. During the COVID-19 pandemic, youth mental health and substance use services rapidly moved to virtual modalities to meet social distancing requirements. It is important to understand youth attitudes toward and experience of virtual services. Objective. This study examined the attitudes toward and experiences for virtual mental health and substance use services among youth drawn from clinical and non-clinical samples.Method. 409 youth completed a survey including questions about their attitudes toward and experience of virtual services. The survey included quantitative and open-ended questions on virtual care, as well as a mental health and substance use screener. Results. The majority of youth with mental health or substance use challenges would be willing to consider individual virtual services, but fewer would consider group virtual services. However, many have not received virtual services. Youth are interested in accessing a wide variety of virtual services and other supportive wellness services. Advantages and disadvantages of virtual services are discussed, including accessibility benefits and technological barriers.  Discussion. As youth mental health and substance use services have rapidly gone virtual during the COVID-19 pandemic, it is essential that we hear the perspectives of youth to promote service utilization among those in need. Diverse, accessible, technologically stable virtual services are required to meet the needs of different youth, possibly with in-person options for some youth. Future research, engaging youth in the research process, is needed to evaluate the efficacy of virtual services to plan for sustainability of some virtual service gains beyond the pandemic period.