Tsang Vivian W L, Lin Michelle C Q, Huang Natalie, Tsoi Sally, Hu Jack, Sinclair Sonja, Watson Priya, Baer Susan, Sassi Roberto
Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Chemical Biology, University of British Columbia, Vancouver, British Columbia, Canada.
PLoS One. 2025 Jun 23;20(6):e0323199. doi: 10.1371/journal.pone.0323199. eCollection 2025.
There is a lack of mental health and substance use providers for youth in BC, particularly in rural and remote areas. To address these gaps, Canada's first child psychiatry access program, BC Children's Hospital Compass Program, was developed in 2018 to support providers across the province in providing evidence-based mental health and substance use care to youth under 25. This article describes the program's first five years and provides an overview of its creation, utilization, and clinical uses.
Quantitative data collected by the Compass Program from September 2018 through September 2023 were analyzed. Participation and utilization of the service by providers in the province were analyzed and descriptive statistics, including means with standard deviations for quantitative variables have been used to describe demographic and other medical factors related to participants.
A total of 2336 new providers have been enrolled since Compass' inception. Number of clinical calls into Compass remained steady over the five-year period with an average of 1085 individual providers served per year. Service use is highest in Vancouver Coastal Region (27.3%), followed by Northern Health (21.4%), Interior (15.7%), Vancouver Island (14.5%), and Fraser (13.4%), and Yukon (0.3%). General practitioners make up over a third of all encounters (34.6%), followed closely by pediatrician encounters making up 27.5% of total encounters from 2018-2023. These two provider types comprise over 60% of all encounters over the 5-year timespan. Encounters with other provider types were less common, with the third most common encounter being Child and Youth Mental Health (CYMH) clinicians, totalling 8.6% of total encounters. 37.6% of encounters were for male patients and 42.9% for female patients with 6.8% reporting "Other" genders and 12.7% declining to answer. Medication concerns are the most common reason for accessing Compass, regardless of gender. Therapy questions, resource coordination issues, and diagnostic clarification followed in frequency, comprising a similar amount of consults. Compass consultations have the potential to benefit three groups of people: the specific patient being consulted on, the provider requesting the consultation, as well as the provider's colleagues who might benefit from peer consultation.
Capacity building is important given Compass receives calls from rural and remote areas where there are no psychiatrists or child psychiatrists where general practitioners and clinicians regularly work with patients along the entire spectrum of mental health and substance use disorders.
不列颠哥伦比亚省（BC）缺乏为青少年提供心理健康和物质使用方面服务的专业人员，尤其是在农村和偏远地区。为了填补这些空白，2018年设立了加拿大首个儿童精神病学接入项目——BC儿童医院指南针项目，以支持全省的专业人员为25岁以下青少年提供循证心理健康和物质使用护理。本文介绍了该项目的头五年情况，并概述了其创建、利用及临床应用。
对指南针项目在2018年9月至2023年9月期间收集的定量数据进行分析。分析了该省专业人员对该服务的参与和利用情况，并使用描述性统计方法，包括定量变量的均值及标准差，来描述与参与者相关的人口统计学和其他医学因素。
自指南针项目启动以来，共有2336名新专业人员登记注册。在这五年期间，拨打指南针项目的临床电话数量保持稳定，平均每年为1085名个体专业人员提供服务。服务使用率在温哥华沿海地区最高（27.3%），其次是北部健康区（21.4%）、内陆地区（15.7%）、温哥华岛（14.5%）、弗雷泽地区（13.4%）和育空地区（0.3%）。全科医生占所有会诊的三分之一以上（34.6%），紧随其后的是儿科医生会诊，占2018 - 2023年总会诊的27.5%。在这五年期间，这两种专业人员类型占所有会诊的60%以上。与其他专业人员类型的会诊较少见，第三常见的会诊是儿童和青少年心理健康（CYMH）临床医生，占总会诊的8.6%。37.6%的会诊是针对男性患者，42.9%是针对女性患者，6.8%报告为“其他”性别，12.7%拒绝回答。无论性别如何，用药问题都是接入指南针项目最常见的原因。治疗问题、资源协调问题和诊断澄清的频率次之，占咨询量的比例相近。指南针项目的咨询有可能使三类人受益：接受咨询的特定患者、请求咨询的专业人员以及可能从同行咨询中受益的该专业人员的同事。
鉴于指南针项目接到来自农村和偏远地区的电话，这些地区没有精神科医生或儿童精神科医生，而全科医生和临床医生经常与患有各种心理健康和物质使用障碍的患者打交道，能力建设很重要。
