Ask the expert: How Foundry BC adapted its model of care to serve children and youth during the COVID-19 outbreak

Throughout the COVID-19 pandemic, Children’s Health Foundation is committed to supporting Island families. This post is part of our Ask the Expert blog series in which our CEO Veronica Carroll interviews experts across Vancouver Island and the surrounding islands on issues affecting children’s health and how families are adapting during these unprecedented times.

Veronica recently connected with Dr. Steve Mathias, Executive Director of one of our community partners, Foundry BC, to learn more about their unique model of care, how  Foundry Centres adapted their services during the pandemic, and the organizations’ plans for expansion on Vancouver Island.

Can you tell me a little bit about your background and how long you have been involved with Foundry BC?  

My work started in the inner city of Vancouver, working with homeless youth who were either staying in a shelter at Covenant House or living on the streets. Based on those experiences and the work of my colleagues doing outreach with homeless youth, we found that many people we served were not from Vancouver; they had come from communities around the province. When we dug a bit deeper, we learned that many of these youth had simply fallen between the cracks. Whether they had left home on their own volition or not, they had migrated to the inner city where it was not a safe environment for them. Collectively, we were inspired to come up with a better solution to try and help these young people.

We began by developing a new model of care that would allow service providers in the community to work together so that it would be abundantly clear to young people where they could get help. While the initial focus was to ensure there were mental health and substance use supports in place, we also ensured that physical health and critical social services were available for young people. We knew that most communities have these services in place, but we realized very quickly that young people have no idea how to access these supports.

Another barrier we identified was that those young people seeking support needed to know “what was wrong with them” to get help. This is a difficult situation because it forces youth to acknowledge or believe that there is something wrong, and it brings so much stigma. With the Foundry model, we aimed to move away from the question of “what is wrong with me” and move towards the question of “how can I get help” or “how can I solve this problem.”

This was our vision back in 2015 when we first sought government and philanthropic support to create these community health and social centres around the province. As a result of leading that work, I became the Executive Director of Foundry BC.

What inspires your most about your day-to-day work?

I love hearing stories from young people who recognize that Foundry is a safe place where they can access the help they need. The way they describe that experience is so heartwarming and unscripted. I find it very inspiring to hear a young person’s account of what it was like to get help, while the work is being done by hundreds of service providers who represent more than 140 different organizations, but for that young person, their experience is with Foundry.

You mentioned that you have centres located across the province. Can you speak to where they are located on Vancouver Island, and if there are plans to open any new centres on the Island?

Right now, we have nine centres located in different corners of the province distributed throughout our local Health Authorities. The first Centre to open under the Foundry model was in Campbell River, with a second Centre following in Victoria, which is supported by Children’s Health Foundation of Vancouver Island. The John Howard Society is the lead agency in Campbell River.

Currently, we are planning on opening two new centres on Vancouver Island, one in Comox Valley and one in Port Hardy.

If someone wants to access the supports at Foundry BC, is an assessment or referral required?

No – part of our strategy is to make our services as low-barrier as possible. Most of the youth we serve walk-in self-referred or have heard from a family or friend that this service exists.

Foundry BC recently adapted its service offerings to include virtual supports. Was that done in response to COVID-19 or is this something that had already been planned?

Both. The move to offer virtual supports at each of the centres happened organically. When COVID hit, our centres didn’t want to shut their services down; they wanted to ensure that young people could continue to access the support they needed, so they moved overnight to providing virtual care.

Provincially, we recognized that there were going to be a lot of young people who could not access resources because they did not have a Centre nearby. To meet that need, we developed a network of clinicians and counsellors that could offer counselling services virtually. We have been operating now since early April, providing solution-focused, single-session, walk-in counselling to any youth that calls our number. Our hours typically range from 1:00 pm to 8:00 pm every night.

With the addition of virtual supports, have you noticed an increase in youth from rural and remote communities accessing this service?

I think it is trending in that direction. There was a lovely blog on the First Nations Health Authority website about a young man from Haida Gwaii recommending our Foundry services to others, so we are seeing the breadth of young people coming through, who represent all ages as well. We are seeing young people from the ages of 12 to 24 calling in.

We are also getting folks from larger communities, like the City of Surrey. Surrey, which does not have a Foundry Centre, so it is exciting that those youth are now getting help.

Has there been an increased demand for services resulting from the pandemic?

Demand is difficult to measure. It is entirely likely that we have young people who want help, but who may not feel safe visiting a Centre in person due to COVID and are not accessing care due to social distancing. I think that as more people become aware of our virtual service platform, demand will pick up exponentially.

Have there been any common questions/concerns you have heard from youth since the outbreak of COVID-19?

Most of the questions we receive from youth are similar to what we have heard in the past. More than anything, young people continue to struggle with anxiety and depression, whether they are isolated or not. We also continue to get questions from young people about where and how to access services and supports.

Is there any advice you would give to parents or caregivers who are concerned about their child’s mental health at this time?

COVID has provided parents with a remarkable opportunity to form deeper connections and engage in more dialogue with young people, because we are living in such close quarters. If you are comfortable having those conversations, I would suggest checking in to see how your child is feeling. What do they miss about their life before COVID? What are they finding difficult?

We naturally assume that there is going to be a spike in anxiety for young people, but it is nuanced. Some young people are less stressed and anxious now because they don’t have to attend school.

My advice to parents is to reflect with your young person – ask questions, try to have meals, and play games together, try to get away from giving opinions. Think about how you can connect with your young person to make them comfortable opening up.

In terms of telltale signs, look for disrupted sleep, changes in eating patterns, changes in interest level, more isolation than you would expect, and expressed feelings like sadness, hopelessness, or intense worry.

If you are concerned or have any questions, please contact us and utilize our services at FoundryBC.ca or connect with a local Centre in your community.

Have you experienced any challenges in delivering support virtually?

Young people are often not used to using platforms like Zoom or Microsoft Teams so that technology can be a bit awkward. We are currently developing an app that will allow clinicians and youth to communicate directly with each other.

One big challenge we face is that not everyone feels comfortable delivering or receiving therapy virtually. A lot of young people would like to make a call, put their earphones in, and go for a walk. They do not necessarily want to sit down at a screen. We have come to understand that we need to be as flexible as possible for young people when they are calling in. That said, some young people prefer to receive virtual care before they meet face-to-face.

Is there a story that you tell yourself that inspires you to continue the important work that you do every day?

The first week that we opened Foundry on Granville Street in Vancouver, I had a patient I had been working with for almost five years. She had seen me in six or seven different locations because we were continually having to move and find new office space, often in unfriendly settings.

I remember when she came in for her first appointment with me, and we started talking about all her health care needs. We touched on substance use, reproductive health needs, as well as some physical health needs, and I told her she could get all those services in one place. I told her to go to the front desk and book all her appointments, and I remember her looking at me and smiling and saying, “so this is like a one-stop-shop?” She immediately understood what we were trying to achieve, and it resonated with her. She was coming in from the suburbs for her services and was spending a lot of time chasing down care providers. The thought that she could just go in and access all those services in one day was a significant relief.

I think that it should be okay that our young people have convenient access to services. It should be okay that we have care providers that work together, see each other, and know a young person as a team rather than as individuals.

Your model stared with the Granville Centre? Is there something about that Centre that inspired you to envision opening centres across the province?

The model we started at Granville was a prototype. When we launched the Foundry initiative, Campbell River was our first Centre, and it was a bit of a litmus test for us to see if two relatively distinct communities would benefit from a similar model.

Some early critics of this model felt it was great for an inner-city but questioned how it would work in a small rural community. What we were able to show is that the Foundry model is successful because it is rooted in establishing partnerships. Unless you live in a community where you are the sole service provider, you will always provide better care through meaningful and intentional partnerships. If you can identify, like we have, the services young people need, you will have young people come in large numbers.

I think the aha moment for us came when we opened the Foundry Campbell River, and hundreds of young people came through the door. Close to 10% of the youth in Campbell River used the Centre in the first year.

Since that time, we have engaged in positive dialogue with seven provinces across the country. We have also been consulting with folks at Stanford University, and they are opening two centres that are going to be very similar to Foundry. The recognition of intentional partnerships coupled with a brand that resonates with young people is a simple, but successful formula.