Virtual, In-Person and Hybrid Utilization Patterns of Youth Accessing Integrated Youth Services: A Retrospective Cohort Study of Youth Ages 12–24

PURPOSE: Youth mental health and substance use issues are rising worldwide, along with barriers to timely, culturally, and developmentally appropriate care. Integrated Youth Services (IYS) offer early intervention through in-person, virtual, and hybrid options. The objectives of this study were to: (1) compare the demographic and clinical characteristics of youth accessing three types of service modalities (virtual, in-person, and hybrid), and (2) understand the service utilization patterns (number and frequency of visits, repeated visits rate, new registrations) among an IYS youth cohort. METHODS: We reviewed records of 41,034 youth aged 12-24 years who accessed an IYS initiative in British Columbia, Canada, from April 2020 to November 2023. Data included demographic and health surveys completed by youth when they registered for services and service records after session completion. Descriptive and inferential statistical analysis methods were used for analysis. RESULTS: Youth accessed IYS through virtual, in-person, and hybrid services. Younger youth (12-14 years) preferred in-person care, while older youth (21-24 years) mostly used virtual services. Virtual users reported higher distress and poorer overall health. Despite being introduced during COVID-19, virtual services remained in use throughout the study. Hybrid users had the highest repeat visit rates. Twenty five percent of all youth said that they would have gone nowhere if it were not for the IYS initiative. DISCUSSION: Findings underscore the importance of diverse IYS delivery models. Decision makers should support hybrid models, maintain strong in-person care, and expand virtual services to improve accessibility and outcomes for youth.