CAMH Youth Wellness Hubs work to streamline medical records for young visitors | Canada Voices

Through the ground-level glass doors of an office tower across the street from the Scarborough Town Centre, a major mall in Toronto’s east end, is a hangout spot for young people that has just about everything.

There’s a kitchen stocked with fresh vegetables. A living area with a foosball table, a TV and beanbag chairs on the floor. A recording studio.

And past the rooms for recreation are those housing services for more serious needs. A computer lab for catching up on school work. Counselling rooms where a therapist can listen. An exam room staffed with a nurse practitioner.

It’s a lot to provide in one place. But for the Scarborough Youth Wellness Hub – one of 30 such sites that have popped up in Ontario over the past few years – the variety is the point.

“You could come in the door to play foosball,” or “you could be coming in to see the nurse,” said Jo Henderson, executive director of Youth Wellness Hubs Ontario (YWHO), who uses the pronoun they.

“Ideally, you’re actually participating in lots of different things,” they said.

The hub model was devised to bring together disparate services under one roof, but it has also been one way of addressing another problem: scattered medical records.

As a Secret Canada investigation from The Globe and Mail recently explained, Canada’s medical records system is deeply fragmented, with files living in a mix of physical and digital formats spread across various service providers that can’t always communicate with each other.

The YWHO network provides one novel way of bringing together those services and records – while also having to navigate additional challenges that arise from helping young people who may be experiencing mental-health and substance-use concerns.

Dr. Henderson, who is also scientific director of the McCain Centre for Child, Youth and Family Mental Health at the Centre for Addiction and Mental Health, said the work for what would become YWHO began in 2010.

“We were hearing from young people that there was a lot of fragmentation, and we wanted to try and figure out how might we promote better collaboration across sectors,” they said.

The dangers were that every time a young person tapped into a new service, there would be a new waiting time and another possibility they would disengage from help. Also, their records wouldn’t travel with them, forcing them to repeat a difficult story again and again, which could be traumatizing.

At first, Dr. Henderson and their team thought about how to standardize measurements across organizations to better keep track of how those young people were doing. But then their thinking grew bigger: What if they could create a whole new system instead?

First, all services would be brought under one roof, so a young person wouldn’t bounce between different providers. Hours would have to be convenient for students in school during the day, so it had to be open on evenings and weekends. And there had to be some fun mixed in, with no signs on the door like “addiction services here.”

After years of testing the model and securing funding from government and philanthropy, 10 YWHO sites opened their doors in 2019 across the province. That’s since grown to 30 locations, with mobile services in other communities. In the fiscal year that ended March 31, YWHO said it served 28,336 individuals for a collective total of 160,179 visits.

One long-time visitor is JC, a now-21-year-old who helps organize events at the Scarborough Youth Wellness Hub. (The Globe is not identifying JC by their full name because they began accessing these services as a minor.)

JC said their parents, who immigrated to Canada, were not used to seeking help for mental health. An older sibling first tried counselling at Strides Toronto – a non-profit that plays host to YWHO’s Scarborough site – and recommended JC try the same.

They did, and came to value both the services and the sense of community they found there. They now volunteer on the hub’s youth advisory committee and help organize seasonal parties.

“I always have a better day when I come here,” they said.

But while centralizing records within the YWHO system solves some problems, there are still other challenges to be overcome, such as sharing those records outside the system if needed.

One big barrier is that young people are not required to present a government ID when they register. Jessica Myers, manager of the Scarborough Youth Wellness Hub, said this was a deliberate choice to make services as easy to access as possible. A young person may need to seek help without their family’s knowledge or against their wishes.

“I’m sure there are lots of young people who walk in and don’t give their real names, and that’s okay,” she said. “We want them to come into the space and be as comfortable as they can be when they come in.”

Other personal characteristics might be different, too. A young person who is LGBTQ might identify as a different gender at the hub than they do at school.

Ms. Myers said that they do need to verify a person’s identity to refer them to government services outside the hub. “In those cases, hopefully we’ve built a better relationship with that young person and they’re probably more open to sharing those things with us,” she said.

“But, again, we would try to meet young people where they’re at. Try to navigate things as best we can with what information they’re willing to share.”