Abstract
Introduction: Mental health and addiction services for youth in Canada continue to be fragmented. In response, Youth Wellness Hubs Ontario (YWHO) emerged as a one-stop-shop integrated youth service model serving young people aged 12-25 across the province of Ontario. Launched in 2017 as a pilot in six communities, today there are 14 sites with stable funding. Youth and family engagement, integration, partner collaboration, and use of standardized measures are crucial core components of the YWHO model. At the end of a 3-year pilot, we conducted an implementation evaluation to identify areas of success, improvement, and service delivery modification resulting from COVID-19.
Methods: This presentation will highlight the barriers and facilitators to the implementation of the YWHO model from the perspectives of service providers and site leads. We will also cover the rapid modifications to service delivery implemented by sites in response to COVID-19. Key informant interviews were conducted from January to February 2021 with service providers and/or site leads from ten YWHO sites. Reflexive thematic analysis was used to analyze all interview data.
Key Findings: Several barriers and facilitators to the implementation of the YWHO model were identified. Service providers noted barriers at the site, community, and system level. At the site level, limited staffing and financial resources, physical hub location, coordination and communication, and establishing youth and family advisories all posed challenges. A few of the barriers at the community and system level included multiple data platforms and duplicate data entry, low family engagement, inconsistent branding, designing truly integrated service pathways, buy-in from partners, transition to virtual service delivery, lack of clinical and cultural specific services, collection and use of equity data, and regular use of standardized measures and outcomes. Identified facilitators include supports from the backbone organization, established core components, integrated governance, solid partnerships, excited youth and regular youth engagement, dedicated staff, stable and flexible funding, and leadership support. In the next phase of the implementation evaluation, youth advisory members will be engaged to review survey tools and facilitate focus groups for qualitative data collection from youth accessing YWHO services.
Conclusion: Implementation of integrated youth services is highly collaborative and quite complex. Service providers and site leads identified several barriers and facilitators to implementing the YWHO model of service delivery at the site, community, and system levels. Learnings will inform how various stakeholders work together to support youth in their communities to design and implement services that improve youth mental health and overall well-being.
Implications for applicability: As interest in integrated youth services increases, the need for knowledge related to the optimal implementation of such models increases. In addition to informing improvements to YWHO, findings from this work will help inform the successful implementation of other integrated youth services nationally, and internationally.