Short title of the paper … Introduction: Peer support has increasingly been integrated into youth mental health programs globally. Peer support workers are an important ally in an individual’s recovery journey, providing both emotional and instrumental support and advocacy through their lived experiences. Objectives: To conduct a scoping review examining peer support services for youth with mental health concerns. Methods: This scoping review was prospectively registered with The Open Science Framework and followed the PRISMA scoping review extension checklist. In consultation with a health services librarian, seven electronic databases (i.e., MEDLINE, PsycINFO, Embase, SocINDEX, ERIC, CINHAL, and Education Research Complete) were searched from inception to May 2023. Two blinded reviewers chose peer-reviewed studies for inclusion in this scoping review if the research examined youth with mental health concerns that were involved in a peer support intervention or program. Results: After duplicate references were removed, 4,001 titles and abstracts were screened. In total, 70 studies met the inclusion criteria for this scoping review. A total 11147 youth (mean age 19.5 years) were identified as receiving peer support. About half the studies examined peer support service or program only (34/70; 49%). In others, peer support was examined alongside elements such as group therapy (29/70; 41%), goal setting (5/70; 7%), and cognitive-behavioural therapy (CBT) (5/70; 7%). Peer support services were identified as being significantly effective in treating mental health concerns in 81% (57/70) of studies. Conclusion: This scoping review demonstrated the ability of peer support services in aiding young people with mental health needs. Offering peer support may help mitigate future mental health problems in adulthood and increase quality of life.

Aim: Aire ouverte, an integrated services initiative for youth aged 12–25, is under development in the province of Quebec, Canada. This study’s aim is to explore youth’s perspective regarding their experience within an Aire ouverte located in a remote and rural region of the province, their understanding of health, and how they engaged in a Photovoice process. Methods: We conducted interviews combined with a Photovoice approach. Participants (n=6) were instructed to document their experience within the Aire ouverte services, their understanding of health and how they engaged in a Photovoice process by taking pictures over a 2-month period and selecting a maximum of five for a final individual interview. Transcripts were analyzed to identify recurring themes using an inductive approach. Results: Youth considered Aire ouverte as an effective means to rapidly access healthcare. They highlighted the welcoming facilities and staff attitudes as a key component of their experience. Youth were satisfied with their experience. For them, health requires maintaining a balance, as it is fragile, requires maintaining balance within psychological, physical, social and environmental aspects of their lives. Finally, youth described the Photovoice process as a fun and creative way to express themselves and share their story. Participants also noted the empowering nature of the Photovoice process and experienced positive emotions. Conclusions: This study highlights that the services provided at Aire ouverte are consistent with the principles of youth-friendliness within integrated care. Further studies should be able to capture holistic views of health and youth’s experience.

Aim: Patient-reported outcome measures (PROMs) provide valuable information and promote shared decision-making but are infrequently used in psychosis. Self-Rated Health (SRH) and Self-Rated Mental Health (SRMH) are single-item PROMs in which respondents rate their health and mental health from ‘poor’ to ‘excellent’. We examined the psychometric properties of the SRH and SRMH in early intervention for psychosis contexts in Chennai, India and Montreal, Canada. Methods: Assessments were completed in Tamil/English in Chennai and French/English in Montreal. Test-retest reliability included data from 59 patients in Chennai and Montreal. Criterion validity was examined against clinician-rated measures of depression, anxiety, positive and negative symptoms, and a quality-of-life PROM for 261 patients in Chennai and Montreal. Results: SRH and SRMH had good to excellent test-retest reliability (ICC>0.63) at both sites and in English and Tamil (but not French). Results for criterion validity were mixed. Whereas in Montreal, low SRH was associated with not being in positive symptom remission, and poorer functioning and quality of life, SRH was associated only with functioning in Chennai. No associations were found for SRMH in Montreal. In Chennai, however, low SRMH was associated with not being in positive symptom remission and poorer functioning. Conclusions: Our work advances knowledge of more feasibly integrating single-item PROMs into clinical settings. Importantly, it highlights how PROMs may perform differently across languages and contexts. More critical work is needed to understand if discrepancies between PROMs and CROMs are indicative of poor validity of PROMs or “valid” differences between patient and clinician perceptions.