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ED2Foundry: Co-designing interventions to improve youth experience in the ED

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The ED2Foundry project aims to improve the way youth with mental health or substance use needs in the emergency department (ED) are referred to community health services. The project, which ultimately aims to promote integration between these parts of the health system, has recently been extended to expand its work.

Dr. Skye Barbic

“Over half of young people in Canada who go to the emergency department with a mental health concern have never been in contact with mental health services before that point,” said Dr. Skye Barbic, CHÉOS Scientist and project co-lead. “They may not know what kind of services are available to them.”

ED2Foundry was originally funded by the Michael Smith Foundation for Health Research to support a workshop bringing together stakeholders, including community members, care providers, and researchers, to design an intervention to improve how youth are transitioned from the ED to Foundry, a provincial network of integrated youth mental health services with locations around B.C. Along with Dr. Barbic, the project is co-led by CHÉOS Emergency Medicine Program Head Dr. Frank Scheuermeyer, and the study team includes CHÉOS Scientists Drs. David Barbic and Steve Mathias.

Speaking about the impetus for the project, Dr. Scheuermeyer notes that “there is currently no emergency department

Dr. Frank Scheuermeyer

standard of care to connect young people who are having mental health or substance use issues to appropriate services.”

How do we improve mental health care for young people?

Due to the pandemic, the study team collected information about what was needed to improve patient experiences in the ED via one-on-one Zoom and phone calls. Participants included health care providers, other service providers, and family members, representing nine different communities in B.C.

“The general consensus was that the patient experience is just not good enough,” explained Dr. Barbic. “Participants felt that there needs to be a better way to support young people.”

Major issues noted by the participants included the context of the environment (wait times, physical environment, stigma, etc.), the acceptability and effectiveness of the assessments used for young people, and the lack of adequate communication between individuals as well as between different services.

Now, with support from the Providence Health Care Research Institute (PHCRI) and the BC Ministry of Health, the project has been extended to adapt this information into tangible changes at two centres in the province.

“Starting this fall, we will be engaging staff and patients at St. Paul’s and Lion’s Gate Hospitals to begin co-designing interventions to improve the patient experience,” explained Dr. Barbic.

The researchers aim to develop a clinical care pathway that will involve screening in the ED, referral to Foundry or other similar services, and active peer support follow-up.

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