“#GetReal” is the defining hashtag of this Mental Health Week. As youth facing the coming mental health repercussions of the COVID-19 pandemic, we ask: what does getting real look like? Doctors are warning that social isolation and a lack of accessible mental health services have formed a perfect storm for what some call a “second pandemic” of mental illnesses. This crisis will not be solved through social media campaigns or business as usual. For us, getting real means getting a real, nationwide mental health solution backed by rigorous evidence.
The good news is that Canada already has one.
For over five years, ACCESS Open Minds (Esprits Ouverts), a pan-Canadian network of service providers and researchers, has been dedicated to developing and evaluating an innovative new mental health service model called Integrated Youth Services. Across ACCESS Open Minds's 16 sites that span the geographic and demographic diversity of our country, the data shows that this model is leading to better outcomes throughout Canada.
Rather than leaving youth and their families to navigate a convoluted, disintegrated system, ACCESS Open Minds sites bring everything under one roof. Doctors, therapists, and social workers see youth as a holistic and integrated team, making collective decisions in a timely, youth-focused manner, free of cost. This model allows these ACCESS Open Minds clinicians to see the vast majority of youth within 72 hours of initial referral, versus over four weeks of waiting in typical service delivery models.
In this way, Integrated Youth Services do more than just treat symptoms. They also work towards building the resilience and mental health of the communities they serve. Mental health crises are often a matter of dominoes falling, and most approaches today deal with the brutal crash of that final piece. At ACCESS Open Minds sites, an upstream approach is taken instead. Mental health professionals work hand-in-hand with youth peer supporters, and addictions workers develop patient plans with career and housing counsellors. Together, these tight-knit teams get to youth earlier than any one service could, taking every domino into account and preventing chain reactions from going any further.
As the COVID-19 pandemic has so frequently shown us, this kind of preventative approach pays dividends. For every dollar invested in the ACCESS Open Minds model, the healthcare system is saved an average of $10 in service costs. Because youth are often being seen and helped before things take a turn for the worse, taxpayers pay up to $4,500 dollars less per young person per year when these sites are in the community. Even more importantly, youth themselves are reporting that the model works. Across the country, youth who access these services are reporting reduced distress, less severe mental health concerns, and improvements in school, work, and social functioning.
Perhaps the most unique thing about ACCESS Open Minds, however, is its youth-centred approach. Following the mantra “nothing about us without us”, ACCESS Open Minds has partnered with youth themselves to co-develop everything from the visual aesthetic of each site to the fundamental evaluation questions that drive service improvement . Each site has advisory bodies made up of local youth who tailor the project's nation-wide principles to the unique context of their home. This means many sites have become de facto community centres, providing art nights, tutoring, cooking classes, and a plethora of other activities developed by youth, for youth.
Healthcare workers may know how to run a clinic, but community members know what their friends and families need in the day-to-day. ACCESS OM gives them the means to provide that while still contributing to a national evaluation and knowledge-sharing network.
At the national level, ACCESS Open Minds is informed by the National Youth Council, a youth-driven oversight and advisory body. As members of this council, the authors of this article have intimate knowledge of the mental health system. Many of us have experienced first-hand the ways in which the current system can fail youth, and we are sharing the alternative proposed by ACCESS Open Minds because we believe that, together with researchers and clinicians from across the country, we have contributed to developing a model that will help get Canada through this historic crisis.
Young people have a profound investment in how the coming months and years will play out. The future wellbeing of our friends, our siblings, and, indeed, our entire generation is at stake in the decisions we make today as a country. We must go beyond the well-worn mantras of destigmatization and self-care, and instead accept that a national integrated mental healthcare solution is needed. By seamlessly bridging the clinic and the community, ACCESS Open Minds offers just that.
Co-written by the Access Open Minds National Youth Council, led by Feodor Poukhovski-Sheremetyev (co-lead) with contributions from Jimmy Tan, Tess Carrigan, Gabriella Urgel, Emily Saunders, and Chloé Guinaudie.