Equity and access to a regional child and youth mental health and addiction navigation service: a secondary analysis study

Abstract

Abstract Background To assess equity of access to a coordinated access service (1Call1Click.ca) in Eastern Ontario that connects infants, children, and youth to mental health, addictions and substance use health (MHASUH) support/services. Focusing on Social Determinants of Health (SDH), we analyze clientele for acuity and compare clientele demographics to service area population using census data. Method Secondary analysis study of all clients (N = 9,694) (birth-21 years) who completed a 1Call1Click.ca intake between June 2021 and December 2023. We compared demographic characteristics (racial background, family income, and gender identity) of clients to regional data from the 2021 Census of Canada. We also examined whether SDH characteristics were associated with MHASUH need severity using standardized assessment tools (CASH Bundle). Results Compared to the regional population, 1Call1Click.ca was accessed at higher rates by service clients who were: (1) cisgender-female, non-binary, and transgender individuals, (2) clients from families with the lowest and highest incomes, and (3) who identified with multiple and “other” racial backgrounds. Underrepresented groups included cisgender-males and moderate-income households ($60,000–89,999 CAD). Filipino, Japanese, Chinese, South Asian, and Indigenous identifying individuals accessed services at lower-than-population rates. Small differences in MHASUH acuity were observed for racial background, gender identity, and family income, though not uniformly across measures. Conclusions Clients from historically disadvantaged groups accessed 1Call1Click.ca at rates largely representative of or exceeding those in the regional population. Differences in acuity were small and inconsistently identified. These findings suggest potential for coordinated access services in increasing equity for children and youth historically disadvantaged by SDH.