A Holistic Approach for Youth Mental Health

When it comes to serving the needs of youth with mental illness, Canada is falling short. In Canada, more than 70 per cent of people with a mental health problem or illness are struck when they are young – in adolescence and early adulthood. According to the Graham Boeckh Foundation (GBF), a family foundation based in Montreal, this is also the age group where there is the least amount of support available. It is also the age group where intervention can make a huge difference. There is mounting evidence that early, evidence-based intervention leads to significantly better long-term outcomes.

Motivated by their family’s personal experience of what they saw as the failure of the mental health care system – poor access, misdiagnoses and improper care and supervision – the Boeckh family set up the Graham Boeckh Foundation to improve how patients with mental illness and families are treated in Canada.

The Foundation’s goal is to be a catalyst for transforming mental health services by initiating a suite of strategic projects. At the core of the Foundation’s strategy is fostering collaboration, breaking down the silos within the mental health sector and placing patients and families at the centre of care.

Thinking boldly about the government as a co-funder, the GBF launched a unique and ambitious funding partnership in 2012 with the federal Canadian Institutes of Health Research to start a competition, the Transformational Research in Adolescent Mental Health (TRAM) initiative. The Foundation saw its role as a catalyst that could infuse innovation into the system and that could help government leverage philanthropic support.

With a contribution of $12.5 million over five years from each partner, the CIHR and the GBF financed TRAM to collectively build one pan-Canadian research-to-practice network to ensure that all steps are available to any young person in Canada who needs them, regardless of what type of mental health problem or illness they are suffering from.

Through the TRAM competition, individuals and organizations came together from five different areas – research, service delivery, government, patients, and the non-profit community – to form 55 networks that submitted an expression of interest. Seventeen networks were chosen and brought together for a strengthening workshop to share their theories of change. GBF and the CIHR worked to help the groups exchange different ideas and identify connections with the goal of strengthening the original ideas.

In 2014, the competition led to the creation of the ACCESS Open Minds network which is demonstrating how youth mental health services can be transformed for youth at risk in 12 communities across Canada. The network brings together youth, families, care providers, policy makers, researchers and community organizations with the goal of giving youths aged 11 to 25 years faster access to services designed specifically for them, with them. Along with families and carers, they are involved in every aspect of ACCESS, from the design and evaluation of services, to the creation of content for the website.

The five main objectives to be achieved through the transformation are:

  • Early identification;
  • Quick access for an initial assessment (within 72 hours);
  • Abolition of transition based on the age of 18, creating a seamless service for 11-25 year-old youth;
  • Access to high-quality, evidence-informed interventions within one month, when needed; and
  • Family and Youth Participation.

Lessons Learned

The GBF has learned a number of lessons through its unusual partnership with CIHR. The dividends have been huge. They include follow-on opportunities to develop large, joint venture projects with a number of provinces and to be a catalyst for the development of a National Knowledge Translation Platform in youth mental health.

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One key challenge the GBF worked through was in navigating the pace. The government’s pace dictated the pace at which progress was made. Understanding culture and context varies depending on the level of government and from province to province. The GBF recognized that flexibility in its thinking and approach was key to the success of the initiatives.

Persistence was an important attribute at every stage. It helped the Foundation take a long view and find the “early adopters” who were willing to test out new ways of doing things. No level of government wants to be seen as a laggard and so the early adopters who help get an initiative off the ground can help inform projects developed with other provinces. The Foundation is currently working to help develop a system to promote learning and sharing of methods and lessons across the provinces and territories.

Overall, the GBF’s approach of acting as a catalyst for the transformation of the mental health care systems across Canada has been successful. The foundation believes that it is important to provide intellectual resources as well as financial support. For the GBF, the intellectual and social capital that a philanthropic organization can bring to the table is as important as the financial contribution it provides. This can’t be underestimated. The GBF is not a large foundation in financial terms. But limited resources wisely and imaginatively applied can have enormous impact, as the GBF has convincingly demonstrated.

In philanthropy money is not everything. Granting is not as effective as project and program partnering – to find other philanthropic, private and government organizations to work with on a common cause. Philanthropy can lead by taking risks that many other institutions cannot.

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