Researcher Background
Dr. Iyer, the supervisor for this project, is a clinical psychologist and the Canada Research Chair in Youth, Mental Health, and Learning Health Systems. She has done extensive research and clinical work in youth mental health, often championing a participatory approach to involve youth as partners in the research process. She runs a large research program with many collaborators, staff, students and youth research partners, called the Youth Mental Health Collective. Through this, she has made many connections with diverse youth from collaborations on provincial, federal, and international youth mental health projects like Aire Ouverte, ACCESS Open Minds and an Indigenous integrated youth services network, that deeply involve diverse youth stakeholder groups (as partners with lived experience co-designing services). These are youth who are leaders, advocates, research partners or co-designers, and not youth who have received care from Dr. Iyer or participated as research subjects in her previous research projects.
John is student of Dr. Iyer at the Master's level in McGill University's Department of Psychiatry. He graduated from McGill in 2024 with a Bachelor of Science Honours Psychology degree. His previous research projects investigated experiences of hope in first-episode psychosis treatment and service user satisfaction with a national network of integrated youth services. Currently, his research focuses on queer and trans youth mental health and this research project will be part of his Master's thesis.
Purpose of this Research Project
Research on 2SLGBTQIA+ youth mental health has mainly focused on the challenges this group faces, such as high rates of mental health problems (Kingsbury & Findlay, 2024), inadequate mental health care services (Ferlatte et al., 2019), and stressful experiences like bullying, coming out, stigma and rejection (Hatzenbuehler & Pachankis, 2016). While this work has informed and guided improvements for 2SLGBTQIA+ youth, an overemphasis on problems creates a sense of pessimism, obscuring what is already working well, and devaluing health care workers (Akoo et al., 2024). In other healthcare contexts, scholars have addressed similar research imbalances by examining care experiences that exceed expectations, so-called brilliant care. This scholarship is useful for understanding ways that services and providers can foster engagement, especially for those who have received substandard care, and it recognizes the effort and impact of care workers who manage to deliver such services despite imperfect and constraining systems (Dadich & Hanckel, 2024). Informed by previous brilliant care research and aligned in its philosophy, this ongoing qualitative study asks, “What makes mental health care brilliant or exceptional for 2SLGBTQIA+ youth?” Across Canada, we have asked 2SLGBTQIA+ youth to nominate a mental health care provider for an exceptional care award and explain how the provider went above and beyond. Once nominated, providers are congratulated for having been nominated by a young person for exceptional care impact on a young person and invited to a semi-structured in-depth interview that will explore their experiences, approaches, and motivations working with youth. Youth nominations and provider interview transcripts will be analyzed following Braun and Clarke (2006) reflexive thematic analysis. The findings will be published in scientific journals and shared as infographics and video capsules among interest holders, notably service providers, managers, and youth advocates. This study has the potential to bring to light aspects of care that young 2SLGBTQIA+ most appreciate, and its positive framing might foster optimistic reflection for youth and providers alike.
How this Research Will Help 2SLGBTQ+ People and Communities
While studying what is unacceptable, substandard, and harmful experiences in care has improved services for 2SLGBTQIA+ people, there very little research on what makes accessing mental health care a very positive experience. We hope that this study will contribute to improving mental health care and services for 2SLGBTQIA+ youth by uncovering and disseminating what they recognize as exceptional care. The findings of the study will be shared with mental health service providers and other youth-facing helping roles. Additionally, the study's findings will likely have implications for policy makers whose decisions carry downstream effects on the mental health care system.
Additionally, participants might feel rewarded for contributing to advancing the quality of mental health care for other youth by supporting a study that seeks to characterize brilliant or exceptionally positive experiences of care.
Eligibility & Participation
Participants must be:
A young person between the ages of 18-29
In Canada, and
wants to nominate a mental health care provider they've seen in the last two years
Compensation
Youth will not be compensated to ensure that participants’ nominations are authentic and based on their actual experiences of brilliant care, and not motivated by the compensation. Further, the nomination form is very brief, approximately 10 minutes, and does not impose an undue burden or inconvenience.
Participant Support & Mitigation Measures
There are no serious risks associated with this project. Participants’ data will be stored and managed securely. However, despite their low likelihood, events like data drive breaches and email interceptions remain possible. While we are specifically asking about positive experiences, asking youth to think about their experiences in care might remind them of a negative experience related to their care. Preventatively, the form will provide links to online mental health resources for youth to access. Given the small sample sizes, there is also a risk of both youth and service provider participants identification when reporting results. As such, sample descriptions will remain general. To protect the identity of service providers, they will choose a pseudonym, and identifiable information like the names of people, places, and organizations will be removed before analysis. Lastly, to avoid service providers guessing who nominated them, they will not be given any information about the service user who nominated them. However, youth are welcome to inform their service provider about their nomination if they want to make their appreciation known.
How to Participate / Recruitment
We will recruit youth widely through our personal and professional networks to obtain approximately 80 service provider nominations. Additionally, we will begin recruiting youth from specific clinical settings after receiving ethics and/or appropriate institutional or community approvals from those settings. In these cases, participants will be recruited via social media, flyers posted in waiting rooms, and targeted recruitment. Dr. Iyer, the supervisor for this project, has done extensive work in youth mental health, often championing a participatory approach to involve youth as partners in the research process. She runs a large research program with many collaborators, staff, students and youth research partners, called the Youth Mental Health Collective. Through this, she has made many connections with diverse youth from collaborations on provincial, federal, and international youth mental health projects like Aire Ouverte, ACCESS Open Minds and an Indigenous integrated youth services network, that deeply involve diverse youth stakeholder groups (as partners with lived experience co-designing services). These are youth who are leaders, advocates, research partners or co-designers, and not youth who have received care from Dr. Iyer or participated as research subjects in her previous research projects. Dr. Iyer will introduce the student researcher (or another research staff member who will support this project) to youth she thinks will be interested in participating and/or sharing the survey. These key contacts will be invited to participate themselves or to share study information with other eligible youth who may be interested in participating in the study. We will also recruit youth through the student researcher and the PI’s team’s networks and social media (e.g. LinkedIn, twitter), that include youth 18-29 or connections to youth groups, as well as by including this poster on our team Youth Mental Health Collective’s website. The study will be shared among members of professional and student organizations such as the Canadian Psychological Association or McGill department newsletters to students. We will also introduce the project to community organizations to help with targeted recruitment, for example the Montreal LGBTQ+ Community Centre or Projet Nuance. The study poster will be displayed on community boards in public spaces that youth frequent such as libraries, student lounges, and grocery stores. In these instances, we will seek inputs from community organizations to ensure we are following their recommended procedures or getting appropriate approvals. Finally, we will contact the youth who participated in previous research projects with Dr. Iyer’s lab who had indicated in their consent form that they would accept being contacted for future studies.
Interested youth will be contacted explaining the study and a link or QR code to an online registration page will be shared with them if they are interested in participating. The participant inputs their name and email to register for the study. After submitting, they will immediately receive an automatic email containing a unique link (using a randomly generated 15-character participant ID code). Occasionally, automatic emails from LimeSurvey are not delivered to the receiving mailbox and returned to the sender. In these cases, a member of the research team will send the registration email to participants separately. A pdf copy of the information and consent form will also be attached to the email for the young person’s reference and records. After accessing the link, the youth will be presented with the information and consent form, as well as check boxes showing they understand what is involved in participating and asked whether they agree to participate or not. They will have opportunities to ask questions throughout the recruitment process. After they have consented, youth will be prompted to nominate a service provider whom they feel provided exceptional or outstanding care to them and to briefly answer a few demographic questions. At the end of the form, youth will receive a confirmation email thanking them for participating in the study and inviting them to share the study poster with anyone they think is eligible (in the targeted age range, has received mental health services) and may be interested in participating. If a young person has registered to participate but not yet completed the consent or questionnaire, they will be sent up to three reminder emails.
For the recruitment of service providers who have provided exceptional or outstanding mental healthcare, we will rely on the nominations made by youth. Once service providers are nominated, our team will contact them by phone or email via information provided by youth or found online to give them their certificate for exceptional youth mental health care (see attachment) and introduce the project. If they are interested in participating in the study, they will be invited to click a link (that will take them to the consent form) and asked to review it and provide consent if in agreement. Like the youth participants, service providers will have opportunities to ask questions by contacting us. The same email will also include a doodle poll with various date and time options for scheduling an interview. Service providers will be able to select an option from the doodle poll and/or email the team indicating the date and time they would like to schedule the interview (or to let us know if none of the date and time options work). Service providers will thus receive recognition for having been nominated by youth, regardless of whether they consent to the study.
At the end of the scheduled interview, the team member who conducted the interview will request the service provider to fill out a short online form asking about their demographic and clinical characteristics (Appendix 3). If excess nominations are received, participants will be selected based on the identity of the youth who nominate them to ensure diverse perspectives are represented in the findings (e.g., ensuring that we have nominations from as many diverse youth as possible).