A nationwide study led by McGill University researchers reveals that redesigning youth mental health services can significantly reduce wait times and improve access to care—especially in Indigenous, remote, and underserved communities.
The findings, published in JAMA Psychiatry, evaluate the outcomes of the ACCESS Open Minds project, a national initiative launched in 2014 to overhaul how young people interact with mental health care services.
“Our goal was to transform existing clinics, schools, and youth centres into spaces that were more accessible, youth-friendly, and culturally appropriate,” said Dr. Srividya Iyer, lead author of the study, professor in McGill’s Department of Psychiatry, and researcher at the Douglas Research Centre.
Major Impact on Access and Wait Times
Traditionally, accessing mental health services in Canada requires a professional referral—a process often seen as a barrier by young people. The ACCESS Open Minds project removed this obstacle, allowing youth to seek help directly.
The program also introduced ambitious service targets: initial evaluation within three days and commencement of treatment within 30 days. These benchmarks surpass the capacity of most public mental health systems, where wait times often range from 45 days to over a year.
Between 2014 and 2018, nearly 8,000 youth aged 11 to 25 accessed services across 11 study sites. Most were seen within three days. Referrals increased by 10% every six months, highlighting both growing demand and improved access.
“At our downtown Montreal site for homeless youth, demand surged, yet with just two additional staff, we managed to see most individuals within 72 hours,” said Dr. Iyer, who also serves as Canada Research Chair in Youth, Mental Health and Learning Health Systems.
The success was achieved primarily by reconfiguring existing workflows, enhancing staff training, and strengthening coordination between service providers—largely without the need for extensive new resources.
Community-Based, Culturally Sensitive Models
Of the 16 communities served nationwide, five were located in Quebec. In Nunavik, an Indigenous region in northern Quebec, the team collaborated with local youth and Elders to convert a garage into a youth hub—offering a welcoming space where teens could gather and repair hunting gear.
In downtown Montreal, holistic support was delivered through partnerships with shelters, clinics, soup kitchens, and community programs. One innovative collaboration involved Cirque Hors Piste, a local circus organization, which helped provide creative and artistic outlets for vulnerable youth.
“We wanted to treat the whole person, not just their symptoms,” said Iyer. “Programs like the circus give young people a way to express themselves and build trust in the system.”
A National Model for Youth Mental Health Care
The ACCESS Open Minds model has since inspired mental health policy reforms, including Quebec’s Aire Ouverte network, a province-wide youth mental health initiative. Similar models are now being explored and adopted in other provinces.
Looking ahead, researchers are also turning their attention to broader systemic issues affecting youth mental health.
“From climate anxiety to unaffordable housing, insecure employment, and the impact of AI, we need to consider how these root causes are shaping mental health outcomes,” Iyer said.
The ACCESS Open Minds project was developed and evaluated by McGill University in partnership with universities across Canada, youth and families, community organizations, and policymakers.
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