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Understanding their heterogeneous needs is essential for designing integrated care models. This study examined characteristics, help-seeking reasons, and service use among youth accessing ACCESS Open Minds (ACCESS-OM)-\n                      <jats:italic toggle=\"yes\">R\u00e9seau d\u2019intervention de proximit\u00e9 aupr\u00e8s des jeunes de la rue<\/jats:italic>\n                      (RIPAJ), a Montr\u00e9al-based network serving homeless and at-risk youth.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed sociodemographic and clinical data, presenting concerns, and services received by youth referred to ACCESS-OM-RIPAJ (2016-2020). Latent class analysis (LCA) identified clusters based on (1) presenting concerns and (2) service use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 681 referrals were made to ACCESS-OM-RIPAJ. LCA identified 4 distinct help-seeking clusters: (1) a group characterized by severe material deprivation, including homelessness and unmet basic needs, alongside notable social isolation and higher prevalence of psychotic symptoms, who were more often referred to specialized psychiatric services; (2) a group defined by substance misuse with homelessness and financial instability, with fewer co-occurring concerns, requiring coordination across services; (3) a cluster marked by trauma-related experiences, family difficulties, and suicidality, with less clearly defined service use patterns; and (4) a group characterized by emotional distress, occurring alongside financial precarity and risk of homelessness, who were primarily offered psychological interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings highlight the heterogeneity of needs among homeless and at-risk youth and the importance of integrated, multi-component mental health programs. Improving access to care across the continuum of needs and presentation severities is essential for preventing adverse outcomes and addressing the cyclical relationship between mental health and homelessness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07067437261468896","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:14:05Z","timestamp":1785762845000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding Heterogeneity and Patterns of Services Utilization of Homeless and at-Risk Youth: Results From the ACCESS-OM-RIPAJ Cohort: Comprendre l\u2019h\u00e9t\u00e9rog\u00e9n\u00e9it\u00e9 et les habitudes d\u2019utilisation des services chez les jeunes en situation d\u2019itin\u00e9rance et \u00e0 risque : R\u00e9sultats de la cohorte ACCESS-OM-RIPAJ"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7014-645X","authenticated-orcid":false,"given":"Giuseppe","family":"D\u2019Andrea","sequence":"first","affiliation":[{"name":"Neuroscience Axis, University of Montr\u00e9al Hospital Research Centre (CRCHUM), Montr\u00e9al, Canada"},{"name":"Douglas Mental Health University Institute"},{"name":"McGill University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2421-4618","authenticated-orcid":false,"given":"Charles","family":"Tessier","sequence":"additional","affiliation":[{"name":"Neuroscience Axis, University of Montr\u00e9al Hospital Research Centre (CRCHUM), Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Aubin","sequence":"additional","affiliation":[{"name":"Douglas Mental Health University Institute"},{"name":"Dans La Rue, Montr\u00e9al, 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University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5367-9086","authenticated-orcid":false,"given":"Srividya N.","family":"Iyer","sequence":"additional","affiliation":[{"name":"Douglas Mental Health University Institute"},{"name":"McGill University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3333-9652","authenticated-orcid":false,"given":"Amal","family":"Abdel-Baki","sequence":"additional","affiliation":[{"name":"Neuroscience Axis, University of Montr\u00e9al Hospital Research Centre (CRCHUM), Montr\u00e9al, Canada"},{"name":"Department of Psychiatry and Addictology, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the ACCESS Open Minds 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