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GBF Newsletter 7.3
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February 2022
GBF’s Decade-Long Work in Youth Mental Health
This special newsletter is the story of GBF’s decade-long work in youth mental health — both the accomplishments and the future directions. It highlights a story of system transformation and how philanthropy can play a central role in helping to address complex social challenges.
The NorWest Co-op Community Health Youth Hub in Winnipeg. Photo supplied by NorWest.
THE TRAGEDY OF A FRAGMENTED SYSTEM 
Traditionally, mental health care systems for youth have been highly fragmented with long wait times and large gaps in services. Moreover, youth transitioning out of the child system at ages 18 or 19 often received either no care or inappropriate care at an age when the burden of mental illness is at its greatest. The result has been a tragedy of missed opportunities for improved access and early intervention.
A PAN-CANADIAN MOVEMENT IS BORN
A decade ago, Canadian society was becoming increasingly aware of these problems but had not yet acted in an organized way — then GBF and the Canadian Institutes of Health Research (CIHR) decided to collaborate on catalyzing change. Together, we put out a call for proposals to support networks to transform youth mental health care in communities across Canada and to evaluate the transformation. This "call" was branded TRAM, Transformational Research in Adolescent Mental Health. TRAM engaged hundreds of people in the mental health sector across Canada, resulting in the funding of the ACCESS Open Minds network and helping to spawn a pan-Canadian movement now known as Integrated Youth Services (IYS).
 
RISE OF PROVINCIAL IYS INITIATIVES 
TRAM highlighted the importance of a principles-based approach for effective and client-centred services for youth aged 12-25. These principles, including the importance of youth and family engagement and continuity of care across transition ages, allowed integrated models of care to be co-created directly with provincial governments, as they have jurisdiction over health and social services. Through working collaboratively with governments and other funders, GBF helped to establish one-stop-shops or hubs with wider collaboration across youth-serving organizations. This approach is helping to ensure that ‘every door is the right door’ for youth and has become a hallmark of the Canadian approach to IYS.

The first provincial IYS initiative, called Foundry (British Columbia), was established in 2015. This was soon followed by Youth Wellness Hubs Ontario (YWHO) and Aire ouverte in Quebec, and more recently, the Manitoba Youth Hubs Initiative (see the graphic: Some IYS Milestones). Initiatives are now emerging across the country, and GBF is helping to co-create and co-fund additional IYS projects across the country.
 
Some IYS Milestones
 
IYS IS PUTTING YOUTH AT THE CENTRE OF CARE
By focusing on IYS initiatives that put youth and families/caregivers at the centre of care and have the key elements of an organized mental health care system (see the graphic: IYS Key Components), GBF is continuing to support the transformation of youth mental health across the country. These initiatives have backbone organizations supporting implementation of IYS across a network of community sites. Youth and caregivers are involved in the design and delivery of the supports and services (see the graphic: IYS Services). Key elements also include a holistic suite of services delivered in a manner that is youth friendly and culturally safe, and in diverse community settings, including urban, rural, remote, and Indigenous communities.
 
IYS Key Components
 
IYS IS RAPIDLY SCALING UP
Provincial IYS initiatives are underway or being developed in nine of the ten provinces with IYS hubs open or planned in over 100 communities. IYS has also been welcomed by diverse communities across the country, including by many Indigenous communities and organizations; several IYS sites are Indigenous-led while many others offer Indigenous-specific services.

Moreover, collaboration across IYS initiatives is creating a rich, pan-Canadian ecosystem with knowledge sharing and a number of pan-Canadian research and evaluation projects underway, including for employment (Individual Placement and Support — IPS). Foundry BC, YWHO and ACCESS Open Minds have taken leadership in transferring knowledge, as has Frayme, the pan-Canadian knowledge mobilization network for youth mental health.
 
IYS Services
THE JOURNEY CONTINUES
The adverse effects of COVID-19 on young-adult health and wellbeing, and on the social determinants of health, are increasingly evident in Canada. Serious concerns resulting from the pandemic reach across all sectors, and IYS has the ability to respond. While it has tremendous momentum, across Canada, a great deal of work is still needed to ensure that IYS achieves its full potential in terms of delivering high-quality and equitable services that can truly help all Canadian youth and their families/caregivers. In this regard, one of GBF’s priorities is to support enhanced measurement, research, and knowledge mobilization to help develop IYS initiatives as learning healthcare systems.
THANK YOU AND CONCLUSION
We are grateful to our partners who have helped to build IYS, especially the youth, families, service providers, researchers, provincial governments, and backbone organizations across the country. In addition, we give a special thank you to all of our co-funding partners including Bell, CIHR and other pan-Canadian philanthropic funders such as RBC and Medavie Health Foundation, as well as our many regional and local philanthropic partners across the country. We feel privileged to work with you to address an important societal need.
 
IYS is increasingly recognized as the most promising opportunity to build organized, accountable, and equitable mental health care systems across Canada. However, from GBF’s perspective, the journey that began a decade ago has only just begun. Future priorities include development of IYS in all provinces and territories, and implementation of systematic quality improvement and innovation. We look forward to working with many partners across Canada to truly make a difference for the mental health of all youth and their caregivers.
IYS CREATIVE CONTENT
Please see the foundation’s website for information on IYS, including a variety of reports, webinars and videos, including our webinar on learning healthcare systems for mental health. In addition, the following brief videos produced by the Bell-Graham Boeckh Foundation Partnership describe IYS and feature different youth hubs from across the country:

Integrated Youth Services: A Pan-Canadian Perspective

Eskasoni First Nation, Nova Scotia

Chatham-Kent, Ontario

The Alex, Calgary, Alberta

Acadian Peninsula, New Brunswick
 
Foundry Kelowna (Daniel Jones Photography) - Copyright of Evolve Design Build 2017
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