Be Safe: Youth with lived experience contribute expertise

Evidence in Action

What you need to know

As part of Ontario’s Systems Improvement through Service Collaboratives (SISC) initiative, the Centre for Addiction and Mental Health (CAMH) partnered with the provincial youth mental health program mindyourmind to support the work of the London Service Collaborative.

Through this partnership, youth with lived experience have contributed their expertise to help develop Be Safe, a mobile app with a paper-based “pocket guide” companion. This resource is designed to help youth manage mental health and addiction crises and identify services in London and surrounding areas.

In the latest Evidence in Action, EENet’s Andrea Flynn profiles how this app came to be. Read this profile below or access the PDF here.

Evidence in Action profiles knowledge generation, exchange, and implementation activities across Ontario.

Youth partners from mindyourmind, members of the London Regional Implementation Team, and mindyourmind co-founder and program director Maria Luisa Contursi in mindyourmind’s London office. The London Service Collaborative

As part of the Systems Improvement through Service Collaboratives (SISC) initiative, the Centre for Addiction and Mental Health (CAMH) partnered with the provincial youth mental health program mindyourmind to support the work of the London Service Collaborative. 

Through this partnership, youth with lived experience have contributed their expertise to help develop Be Safe, a mobile app with a paper-based “pocket guide” companion. This resource is designed to help youth manage mental health and addiction crises and identify services in London and surrounding areas.

[Pictured above: Youth partners from mindyourmind, members of the London Regional Implementation Team, and mindyourmind co-founder and program director Maria Luisa Contursi in mindyourmind’s London office.]

About the SISC Initiative

SISC is one of 22 initiatives housed under Ontario’s 10 year Comprehensive Mental Health and Addictions Strategy. Since 2011, 18 Service Collaboratives have been created across the province, including 14 geographically-based Collaboratives and four justice-based Collaboratives. 

Service Collaboratives bring together stakeholders from various sectors to improve coordination of and access to mental health and/or addiction services, with a main focus on children and youth. CAMH is sponsoring the SISC initiative and is collaborating with provincial and local agencies to support the Collaboratives. 
 

The London Service Collaborative is working to improve support and continuity of care for youth with mental health and addiction needs as they transition from the Pediatric Emergency Department to community services, as well as between different community agencies. The evidence-informed intervention being implemented to address this system gap includes various components: 

  1. Procedures to share essential information across agencies. Such information includes the results of screening and/or assessment, clients’ needs and preferences (e.g., their preferred language of service), and which services they are receiving. 
  2. Continuity of care. This involves choosing a contact person in each agency who is clearly identified to the client and their family, and who will ensure the client’s transition is successful. 
  3. Educating youth and families on available services and helping them manage mental health and addiction crises. This component consists of the resource toolkit Be Safe, described below. 

SISC’s definition of evidence includes research, expertise based on clinical practice, and clients’ lived experience. The London Service Collaborative used each of these types of evidence sources when designing their intervention, specifically including: 

  • the Transitional Discharge Model;1,2
  • the Emergency Department Clinical Pathways for Children and Youth with Mental Health Conditions/Addictions;3 and 
  • the lived experience of youth, integrated into the project with the support of clinical expertise in the youth mental health field and drawing from research on meaningful youth engagement. 

Developing Be Safe

A Partnership Is Born

The partnership between CAMH and mindyourmind was brokered by Deana Ruston, a youth member of the London Service Collaborative and a youth partner at mindyourmind
When the Collaborative decided that youth and their families would benefit from knowing which community services would be best for them to access under different circumstances, it occurred to Ruston that mindyourmind could partner with CAMH to develop an educational resource for youth. She presented this idea to the CAMH Regional Implementation Team that is supporting the London Service Collaborative, and the partnership between CAMH and mindyourmind was born, with Ruston acting as the liaison.Youth-Adult Partnerships and the Expertise of Experience

A key goal of SISC is to involve youth with lived experience in a meaningful way to effect system change. In the case of the London Service Collaborative, youth have occupied an integral role through their direct involvement in conceptualizing and developing Be Safe. Youth involvement in this project has been facilitated by mindyourmind’s youth-adult partnership model of engagement.  

, a program of Family Service Thames Valley, is perhaps best known for their award-winning website, where youth can access information, resources and tools relating to mental health issues. mindyourmind’s goals are: 

  • to engage youth and youth-serving professionals to collaboratively work together to reduce the stigma around mental illness; 
  • to increase access and use of services and support for mental health and emotional problems; and 
  • to partner with youth so they amplify their strengths and design for social change. 

The program’s outreach activities commonly make use of technology, such as social media and online platforms, to give youth resources, skills, and information that will help them manage mental health difficulties and get help. Design Thinking,4,5 a creative approach to understanding and solving problems, also strongly informs their work.

Importantly, youth are actively involved in all of mindyourmind’s work. As true partners, youth and adults complete projects as peers with mutual decision-making power, bringing their respective expertise to help reach shared goals. 

The philosophy behind ’s approach is that actively involving youth as partners in program planning and decision-making processes creates a supportive environment that encourages them to contribute their knowledge. Evidence from the research literature as well as from mindyourmind’s own evaluation work suggests that the youth-adult partnership model is a successful and sustainable approach to youth engagement.6,7,8,9,10,11,12

The Process

In developing Be Safe, eight youth contributed their knowledge of what they needed at times of crisis based on their own experience navigating the system. They also brought to the table their expertise of how to best use technology to reach youth, and how service providers can engage youth to use the resource toolkit. 

The first step in developing Be Safe was a weekend-long intensive development session – a Youth Design Studio – in June 2013. Eight youth recruited from mindyourmind’s pool of youth partners participated in this session, which was co-facilitated by mindyourmind staff and youth partner Deana Ruston. By the end of the weekend, the youth had tentatively mapped out and designed the key elements of the mobile app and paper-based “pocket guide” companion. 

Since the Design Studio, youth partners and staff at mindyourmind have worked together to refine the content and format of the mobile app and pocket guide, in ongoing consultation with members of the London Service Collaborative and the CAMH Regional Implementation Team supporting the London Collaborative. 

Youth have been involved at all stages in the process, including contributing to the design of the mobile app alongside mindyourmind tech staff and an external developer (rtraction). Youth were also involved in consultations with community clinicians held to ensure that Be Safe provides accurate information and is aligned with evidence-based practices. They also provided input on Be Safe’s evaluation plan. 

Be Safe’s Components

Mobile App

The app component of Be Safe includes various features designed to help youth manage mental health crises and get help in the London community and surrounding areas, including:

  1. A decision tree, in which the user responds to questions about their immediate circumstances (e.g., whether they or someone else is in danger) and their mental and emotional state. Based on their answers, the app provides suggestions of the resources in London and surrounding areas that might be most appropriate or helpful.
  2. A “Be Safe Plan,” where the user records their key personal information (e.g., name, address), the medication they’re taking, and some personal coping strategies.
  3. A personalized “Get Help” Script, where details are drawn from the user’s personal information to provide suggestions of what they might want to share with professionals or other supports if they are reaching out at times of need or crisis.
  4. A list of resources for mental health and addiction in London and surrounding areas, which provides the service name, a short description of the services offered, the phone number, hours of operation, and ages served.

The app was designed to be widely accessible. It has a clean interface, uses clear language, and uses colours that can be seen by individuals with colour blindness.

Pocket Guide

A companion paper version of the mobile app was also developed to make sure that youth who do not have mobile devices can benefit from the resource or to serve as a back-up copy that youth can keep in a safe location or give to a trusted person in their life. The pocket guide can also be used in a service setting (for instance, so that service providers can help youth complete their Be Safe Plan). The pocket guide includes the Be Safe Plan, a listing of emergency resources in London and surrounding areas, and some key questions to help users identify which resources would be most useful depending on their needs at the time. The pocket guide also includes a space for the user to add an inspirational quote or image.

Dissemination 

Be Safe is being shared with service providers on the London Service Collaborative and more broadly in the London Middlesex community, with key targets including educational institutions and other avenues for reaching youth directly. The app and pocket guide companion are available for free download through mindyourmind.ca/interactive/besafe. The mobile app is also available free of charge in the Apple and Google Play stores. 

Evaluation 

Evaluation is a central goal in both the SISC initiative and ’s work. Several mechanisms are in place to assess the youth-adult partnership model used in the project, as well as to examine youths’ views of Be Safe. For example, London Service Collaborative members will receive a survey to give feedback on the involvement of youth in the initiative.

he youth who helped develop Be Safe will be participating in a focus group about their experience. To help evaluate Be Safe, a survey will be available on mindyourmind’s website and can also be directly accessed through the mobile app. Ongoing efforts will be made to seek feedback from youth and service providers as Be Safe is rolled out. 

Using Be Safe in Other Communities

Because Be Safe was designed to support the London Service Collaborative, the community resources included in the toolkit are specific to the region. However, the remainder of Be Safe’s content is not geographically specific, and could be useful to youth across the province and beyond. In consultation with mindyourmind, the app and paper companion can be adapted for use in other communities at a reasonable cost. For more information about mindyourmind or Be Safe, contact info [at] mindyourmind [dot] ca.

For more information about the London Service Collaborative, contact Beth Powell, Regional Implementation Coordinator: beth [dot] powell [at] camh [dot] ca.

Author: Andrea Flynn
Posted: March 21, 2013

References

  1. Forchuk, C., Reynolds, W., Sharkey, S., Martin, M.-L., & Jenson, E. (2007). The Transitional Discharge Model: Comparing Implementation in Canada and Scotland. Journal of Psychosocial Nursing, 45(11): 31-38.
  2. Forchuk, C., Reynolds, W., Sharkey, S., Martin, M.-L., & Jenson, E. (2007). Transitional Discharge Based on Therapeutic Relationships: State of the Art. Archives of Psychiatric Nursing, 21(2): 80-86.
  3. Provincial Council for Maternal and Child Health. (2012). Final Report of the Emergency Department Clinical Pathways for Children & Youth with Mental Health Conditions/Addictions Work Group. Provincial Council for Maternal and Child Health.
  4. Brown, T. (2008). Design Thinking. Harvard Business Review, June. Retrieved 5 March 2014 from http://www.stanford.edu/~denes/PolandTop500Innovators/General/R0806E-PDF...  
  5. Beckman, S.L., & Barry, M. (2007). Innovation as a Learning Process: Embedding Design Thinking. California Management Review, 50(1): 25-56.
  6. Norman, J. (2001). Building Effective Youth-Adult Partnerships. Transitions, 14(1): 10-12.
  7. Wright, S. (1999). Youth as Decision Makers: Strategies for Youth Engagement in Governance and Decision-Making in Recreation. Toronto: Laidlaw Foundation. Retrieved 3 March 2014 from http://lin.ca/sites/default/files/attachments/nl17.pdf 
  8. Hart, R. (1992). Children’s Participation: From Tokenism to Citizenship. Florence: UNICEF Innocenti Research Centre. Retrieved 3 March 2014 from http://www.unicef-irc.org/publications/pdf/childrens_participation.pdf 
  9. Pereira, N. (2007). Ready… Set… Engage! Building Effective Youth/Adult Partnerships for a Stronger Child and Youth Mental Health System. Toronto: Children’s Mental Health Ontario & Ottawa: The Provincial Centre of Excellence for Child and Youth Mental Health at CHEO.
  10. Dyer, C. (2011). The Art of Youth Engagement: A Guide for Training Youth Engagement Practice within Mental Health Centres. Toronto: The New Mentality.
  11. Garinger, C. (2012). mindyourmind Final Program Evaluation Report. London, ON: mindyourmind.
  12. Garinger, C. (2010). mindyourmind Evaluation Report. London, ON: mindyourmind.