Measuring goal progress using the goal-based outcome (GBO) measure in Youth Wellness Hubs Ontario – an integrated youth mental health service

Abstract

Problem and Context. There is a growing body of evidence indicating that the prevalence of mental health difficulties, in particular anxiety and depression, is increasing among youth, and many young people in this age group (12-25 years) do not get adequate mental health support. Recently, a global movement to transform youth mental health services is underway with the establishment of integrated youth services (IYS) that offer youth-specific care and emphasize early intervention and prevention, developmentally and culturally- informed services, community engagement, evidence-based and evidence-informed interventions, and youth and family engagement. While outcome data has an important role in enhancing the effectiveness of care for youth mental health, having young people define for themselves the area they feel should be the focus of in an intervention are also common measures used in IYS settings. Goal-setting has been used in therapy for several decades, and agreement on goals between young person and their clinician is thought to be central to successfully building a good therapeutic relationship and improving outcomes.
 Who is it for? Service providers, researchers, clinicians, youth and families.
 Who did you involve and engage with? Participants were young people (>5000) who engaged with a Youth Wellness Hub service between April 2020 and October 2022. The data for this study comprised over 15,000 goals. Youth can set up to one, two or three goals at each visit using the Goal-Based Outcome (GBO) tool. Inductive thematic analysis was employed on the types of goals set by young people.
 What did you do? The aim of this study was to explore the type of service goals set by young people who are engaging with integrated mental health services. The study also looked at whether services facilitated progress in goals as set by young people.
 What results did you get? What impact did you have? The analysis identified a number of goal-related themes related to improving mental health, reducing substance use and other addictions, improving physical health, service navigation, and self-improvement. Data from presentation to last assessment will be reviewed to examine change in progress on goals over time.
 What is the learning for the international audience? Understanding the clinical utility of an idiographic measure like the GBO with young people accessing community-based services is critical because the tool allows for capturing aspects of young people’s lives that are of importance to them that may not be as easily captured on standardized outcome tools. 
 What are the next steps? Future directions include continuous learning and evaluation of the GBO in integrated care settings and examining the association between goal progress and standardize outcomes.