This is a quasi-experimental, multi-site cluster controlled clinical trial design with two intervention arms--Treatment As Usual (TAU) and an Integrated Care Pathway (ICP). Eligible participants are between the ages of 13 and 18, who present to community mental health agencies with depressive symptoms as the primary concern. The primary clinical outcome of interest is the difference between treatment groups in the rate of change of depressive symptoms from baseline to 24-week endpoint as measured by the Mood and Feelings Questionnaire. The secondary outcomes include rate of change of functional improvement, as measured by the Childhood Anxiety and Depression Life Interference Scale, and caregiver-rated internalizing symptoms as rated by the Childhood Behaviour Checklist. This study will also be examining implementation outcomes such as feasibility, fidelity cost and acceptability.
Youth is aged 13 to 18 years, inclusive.
Youth and/or their caregiver is expressing that 'depression" (or some synonym) is a concern.
Clinician agrees that depressive symptoms are a treatment target.
Mood and Feelings Questionnaire score is ≥22 at two sequential visits (screening and baseline assessment).
Known or highly suspected presentations of psychotic symptoms that are persistent, affect functioning, and have observable effects on behaviour.
Severe substance use disorder, bipolar disorder, autism spectrum disorder or intellectual disability, severe eating disorder, imminent risk of suicide requiring hospitalization as per judgment of the assessing clinician.
Inability to provide informed consent to the study for any reason
Youth currently in Day Treatment
Centre for Addiction and Mental Health
Lead sponsor
Canadian Institutes of Health Research (CIHR)
Collaborator
The Hospital for Sick Children
Collaborator