Integrated Youth Services (IYS) is an international movement that aims to build integrated mental health and substance use supports for youth across Canada. After more than five years of consultation, planning, advocacy, and development, Choices for Youth (CFY) and 65+ partners across Newfoundland and Labrador (NL) are ready to implement an IYS network for the province, building from CFY’s existing IYS site in NL.
To share more about this best practice model and the impact of investing in this model, Choices for Youth hosted "The Impact and Potential of Regional Integrated Youth Services in NL" on April 27, 2023. Approximately 100 representatives from provincial steering committees, Atlantic IYS networks, officials from across Atlantic Canada, and supporters joined CFY staff at the Emera Innovation Exchange (EIX) to envision a new system of service delivery for youth in this province.
The day began with greetings from the Honourable Carolyn Bennett, Minister of Mental Health, and Addiction.
“As we work to improve Canada’s universal health care system, children, youth, and young adults deserve access to the highest quality of mental health and substance use care no matter where they live in Canada. We are committed to ensuring that the national mental health and substance use service standards that are being developed with provinces and territories are grounded in evidence.”
Keynote Featuring Sheldon Pollett and Dr. Jo Henderson
Sheldon Pollett, Executive Director, Choices for Youth started his keynote with an emotional appeal about the need for change in the systems that provide health services to children and youth in NL. He explained that, although the number of young people living in NL is half what it was twenty years ago, the number of young people accessing CFY services is increasing. NL has fewer youth, but a higher percentage of those youth are coming into harm’s way.
While Sheldon acknowledges the challenging situations facing NL’s youth, he points to the fact that IYS provides better outcomes for youth. Approximately 50% of the youth accessing CFY services come from communities outside the St. John’s metro area. An IYS system featuring regional youth service hubs at strategic locations across the province will help address this by allowing youth to remain in their home communities and access services closer to their families and natural supports.
Dr. Jo Henderson, Director of the Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health at The Centre for Addictions and Mental Health (CAMH) and Executive Director of Youth Wellness Hubs Ontario (YWHO) then gave a keynote that built on Sheldon’s address by presenting a model for IYS that is already operating successfully in Canada through YWHO. Dr. Henderson explained that YWHO started with a simple question – how do we build better systems of care for young people? Inspired by the work that grassroots organizations like Choices for Youth were doing across the country, YWHO built a network of service providers, united in the vision that every young person has the right to achieve their best outcomes.
Dr. Henderson asserted that a key element that makes YWHO, and IYS models in general, successful is that it positions youth at the centre, making them an active part of the process of designing the services. Consultations with youth have been very revealing. Youth want to reduce the fragmentation of services – in an ideal world, they want to walk through one door and access all of the services they need. This holistic approach to service delivery is at the core of IYS and will promote more equitable outcomes.
A common thread that both Sheldon and Dr. Henderson touched on is the importance of early and timely access to culturally appropriate services, and the need for early intervention. This thinking challenges the status quo of the existing youth healthcare system, which focuses on crisis response. An IYS system would instead create a network of networks, bolstered by a team that provides backbone supports such as finance, fund development, evaluation, and communications, and united under a common brand and a core set of principles, but flexible enough to leave room for nuance and regional considerations. This system will engage with youth when, where, and how they require services, eliminating physical and systemic barriers and ultimately providing youth with the services they want and deserve.
Panel Discussion and Q&A
Following Sheldon and Dr. Henderson’s keynote addresses, the event continued with a panel discussion moderated by Dr. Rob Greenwood, Associate Vice President (Public Engagement and External Relations) at Memorial University of NL, featuring representatives from CFY leadership and strategic partners.
One of the panellists, Ian Boeckh, President and Director of the Graham Boeckh Foundation, a non-profit seeking to transform Canada’s youth mental health system, evoked the proverb “It takes a village to raise a child,” likening IYS to “building a village.” Ian celebrated the success that IYS models have already achieved in scaling across Canada, despite external forces like the COVID-19 pandemic. Ian hopes to see approximately 150 IYS locations across Canada in the next three years.
Dr. Francoise Guigne, Assistant Professor of Family Medicine, and Director of the Care of Underserved Populations Enhanced Skills Program with Memorial University’s School of Medicine is one of the physicians who supports CFY’s Outreach and Youth Engagement Centre (OYE). Dr. Guigne emphasized that the work that IYS does can only move “at the speed of trust.” Dr. Guigne praised the OYE Centre staff for their ability to build trust with youth, emphasizing that this trust must be earned. Dr. Guigne also lauded the strength of OYE’s walk-in model for service, versus an appointment-based model, and how she is able to engage with significantly more youth when the barrier of having to make an appointment is removed.
Tavis Mitchell represented the Rural Initiative Outreach Team (RIOT) with the AIDS Committee of NL (ACNL) on the panel. RIOT is a mobile service offering Safe Works Access Program (SWAP) supplies and other supports for individuals who use drugs in the Clarenville Area. RIOT is an example of a network that would operate within the NL-IYS “network of networks,” offering essential services within a specific region of the province. Travis built on Dr. Guigne’s point about barriers, speaking on the need to remove systemic barriers that discourage youth from accessing services, such as the stigma that youth who use substances face when accessing healthcare.
CFY’s Director of IYS, Matthew Piercey then discussed the important role that backbone supports play in the IYS model and gave thanks to members of the Steering Committees and philanthropists like Ian Boeckh, all of whom have been essential partners in developing NL-IYS. Matthew emphasized the importance of engaging youth and praised the CFY Youth Leadership and Advisory Council's role, eloquently stating that they are “the compass that will guide [NL-IYS] forward.”
Tiana Butler, Regional Manager IYS Labrador and NL West began by acknowledging her Indigenous background and the pride she feels in supporting communities in the unceded Mi’kmaq lands of Bay St. George. Tiana wants to ensure that Labrador is not considered “secondary” to Newfoundland with regards to NL-IYS. Tiana’s vision for IYS is a collaborative system where the voices of Indigenous Peoples, New Canadians, and settlers are considered equally. There is room for innovation in NL-IYS, and Tiana believes that the small communities across the province will play a key role in developing new and impactful ideas.
“If you want to look at innovation and ways to move forward, you look at the small communities, because we know how to make things work with limited resources,” Tiana explained.
Dr. Kathy de Jong, Assistant Professor with the School of Social Work at Memorial University, and CFY Director of Strategic Initiatives Jen Crowe explained the role that research and analytics have played in the development of NL-IYS and the importance of doing research respectfully and engaging youth in the process. The data around young people reveal the impact of NL-IYS. Mental health is the number one issue facing youth in NL, followed by family stability and housing stability. Jen emphasized that these issues are interconnected and that helping young people access affordable housing or helping with their family situation will have a positive impact on their mental health as well.
There is already evidence in the data that supports this point – young people engaged with CFY’s services are experiencing a 60% increase in housing stability and an 88% decrease in emergency healthcare access. When young people are given the resources and opportunities to succeed, their health outcomes are improving.
The panel concluded with a question-and-answer session that touched on a variety of related topics, including barriers to collaboration between service providers within the NL-IYS networks, the importance of investing in a Basic Income program in NL, and the value of NL-IYS engaging with local school systems.
The full event was broadcast live on Choices for Youth’s YouTube page. You can view the recording here: https://shorturl.at/bN349
Written by Chris Morris