Original Title: Avis: services externes intensifs pour la clientèle jeunesse présentant des troubles liés à l’utilisation de substances psychoactives

Authors' objectives: Currently, specialized youth addiction rehabilitation services in Québec are available in outpatient or inpatient settings. However, despite the fact that outpatient services are offered province-wide through weekly or bi-monthly meetings, they do not always meet the youth’s needs in terms of treatment intensity. Furthermore, due to the limited number of inpatient services, some youths are forced to leave their home environment (family, school, community) for up to six months in order to access them. These constraints have also been highlighted by Québec drug rehabilitation centres (DRC) workers in the assessment report on the Mécanismes d’accès jeunesse en toxicomanie (MAJT, centralized application processing system for youth with substance abuse problems) [Tremblay et al., 2014]. Based on these findings, the Direction des services en dépendance et en itinérance (Homelessness and Addiction Services Division) of the Ministère de la Santé et des Services sociaux (MSSS, Quebec Ministry of Health and Social Services) asked Quebec’s Institut national d’excellence en santé et en services sociaux (INESSS, National Institute of Excellence in Health and Social Services) to lay down principles and guidelines for the deployment of specialized intensive outpatient services for youth with substance use disorders in Québec.

Authors' results and conclusions: RESULTS: The various sources of information led to the development of five overarching guiding principles and 12 clinical guidelines, grouped according to four themes: 1) Youth assessment and referral to intensive outpatient services; 2) Care management for the youth clientele; 3) Treatment intensity; 4) Service delivery modes and preferred interventions in intensive outpatient services. All of these guiding principles and guidelines are to be considered as a whole when carrying out clinical work with youths. The 12 guidelines- #1: assessment of target clientele; #2: referral of target clientele; #3: transitional measures; #4: involving family and other significant persons; #5: comprehensive treatment; #6: taking into account the youth’s physical and mental health and psychosocial development; #7: developing positive interpersonal relationships and interests not focused on substance use; #8: treatment intensity; #9: continuing care; #10: service delivery modes and preferred interventions in intensive outpatient services; #11: service delivery via a combination of coordinated interventions and activities; #12: delivering services through structured family or group programs. CONCLUSIONS: Although there is little data collected on formally identified intensive outpatient services, the triangulation of information sources highlights the relevance of offering youths with substance use disorders an environment that is both structured and flexible. In light of the multidimensional aspect of substance use, consideration of the overall needs of young people must be encouraged. Collaborative and partnership relationships at the sectoral and intersectoral levels also need to be established with the goal to provide comprehensive treatment and addressing the long-term needs of the youth. Implementing procedures for collaboration between the youth workers and the services offered fosters the young people’s engagement, mobilization and, ultimately, their rehabilitation.

Authors' methods: Three assessment questions guided the drafting of this report. The first question sought to determine which programs or combinations of treatments and activities could promote rehabilitation for youth with substance use disorders. The second question focuses on the terms (duration, format, frequency, intervention setting, place in the continuum, etc.) and essential components (with respect to assessment, family involvement, continuity of services, etc.) specific to intensive outpatient rehabilitation services for youths with substance use disorders. Finally, the last question entailed documenting the perceptions and insights of young people and their relatives regarding intensive outpatient services. Three main information sources were used to address these questions: 1) the scientific and grey literature; 2) the stakeholders by means of focus groups with youth workers and managers; 3) the advisory committee, made up of managers, clinicians, youth workers and a researcher.

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/services-externes-intensifs-pour-la-clientele-jeunesse-presentant-des-troubles-lies-a-lutilisation-de-substances-psychoactives.html

Year Published: 2019

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/services-externes-intensifs-pour-la-clientele-jeunesse-presentant-des-troubles-lies-a-lutilisation-de-substances-psychoactives.html

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: Gouvernement du Québec