ED2Foundry: Enhancing the transition from the emergency department to community services for young people with mental health and substance use disorders

Foundry

Despite a significant rise in emergency department (ED) visits by young Canadians (aged 12-24) with mental health and substance use (MHSU) concerns over a decade, there remains a profound disconnect between ED’s and MHSU integrated youth services such as Foundry. The aim of our work was to better understand the experiences of young people presenting to the ED with MHSU concerns and how they are connected to community services afterwards. We conducted 26 semi-structured phone and in-person interviews with key stakeholders across various communities in British Columbia (BC), including youth, family members, and health providers. We conducted a thematic analysis. Our results yielded three main findings: (1) a need for better communication between youth and service providers, (2) assessment tailored for young people, and (3) youth-centered infrastructure (such as waiting rooms, and more staffing). Based on this, our team will develop an intervention to implement a 2 EDS in BC.

Presenters

Madelyn Whyte
Madelyn is a 23-year-old mental health and substance use activist and researcher. She is a recent biochemistry graduate from the University of British Columbia. She is currently a research assistant at Foundry working on various mental health and substance use studies.

Krista Glowacki
Krista is an occupational therapist who has worked in the field of mental health for over a decade. In 2020, she completed her doctorate exploring the relationship between mental health and physical activity at the University of British Columbia. She is currently the Mental Health Lead at Infinity Health, and a Postdoctoral Research Fellow working with Dr. Skye Barbic and the community organization Foundry, researching the use of Wellness and physical activity programs in the community for youth with mental health and substance use disorders.

Key takeaways

  • There is a strong disconnect between emergency departments and community services ie: Foundry
  • They conducted 26 semi-structured interviews with key stakeholders to idealize the transition process from ED2Foundry
  • Within communication, an ED needs a service user to repeat their story multiple times - this experience can be traumatizing
  • The next theme is person-centered care
  • During assessments, it is important to consider sociocultural components of care. As well, some youth feel that they need to present their symptoms in a way to meet "enough symptom criteria" to receive appropriate supports
  • Intervention ideas - had 9 in total. A range of excellent ideas from their interviews. Some include Care Packages, Education of ED Staff, Implement an Existing Assessment into ED

Key Learning Objectives (defined by presenters)

  1. To describe barriers and facilitators in the current system that can be detrimental to young people when presenting to the ED with mental health and substance use concerns
  2. To acknowledge and better understand how young people with MHSU concerns experience the ED, are assessed within the ED and referred to community integrated youth services
  3. To describe solutions for how the ED experience can be enhanced for young people and families through change at systematic/policy levels, interpersonal levels, and community levels

Key Themes

  1. Youth mental health substance use
  2. Communication in the ED

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