Integrated youth services preferences of justice-involved youth and their caregivers : a discrete choice conjoint experiment

Mental health and/or substance use (MHS) challenges affect approximately 95% of youth in the criminal justice system, with only three in ten justice-involved youth receiving treatment for their MHS needs. Fragmented care is one of the leading barriers to youth accessing MHS services. One suggested solution to this problem is the implementation of integrated youth services (IYS). Tailoring IYS to meet the service preferences of youth and their caregivers may enhance service utilization, potentially leading to better outcomes for youth with MHS challenges. However, it is unknown in what ways justice-involved youth and their caregivers differ from their non-justice-involved counterparts in terms of their IYS service preferences. This dissertation explored this question by conducting a secondary analysis of data gathered from a larger Ontario-wide discrete choice conjoint experiment (DCE). Specifically, N = 476 participants (n = 55 justice-involved youth, n = 188 non-justice-involved youth, n = 42 caregivers of justice-involved youth, and n = 191 caregivers of non-justice-involved) completed thirteen choice tasks representing different combinations of integrated youth services. Study 1 contrasted the IYS component preferences of justice-involved youth and non-justice-involved youth; Study 2 contrasted the IYS component preferences of caregivers of justice-involved youth and caregivers of non-justice-involved youth. Results demonstrated that all groups examined in this dissertation exhibited preferences for a broad range of core health and additional services. All youth and caregiver groups also exhibited a preference for fast access to care in a community setting that specializes in mental health services, with the incorporation of e-health services. Justice-involved youth prioritized working with a trained peer support worker to learn life skills and help them with the services they need over all other service characteristics. Playing a leadership role in making decisions within IYS organizations was also a high preference among justice-involved youth. Among caregivers in both groups, information sharing, and caregiver involvement were a priority. Caregivers of justice-involved youth showed a unique preference for involvement in family counseling with their youth. Data gleaned from these studies provide an understanding of what components of IYS models may help to engage justice-involved youth and their caregivers in MHS treatment.