A new integrated health and social services care initiative will change the way youth and young adults access mental health and substance use support in BC
by Melissa Edwards; photography by Brian Smith & Mike Savage
Alex Mann-Kuefler considers himself living proof of how an integrated approach to support can change lives for young people in British Columbia. Three years ago, the St. Paul’s Inner City Youth Program (ICY),
first featured in Promise in 2012, helped support Alex in developing a healthy lifestyle after one of the program’s doctors found the former anthropology student living in Vancouver’s Downtown Eastside—undernourished, self-medicating with pot and besieged by hallucinations caused by undiagnosed schizophrenia.
Through ICY, Alex was provided with clean, safe housing, access to better food, and peer support that helped him set career and health goals, along with counselling and clinical mental health care. Alex’s mental illness was diagnosed, and he was given medication that resolved his delusions. He was even able to take on a part-time job. “[With the help of ICY] I was finally free after having suffered the terrible affliction that is psychosis for a year,” says Alex.
Preparing to take the next step
In 2012, a $1.6-million donation from Silver Wheaton helped launch the program that turned things around for Alex. In 2015, financial support from Variety – The Children’s Charity led to the construction of the Granville Youth Health Centre—a youth-friendly storefront with integrated services that intervene early and provide support to young people before crises, such as substance use or undiagnosed mental illness, can do lasting damage.
Now, thanks to the work of a groundbreaking co-operation between two provincial ministries and four health and social service foundations, the lessons learned from this model are about to be put into action on a larger scale with the launch of the BC Integrated Youth Services Initiative (BC-IYSI).
During a proof-of-concept phase, the BC-IYSI will lead the launch of a branded network of five storefront style centres—one in each health region of the province—that will allow youth in need to access comprehensive health and social services, combined with e-health access,web-based supports and telephone help lines. The centres, which will serve youth and young adults ages 12 to 24, will help youth bridge critical transition points, such as leaving home, changing schools, or graduating from youth care to the adult care system.
Comprehensive mental health and addiction care for youth
“The main thrust [of BC-IYSI] is primary health care with mental health and substance use services, but it’s going to be broader than that,” says Pamela Liversidge, director of policy and partnerships for BC-IYSI.
By combining these core clinical services with employment support and education (and potentially more ancillary services such as recreation, child care, food security or even legal aid), and by offering them in a bright, non-intimidating space that is welcoming for youth from the moment they enter, the initial five planned centres can overcome the barriers created by stigma that prevent many young people from seeking help.
“Once that relationship is built and they’ve stepped in the door, if something comes up around housing or depression, or whatever issue they are facing, they can easily be referred to someone within the same space,” says Liversidge. “It’s holistic—we are treating the whole person.”
This unique initiative is supported by an unprecedented partnership of key organizations. While the BC-IYSI working group—the backbone organization—is hosted at St. Paul’s, it is currently being overseen collectively by a governance committee comprising the InnerChange Foundation, the Graham Boeckh Foundation, the Michael Smith Foundation for Health Research and St. Paul’s Foundation, as well as the Ministry of Children and Family Development and the Ministry of Health.
Dr. Steve Mathias, medical director of the ICY and executive director of the BC-IYSI backbone organization, says the co-operative initiative will not only build on what was learned from the successful St. Paul’s Granville Youth Health Centre model, it is also an answer to the Select Standing Committee on Children and Youth’s January 2006 report, which asked for mental health and social service hubs to be established for youth across BC as part of their recommendations for concrete actions for systemic change in how young people are supported in the province.
“The beauty of this model is that it is flexible, and it recognizes that youth tend to access services differently from adults and from children,” says Mathias. “A community-based approach, one where youth can identify with other youth struggling with the same issues, can be the best opportunity for them.”
The BC-IYSI initiative will unite local organizations serving youth under a single brand that will be able to adapt to meet the specific needs of communities in each region. This cohesive initiative will ensure consistent approaches to evaluation, foundational standards of service and an evidence-based system are applied throughout BC—a system that’s able to respond to the needs of youth and that is able to increase the level of intervention of service quickly and efficiently as needed.
Customizing services for youth
St. Paul’s Granville Youth Health Centre has been the prototype for the BC-IYSI, but the plan is not necessarily to replicate it—not exactly. The backbone organization led a two-stage application process for communities across BC that wanted to take the lead in developing their own centres. The Expression of Interest stage saw 25 community partnerships apply for these centres.
“Among the 25 communities that applied, all had different community organizations leading the charge,” says Mathias. “Youth services have traditionally been grassroots initiatives taken on by organizations that care about the youth in their community.”
An independent jury, including youth and family jurors, deliberated in April and selected five communities based on the strength of their partnerships and proposal, including a highlighted component on meaningful youth and family engagement.
“Every community is so unique,” says Sarah Irving, a peer support worker at the Granville Youth Health Centre. “With the Granville Centre, a lot of our clients are homeless and street entrenched, and our community partners are agencies and resources that serve a population of homeless and street-entrenched youth. But that isn’t necessarily a model that’s going to fit the centres in different communities across the province.”
Irving is now representing the BC-IYSI as a FamilySmart youth consultant to ensure the voices and experiences of families and youth are informing the work of the backbone organization and the development of the regional centres and e-services. Irving herself struggled with mental health challenges and substance use, and she knows how difficult it can be for young people to find help.
“I have seen the power of youth hub models like the Granville Youth Health Centre really helping with navigating the system,” says Irving. “If this hub existed when I was unwell, my journey would have been much different. I would have been diagnosed earlier and things wouldn’t have got to the point that they did. I want that for other young people.”
Alex, too, is now giving back to his community as a trained peer support worker at the St. Paul’s mental health unit. He has a girlfriend, an apartment in the West End, and he is re-enrolled in college.
“I feel healthy and confident that things will turn out for the best,” says Alex. “Every city needs a dedicated mental health youth outreach team like St. Paul’s ICY. Their positivity, energy, perseverance and teamwork
is an inspiration for those of us who aspire to live well and help others.”
You can make a difference, donate now to the BC Integrated Youth Services Initiative.