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Article History

Received: 14 June 2024

Accepted: 3 February 2026

First Online: 12 February 2026

Declarations

:

: This study was performed in line with the principles of the Declaration of Helsinki. Approval was obtained from the Research Ethics Boards of the five principal Atlantic Canadian institutions involved in the ACCESS-MH project.

: All participants provided written informed consent or assent (for those youth under the age of 18) prior to beginning their interview session, with legal guardians providing consent when required for youth below the age of majority. The consent process consisted of a detailed explanation of the study’s purpose, of the data collection process, future publication of deidentified results, and the participant’s right to withdraw participation at any time.

: The authors declare no competing interests.

: This manuscript describes original work supported by grants from the University of New Brunswick and the Canadian Institutes of Health Research (Grant No. TT4-128269). Ethical approval was received for the collection of these data by the five principal Atlantic Canada research institutions (i.e., University of Prince Edward Island [REB #6005704], University of New Brunswick [REB #2014-047], Saint Mary’s University [REB #14–222], l’Université de Moncton [REB #1314-077], Memorial University [REB #13.284]). All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. This research involved human participants and informed consent was obtained from all participants. We, the authors, acknowledge that disclosures are complete for ourselves, to the best of our knowledge. DM conceived of the study, participated in its design, analyzed and interpretated the data, and drafted the manuscript; SR participated in the design and coordination of the study, oversaw data collection, and commented on previous versions of the manuscript. Both authors read and approved the final manuscript. Data were organized and analysed using NVivo software which facilitated a stepwise thematic coding approach.