Using mobile technology to serve transitional-aged youth

Studies show that youth text an average of about 3000 texts a month and always have their mobile phones on them, according to Heather McDonald, Director of Adult & Youth Services. In line with this research, LOFT Community Services field staff now use mobile technology to support and be better linked with transitional aged youth with mental health and/or addiction issues in the downtown Toronto area.

About three years ago, LOFT Community Services decided to re-organize their youth programs to better serve transitional age youth (16-25 years old) with mental health and addiction issues. This shift required research and networking, a change in its programming, and a focus on recruiting service providers who have the competencies needed to work with youth in transition.

This new program started with one community support worker serving 25 clients, and now has 9 community support workers. LOFT serves 212 youth in total – 112 youth in the community and 100 in residence per year.

In the latest issue of Promising Practices, EENet’s Angela Yip profiles LOFT.

Read it below or download the PDF.

Promising Practices profiles innovative practices and initiatives from around Ontario.

About the program

LOFT, once called Anglican House, started as a supportive housing provider in 1953 to serve the Toronto Central and Central Local Health Integration Network (LHIN). Since then, the community agency expanded to serve youth, adults, and seniors through case management, supportive housing, and outreach. 

About three years ago, the organization decided to re-organize their youth programs to better serve transitional age youth (16-25 years old) with mental health and addiction issues.

This shift required research and networking, a change in its programming to ensure they optimized transitions from youth to adult sector, and a focus on recruiting service providers who have the competencies needed to work with youth in transition. This new program started with one community support worker serving 25 clients, and now has 9 community support workers. LOFT serves 212 youth in total - 112 youth in the community and 100 in residence per year.

Using mobile technology to better serve clients

Examples of text conversations
between a community support
worker and a transitional age youth.

Studies show that youth text an average of about 3000 texts a month and always have their mobile phones on them, according to Heather McDonald, Director of Adult & Youth Services.

In line with this research, LOFT Community Services field staff now use mobile technology to support and be better linked with transitional aged youth with mental health and/or addiction issues in the downtown Toronto area. 

Referrals to LOFT’s transitional-aged youth program are mainly through hospital discharges. Clients consist of youth in crisis who need immediate support and rapid service. These youth often have difficulty attaching to others and following through with treatment plans and appointments. So the goal is for staff to create and maintain a sense of attachment and trust with the youth. To accomplish this, there needs to be a strong relationship with the youth and mobile technology makes it easier to achieve this goal. 

The value of using mobile technology

One immediate and positive outcome of using mobile technology is increased client face time. For example, staff can text the client to remind them that they have an appointment. Also, youth appreciate the encouragement they receive from staff via text messaging and say it helps them feel safe and have consistency, because they can access staff quickly.

Julia Vanderheul, Coordinator of the Transitional Age youth Hub at LOFT Community Services, discovered that the youth she works with prefer writing things down and texting than talking directly with the staff. Youth like being able to express their thoughts and feelings in the middle of the night and send a text, then staff can see it in the morning. Julia also noted that sometimes her clients will text her, “where are you now?” and if she has an extra 15 minutes, she can quickly meet up with them. 

The youth say that when they hear the ‘ping’ notifying them that they received a text, it makes them feel thought of, less invisible, liked, and cared about. Some youth say texts are as valuable as face-to-face meetings. It took Heather a while to wrap her head around this departure from the model of face-to-face visits that is used in adult programming.

The youth explained that they will likely forget what was discussed in the meeting, but if it’s a text, they can scroll back and look at messages later. They highlighted the value of taking a screen shot (photo) of supportive texts and they look at the texts over and over again, so they can re-experience that positive feeling of being cared about. Texting is also more cost effective for youth, as they do not have money for phone minutes. It also helps them combat social isolation by being informed of events.    

From Heather’s strategic managerial perspective, she feels that the technology allows each staff to help more youth in less time. Especially for the vulnerable, chaotic youth who need extra support, staff can reach out to them over five times a day. Youth have reported high satisfaction with how accessible staff are and that they are able to get support in a crisis. This is largely due to text communication. Also, the ability to send out mass texts to the 212 youth they serve also saves staff time. For example, LOFT brought in a dentist to provide free services and used a mass text to promote the service to the youth. 

Texting is also a great tool for staff to communicate with each other and ensure they are safe by keeping each other informed of their whereabouts.

How does it work? 

The transitional-aged youth program at LOFT is currently funded by the Toronto Central LHIN, the Ministry of Child and Youth Services, and a significant portion from donors. The mobile phones are included in the organization’s operating expenses, but they did not receive additional funding for this, so they had to adjust expenses to incorporate this cost. Since all staff have the same phone plans, this allowed LOFT a bit of bargaining power with the mobile phone companies. 

Heather stressed the importance of the mobile phones being LOFT phones. Before this practice was in place, if a staff were to use a personal phone to text, their personal number would be shared - which does not set up good work-life boundaries. Managers would not be able to audit staffs’ personal phones and could not ensure that safety, confidentiality and security measures were followed. By providing staff with LOFT mobile phones, there are policies, procedures, and trainings in place that are strictly upheld and reviewed annually. Additional security measures are in place, so if a LOFT phone is lost or stolen it can be locked centrally. Internal auditing is also embedded to ensure quality of services.

Before the texting relationship can begin, the service provider must build rapport with the youth in person and negotiate an agreement to cover issues such as personal boundaries, how and when to communicate, how long it will take the service provider to respond, what to do if they send a text at night and don’t get a response, and who to contact if the service provider is sick or on vacation. It is also important to explain to the youth that texts do not disappear into cyberspace and can be subpoenaed and accessed by the police and the justice system. And there should be a clear conversation about issues such as the separation between the service provider’s work and their personal life and the cost of texting with them.

All staff must be well trained on the policy guidelines, which are available to the public. Among the topics covered are what to do with their LOFT mobile phones when their work day is done and the ban on using these phones for personal calls. 

Dealing with concerns and challenges

Heather said that one reason people are hesitant to incorporate technology and mobile devices is because they feel there is a lack of internal controls. But once expectations, policies, and procedures are clearly laid out, the sky’s the limit. And although it can be a huge investment for a non-profit agency to get mobile phones for every staff worker, she said, the benefits are worth it. 

She also debunked concerns about clients texting that they are suicidal versus communicating this via phone or email. Research hasn’t shown a difference between texting, phone calls, or emails of this nature, Heather noted, but there is an advantage that a text will be received prior to the other forms of communication and the youth are most likely to respond using text as well. In any case, she said, text messages can be audited, for example, to review the quality of service provided, to see if staff completed a risk assessment, if they invited the client to call them, and if youth were given appropriate resources. 

Julia noted that her staff have shown her texts they found challenging to respond to, and asked her advice on how to respond, something that they couldn’t have done with a phone call. Such instances can turn into opportunities for managers to coach staff on boundary setting and quality of care, she added. 

Lessons Learned

Services and how they are provided to adults and youths are different, Heather said. LOFT staff who serve transitional-aged youth generally are now receiving five to 10 times more texts than staff who serve other age groups. For the use of mobile technology to be effective at the program level, it’s also important for everyone — from leadership to staff — to have absolute buy-in and commitment to evolving and to using this technology. That attitude permeates every level of organization at LOFT.

Heather quips that as soon as the organization catches up to one technology, something new will come along. So an organization must be nimble, flexible, and ready to adapt, when the client population consists of youth.

It’s important to evaluate new initiatives in terms of client satisfaction, client-staff attachment, internal controls issues, etc. At LOFT, client impact is evaluated every six months in terms of the social determinants of health, for example looking at such things as mental health supports, housing, and legal involvement.

Through the use of mobile technology with this client group, they have seen improvements such as greater attachment between clients and their service providers and related outcomes. 

Access to clients is changing, so recognizing the positive impact of mobile technologies and balancing the value of face-to-face allows you to see more youth and provides more intensive services for youth who otherwise may have not otherwise be able to access services. 

Next Steps

LOFT now has a 24-hour crisis phone line available through texting as well. This service has just been launched alongside LOFT’s Community Weekend and Evening Treatment Program for transitional-aged youth with addictions, and is available to all LOFT’s clients.

For more information about LOFT Community Services, please contact Heather McDonald, Director of Adult  & Youth Services at HMcDonald [at] loftcs [dot] org or Julia Vanderheul, Coordinator of Transitional Age youth Program at jvanderheul [at] loftcs [dot] org