Date Presented 04/23/2023
Global models of youth mental health service are changing dramatically, with an emphasis on goal orientation, developmentally appropriate care, and evidence. This presentation will describe a model called 'Foundry' and describe the critical role of OT in the conceptualization, design of services, and evaluation of outcomes.
Primary Author and Speaker: Skye Pamela Barbic
PURPOSE: Youth in North America across the world have high rates of mental health and substance use concerns compared to youth in similar high-income countries. In British Columbia, Canada, an integrated youth services organization called Foundry provides services through a Primary Youth Health Care Model. After the pilot phase involving 6 centres, Foundry (foundrybc.ca) expanded to 11 physical centres (soon to be 23) and launched a virtual service. The study purpose was to evaluate 1) the demographics of Foundry clients, 2) the outcomes of service utilization, 3) the impact of the COVID-19 pandemic, and 4) the role of occupational therapy in expansion of the model.
METHOD: Data were analyzed using R for all youth clients accessing both in-person (April 27th, 2018-March 31st, 2021) and virtual services (May 1st, 2020-March 31st, 2021). Cohorts containing all clients from before (April 27th, 2018-March 16th, 2020) and during (March 17th, 2020-March 31st, 2021) the COVID-19 pandemic were also examined.
RESULTS: 23,749 unique youth received 110,145 services at Foundry during the three year period. For all services, the mean client age was 19.54 years (SD = 3.45) and clients most commonly identified as female (62%). Over 60% of youth scored ‘high’ or ‘very high’ for distress and 29% had a self-rated mental health of ‘poor,’ with similar percentages seen for all services and virtual services. These ratings stayed consistent before and during the COVID-19 pandemic. Youth also reported low levels of occupational engagement, with more than 40% reporting doing less than 2-5 hours of meaningful activity each week. Of note, 13% of all youth reported not being in school, work, or training. These numbers were consistent with pre-pandemic values.
CONCLUSION: Overall, Foundry has reached the target age group of 12-24 years, with a 65% increase in number of clients during the study period compared to the pilot stage. The high levels of distress and self-rated mental health, and the lack of change during the COVID-19 pandemic, suggest there is a significant need for integrated youth services in British Columbia and justifies continued expansion and focus on the developmentally-appropriate needs of youth (e.g., work/study, social). As the Foundry model expands across BC and Canada, a critical role is to focus on promoting occupational engagement of youth, and to support the co-design of work/study programs to promote participation, health, and wellness of diverse youth throughout the province.
Mathias, S., Tee, K., Helfrich, W., Gerty, K., Chan, G., & Barbic, S. P. (2021). Foundry: Early learnings from the implementation of an integrated youth service network. Early Interv Psychiatry. https://doi.org/10.1111/eip.13181
McGorry, P. D. (2022). The reality of mental health care for young people, and the urgent need for solutions. Med J Aust, 216(2), 78-79. https://doi.org/10.5694/mja2.51327
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