LAUSR

Having been part of the ACCESS Open Minds (ACCESS OM) project since before its inception, we take pleasure in reflecting on the conception and implementation of the project in its diverse contextual realities. In 2013, partnering with the Graham Boeckh Foundation, the Canadian Institutes of Health Research, launched a call for grant applications under their new Strategy for Patient-Oriented Research. The 18-month application process brought together various stakeholders from across Canada—youth, families, community organisations, clinicians, researchers, and decision-/policy-makers—around the common recognition that extant systems were not meeting the mental health needs of youth. The resultant ACCESS OM network faced a task that represented both an immense opportunity and a substantial challenge. We were to create a model for youth mental health services transformation that had to be evidence-informed yet anchored in all pertinent stakeholders' perspectives. Our model's core strategies had to have inbuilt flexibility to leverage the strengths and accommodate the realities of diverse sites. Some of the flexibility was necessitated by the nature of Canada's public healthcare system, which is federally mandated but provincially administered (with varying combinations of federal, provincial, and local governance in Indigenous jurisdictions). This has proven to be a strength that makes our model likelier to enjoy local buy-in and ownership and broad applicability in and beyond Canada. ACCESS OM is being implemented in 14 diverse settings across Canada (Malla et al., 2018). The articles in this supplement describe how the project's core service objectives are being addressed at seven sites that represent distinct contexts. The transformation of youth mental healthcare on such a large scale has been coordinated by a central office in Montreal through common structures and processes that standardise, support, and accelerate implementation.