The Needs of Most or Most in Need: How Integrated and Transdiagnostic Youth Services Assess and Address Mental Health Needs

OBJECTIVE: This review aimed to explore how integrated and transdiagnostic youth service models assess varied mental health needs and operationalize them to provide appropriate care. Furthermore, given the wide treatment gap for youths with severe needs, it highlights how models identify these youths and direct them to appropriate care. METHODS: This scoping review includes peer-reviewed and gray literature available in English. PsycInfo, MEDLINE, Embase, and CINAHL databases were searched for academic literature (January 2005-June 2023). Gray literature was acquired through outreach to service representatives. Eligible studies described an integrated and transdiagnostic youth mental health service model and included content related to the research objectives. RESULTS: This review included 121 pieces of literature describing 49 service models. Findings indicated substantial variability in the services provided and methods used to assess needs, as well as offerings and processes that were frequently insufficient for supporting youths with severe needs. Most models used two intake assessment tools, and approximately one-quarter had no service option for youths with severe needs. Multiple models did not explicitly describe how identified needs were operationalized into care decisions, with some incorporating exclusions for severe case presentations. CONCLUSIONS: Little evidence has been found for how integrated and transdiagnostic youth mental health service models should be operationalized, and their implementation varies considerably-potentially leaving young people without care or with needs that go unnoticed. Prioritizing research to enhance the operations of these initiatives is critical to ensure that they consistently meet the full breadth of needs experienced by youth populations.