Leveraging integrated youth services (IYS) for social prescribing: A case study of Youth Wellness Hubs Ontario

Mental health service use among youth continues to be low while treatment for substance use has been found insufficient at meeting youth needs. Youth seeking services commonly experience multiple internalizing and externalizing difficulties as well as other challenges, such as substance use, that, when are unaddressed or under-addressed, can lead to poor developmental outcomes. The need for quality integrated services addressing these issues concurrently is well documented, yet service frameworks adopting this approach are largely absent from practice. Addressing this service gap, Integrated Youth Services (IYS) is an innovative care approach that incorporates Social Prescribing (SP) practices through establishing multidisciplinary teams of professionals who work together to meet the co-occurring needs of youth and their families. IYS establishes a shared vision of delivering youth services across an integrated network of providers thereby transcending the capacity of individual programs and leveraging the power of a collective network providing wholistic support and reducing fragmentation of care. IYS exemplifies an innovative approach to SP through the development of a closely connected network of inter-disciplinary service providers Social prescribing refers to community-based activities that are person-centered and aim to support individuals in addressing their own social and health needs through community connections. Core elements of SP include community-based service provision and interprofessional collaboration, and SP is commonly characterized by engagement in referrals from clinical to non-clinical community services and the use of multidisciplinary care teams. Therefore, SP is a tool that complements mental health and primary care, and is highly compatible with the IYS model given that both share the goal of reducing health disparities by enhancing social connectedness, emphasizing engagement with non-clinical community services, and reducing health system utilization. Both approaches involve connecting youth to community-based social supports, which often includes screening for needs and actively supporting access to services. Moreover, a key pillar of both SP and IYS is the notion of person-centeredness where interventions are designed to empower individuals to improve their own health. In addition, SP aligns with IYS because both facilitate strong relationships between practitioners by building on pre-existing network strengths, enhancing service tracking, and increasing follow-through when working between services. Evidence supports that challenges with social determinants of health (i.e., access to treatment, food security, employment, education, finances) are common among service-seeking youth, and models of IYS provide service integrated pathways that address the full range of concerns with which youth are presenting. This study used a case study approach to examine descriptive service-related data to understand the reasons youth visit IYS hubs, the needs addressed in service appointments, and the type of service provided. A comparative analysis of service data found that youth across visits to YWHO Hubs are engaging with multiple services and service providers, with a wide range of needs addressed. YWHO is shown to support service use in multiple ways during the development, implementation, and delivery of services. Next steps would include linking service data with clinical outcome data to better understand how SP contributes to improvement in youth outcomes.