Celebrating a decade of youth health care at Foundry

Victoria Sulyma didn’t know what to expect when she walked through the doors of Foundry in Abbotsford, BC, back in June 2022. She knew she felt lonely and lost and she needed help.

Just a few months earlier, Victoria had been attending university in Lviv, Ukraine, living away from home for the first time, and relishing her newfound independence. When Russia invaded in February 2022, that life was over. Initially, she stayed in Lviv, volunteering in bomb shelters and soup kitchens, but as the invasion grew, she knew she had to leave. Victoria began a harrowing journey, travelling on foot to Poland, eventually reuniting with her family and finding refuge in Canada. 

She struggled a lot in those early days. It was difficult settling into a new country, let alone trying to process everything she had been through. “I wasn’t registered for school, I wasn’t employed, my English wasn’t very good, and I just didn’t know where to start,” she says. “I was overwhelmed.”

Victoria began searching online for affordable therapy, and that’s when she came across Foundry—it offered free free health and wellness services for youth ages 12 to 24, and critically, she didn’t need a referral or assessment to access the help. The organization had multiple centres, including one in Abbotsford. 

Victoria dropped by the centre and met counsellors Leisa and Kristi. Kristi began working with Victoria to address her anxiety and PTSD, and connected her to the Foundry Work & Education program, a free program which provides personalized support for young people to explore career paths, access education opportunities, and build skills for long-term success.

Kristi also introduced Victoria to Allison, a peer support worker. The first time the two met at a coffee shop, they just talked—about how Victoria came to Canada, what Abbotsford was like. “Allison was a friendly and kind person, sort of like an older sister. I liked talking to someone my own age. I felt respected.”

Victoria returned to Foundry for counselling sessions with Kristi and then joined in other activities happening at the centre, like craft circles and board-game nights. She was able to practice her English and get advice from other peer-support workers on how to navigate everyday challenges. Victoria soon felt like she had her own trusted circle at Foundry.

With assistance from the Foundry Work &Education program, Victoria was able to get a job at Starbucks and save money for school. She eventually completed a paralegal course and began working as a legal assistant (Allison took her to the mall to shop for professional wear with money provided by the program). “Foundry kept me sane while balancing work, night school, volunteering, and fulfilling my practicum hours,” she says. “I know I wouldn’t have made it without their support.”

Back in 2007, donors to St. Paul’s Foundation provided seed funding to create Providence Health Care’s Inner City Youth Program (ICY), a program for youth navigating housing insecurity and homelessness. Aided by more donor support, the ICY expanded over the following years.

“There was a team of about 25 people who had been working with youth in downtown Vancouver,” recalls Dr. Steve Mathias, a psychiatrist and co-executive director of Foundry. “We were working out of really small office spaces at St. Paul’s Hospital. We had to see young people in their Single Resident Occupancy Hotels, in coffee shops or at youth shelters. And if we missed them, then there was nowhere for them to come and see us.”

In March 2015, St. Paul’s Foundation, Providence Health Care, and the provincial government, with the help of private donors, opened the next iteration of these essential services: Granville Youth Health Centre. It was soon renamed Foundry (the youth themselves selected the title, associating it with a trusted, confidential place to seek help).

The new centre offered a street-level clinic for primary care—access to family doctors and nurse practitioners—but also mental health care, physical and sexual health care, substance use support, youth and family peer support, and social services. It also trained and employed young people with lived experience (those who have struggled with their mental health or with substance use and overcame those struggles) to connect with other young people coming through the door. It was a prototype for Integrated Youth Services (IYS), and the first of its kind in North America. 

The response from young people was immediate and overwhelmingly positive: “They told us that the centre looked like a tech startup,” says Mathias with a grin. Clinicians loved that the facility was designed so they could see a client and then meet in a breakout room with other clinicians to discuss care in real time. It also meant, crucially, that a youth could tell their story once, and then a ripple effect would engage the different supports they needed.  

“We knew early on that we wanted to expand the model to include all youth who needed help,” says Mathias. Research shows that 1 in 4 young people in any given year will struggle with mental health—often low mood and anxiety, but sometimes more serious expressions, with substance use or with psychosis.

Even if the services a young person needs are available in the community, locations are often siloed and difficult to find. Organizations often operate on short-term grants out of temporary sites, like a church basement or off an alley, and waitlists for mental health services are often six to 12 months long. As a result, fewer than 1 in 3 youth with mental health or substance use disorders receive the treatment that they seek. Integrated Youth Services are changing that.  

In 2015, the provincial government announced funding to test out one Foundry model in each of the five regional health authorities in BC. The models opened with further support from St. Paul’s Foundation donors—then, in 2017, additional provincial funding was announced to open a second centre in each region. That was unusual, says Dr. Karen Tee, a clinical psychologist and co-executive director at Foundry, but it was proof that policymakers could clearly see Foundry’s value.

In 2019, the Government of BC launched A Pathway to Hope, a 10-year roadmap for making mental health and addictions care better for people in BC; it listed opening more Foundry centres as a priority action.

“Opening those first few centres felt a little like building the plane as we were flying,” admits Tee. There was initial concern that the downtown Vancouver prototype might not work in a suburban or rural community. The leadership team followed a mantra of open heart, open mind, and they let relationships with young people, their family members, community partners, and staff inform what each centre should look like and what services it should prioritize.

Youth and family advisory committees worked alongside Foundry leadership to co-design the centres. “We needed to understand the differences between communities and to embrace them,” says Mathias. “At the same time, we soon recognized that if you are a young person, 85% to 90% of the things you need to flourish are the same no matter where you live. And challenges are similar, too: young people struggle with school, with friends or classmates, with their parents, some of them with housing, many of them with mental health and substance use.” 

Today there are 17 Foundry centres across BC, plus provincial virtual services offered through Foundry Virtual BC. Another 18 centres are set to open by 2028. “Our vision is for 55 in the province,” says Mathias. “That requires a great deal of fundraising, and a reliance on donor generosity and continuing strong government partnerships.” He notes that Foundry has faced rising construction costs over the years when it comes to building out centres, and space is hard to find.

Centres can take three years or more to build and open. And the original Foundry Vancouver has outgrown its capacity on Granville Street—funding a new facility is critical to ensuring that demand is being met and more youth can access the care they need.

“I don’t know that we’ve ever been more aware of the challenges that our young people are facing than we are right now,” says Mathias. He points to COVID reverberations coupled with economic and political shakiness and climate challenges—they all contribute to a profound sense of uncertainty as to what our youth’s future looks like.

“We need to make sure that our young people feel like they’re living fulfilling lives, and they have purpose and that they are productive,” says Mathias. “If we don’t invest in our young people today, there’s going to be an incredible cost down the road.”

And as for Victoria, she is living on Vancouver Island and working at a new law firm. She is actively involved with Foundry’s youth advisory committees, and keeps in touch with Allison, her original peer support worker. “I just want to say to all young people, and particularly my fellow immigrants and refugees, you are always welcome at Foundry. You can access therapy no matter what, and it can be life changing. The struggle is real for a lot of us, and you’ll find compassion at Foundry.” 

The Foundry model is built on what people need now, says Dr. Skye Barbic, Head Scientist at Foundry and an Associate Professor at the Department of Occupational Science and Occupational Therapy at the University of British Columbia. “The idea of going into communities to listen, and then co-designing the solutions, is remarkable.” What then gets delivered to the community, she says, is a health system that keeps iterating, and an organization that is flexible, constantly evolves, and grows. She and her research team are actively involved in that iteration by studying the gaps in Integrated Youth Services (IYS) that have been identified by Foundry’s clients, their families, service providers, and community stakeholders.

In 2024, Barbic was named a Tier 2 Canada Research Chair in IYS. The accomplishment is both a recognition of Barbic’s significant work, and a celebration of the growth of IYS—which started in Canada at Providence Health Care, thanks to St. Paul’s Foundation donors.

“The chair allows me to focus on understanding the mechanisms of IYS—what’s working and what’s not—and then measure the impact,” says Barbic. “I can share those exciting lessons within BC and across Canada, which will then contribute to building a pan-Canadian system that prioritizes youth mental health and wellness.” This research is an asset to the Foundry team and to the 16,000-plus youth who access Foundry programs every year.

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