Poster

"Objectives: Different studies have concluded that cannabis use disorders (CUD) influenced negatively outcomes in first-episode psychosis (FEP). However, it is rarely mentioned if those cannabis users were also misusing other substances.. Our study examined the specific impact of different SUDs (alcohol, cannabis, psychostimulants) on symptoms, social functioning and service utilization of youth with FEP. Methods: a prospective longitudinal of 2 years follow-up of 176 FEP between 18 to 30 years old, admitted to early psychosis programs in Montreal. Results: Half of CUD present polysubstance use disorder. All substances (drugs and alcohol) are associated with lower functioning (GAF) but drugs have a greater negative impact on most measures at 2-year. Psychostimulants and poly-SUD are associated with bad symptomatic and functional outcome early in the course of illness (from the 1st year of treatment), persisting over time and higher service utilization (hospitalization). Persistent CUD is the only group that deteriorates from Year 1 to Year 2 (symptoms and functioning). However, psychostimulants abusers have a bad outcome from the first year. Conclusions: The negative impact that has been attributed to CUD in previous studies could partly be attributed to methodological flaws (including polysubstance abusers in the cannabis users group). However, our study confirms CUD negative impact on outcome in youth with FEP. Attention should be given to cannabis misusers since their condition seems to worsen over time and to psychostimulant misusers since they have poorer outcome early during follow-up and a high utilization of hospitalization and emergency services."

Adolescence is a critical developmental stage associated with neurodevelopmental changes, a move towards greater independence and a range of important life choices in education, relationships, career, housing and finances. These potential stressors can contribute to the development of mental health difficulties, and attendant negative social and economic consequences. During the transition into adulthood, young people can find it difficult to navigate the move from CAMH (child and adolescent mental health) services which have previously engaged and supported them, to an unfamiliar territory of adult services. In the course of this, some young people are not able to ‘mind the gap’ and fall out of services. There are good services in Camden for young people aged 16-24, but they are fragmented, not primarily centered on young people and tend not to reach out to difficult to engage young people. Minding the Gap was commissioned in the autumn of 2014 with and aimed to improve the outcomes for this group. Its objectives are: to improve the integration of mental health, physical health, youth support and social care services; to deliver client-friendly services; to improve early intervention and prevention; to decrease the number of clients who disengage, and to create a more straightforward access referral pathway. The two-fold approach involves firstly the age alignment of services within Camden, driven largely by a team of ‘Transition Champions’ and secondly, the development of an integrated community youth base in the heart of Camden to bring together mental health, substance misuse, sexual health, advice on employment, training and housing and other support services under one roof. Young people have been consulted and involved at every stage of design and implementation. In this poster, we describe the implementation and outcomes of the project thus far in more detail.

Objectives: Prevalence of substance use disorders (SUD) in First-Episode Psychosis (FEP) is high and usually associated with poor clinical outcome. Our study examined the impact of the course of SUD on outcome in a sample of youth with FEP. Methods: A prospective longitudinal study of 2 years follow-up of 212 FEP, between 18 to 30 years old, admitted to an early psychosis program in Montreal. Results: Cannabis is the first substance abused (42.9% at baseline), followed by alcohol (19.3%). The SUD rate decreases over time by approximately 30%, especially cannabis. Subjects with persistent SUD at 1 and 2 years follow-up have more symptoms and have a worse functional outcome. The Outcomes of those with remitted SUD is somewhat similar to those who never had a SUD. Patients with an active SUD during follow-up were heavier users of emergency and hospitalization services compared those who had never had a SUD or who stopped. Persistence of SUD was associated with more severe dependence, homelessness and cluster B personality traits or disorders, Those who stopped misuse were rather living with family and supported financially by them. Conclusions: A specific intervention for co-morbidity during the first years, targeting those with predictors of persistence, could increase the proportion of youth with FEP who stop substance abuse/dependency and possibly improve their outcome.

Youth engagement in the design and delivery of mental health services and resources is a key means of ensuring services and resources are relevant to youth, decreasing stigma, and promoting mental health literacy and well-being. BC Mental Health and Substance Use Services’ (BCMHSUS) Health Literacy team works with and engages youth in meaningful, unique, and empowering ways. Youth are involved in all aspects of our programming, including service delivery, projects, events, and resource development.BCMHSUS’ Kelty Mental Health Resource Centre is a provincial centre providing mental health and substance use resources and information to children, youth, and families from across BC. Within the Centre, and through a partnership with The FORCE Society for Kids’ Mental Health, youth who have lived experience with mental health challenges (“Youth in Residence”) provide peer support, information, and resources related to mental health to other youth throughout BC. Not only does this provide an empowering, meaningful opportunity for the Youth in Residence, but youth-to-youth peer support has been found to help decrease mental health stigma and contribute in an important way to mental health, well-being, and recovery. The Youth in Residence have also taken a leadership role in the Kelty Centre’s Youth Ambassador Program, an innovative program designed to provide youth across BC with opportunities to promote mental health and well-being in their schools and communities. Kelty Youth Ambassadors have been involved in designing BCMHSUS resources for youth, developing anti-stigma videos, writing blog posts shared through the Kelty Centre, speaking to other youth at Kelty Centre events, and also developing their own mental health promotion projects in their own communities with the support of the Kelty Centre and the Youth in Residence. Youth are also engaged in the planning, design, and delivery of BCMHSUS events and resources for youth. This includes the Balancing our Minds Youth Summit, an annual event for high school youth to learn about mental health and engage in fun activities and thoughtful dialogue. Over 1,400 youth were in attendance at the most recent event in February 2015.