Heffernan, O. S., Herzog, T. M., Schiralli, J. E., Hawke, L. D., Chaim, G., & Henderson, J. L. (2017). Implementation of a youth-adult partnership model in youth mental health systems research: Challenges and successes. Health Expectations, 20, 1183-1188. doi:10.1111/hex.12554
Summarized by Renée Klein Schaarsberg
Notes of Interest: This article describes the implementation of the McCain Youth-Adult Partnerships (Y-AP). Due to Y-APs, youth can be more engaged in decisions that affect them. The research into this specific initiative can provide guidance for other healthcare organizations which are interested in engaging youth.
Summary (reprinted from the Abstract):
By integrating Youth–Adult Partnerships (Y-APs) in organizational decision making and programming in health-care settings, youth can be engaged in decisions that affect them in a way that draws on their unique skills and expertise. Despite challenges, Y-Aps can have many benefits for youth and adults alike, as well as for the programmes and initiatives that they undertake together. This article describes the development, implementation and success of a Y-AP initiative at the McCain Centre at the Centre for Addiction and Mental Health, a large urban hospital.
The McCain Y-AP implementation model was developed based on the existing literature, guided by the team’s progressive experience. The development and implementation procedure is described, with indicators of the model’s success and recommendations for organizations interested integrating youth engagement. The McCain Y-APhas integrated youth into a wide range of mental health and substance use related initiatives, including research projects, conferences and educational presentations. The model of youth engagement is flexible to include varying degrees of involvement, allowing youth to contribute in ways that fit their availability, interest and skills. Youth satisfaction has been strong and both the youth and adult partners have learned from the experience.
Implications (reprinted from the discussion and conclusion):
The McCain Model of Youth Engagement at CAMH was developed using the best available evidence to support the creation of a Y-AP for a mental health-care environment and bolster youth participation in research and other processes. Through collaborative implementation that emphasizes framework-informed guiding principles and adaptation, the Y-AP grows increasingly better equipped to meet the needs of the YEFs and the youth they engage. By upholding core principles of flexibility, mentorship, authentic decision making and reciprocal learning, the McCain Y-AP fosters healthy relationships and genuine partnerships. Within two years, the Y-AP has built McCain capacity to meaningfully engage youth in a wide variety of activities, including research projects, educational presentations, conferences and media and promotional activities.
CAMH’s NYAC emerged from the McCain Model of Youth Engagement. NYAC’s approach to engagement is flexible, casual, developmentally-informed and responsive to individual needs. NYAC is a low-barrier option that allows young Canadians to get involved in mental health conversations according to their skills and availability. Implementation of this model has resulted in high levels of meaningful youth engagement.
The McCain Y-AP integrates key components of youth engagement: flexibility, mentorship, authentic decision making and reciprocal learning, attaining the highest rung of Hart’s (1992) youth engagement ladder, ie, youth-initiated, shared decisions with adults. The challenges of power imbalances have been successfully navigated and youth have been integrated into the McCain team.
Learning from the challenges previously reported, flexibility was integrated into the model, enhancing its success. A multi-level mentorship structure, in which adults mentored YEFs, adults learned from YEFs and YEFs mentored a broader network of youth, created a welcoming environment where a diversity of opinions, contributions and strengths are respected and valued. The result has been skill building that prepares youth to become engaged adults, with potential positive long-term impacts on their health outcomes, while helping guide the adult allies in the development of youth-friendly initiatives.
This process has been a considerable learning experience for the McCain Y-AP team and the organization as whole. Based on this experience, we propose several recommendations for health-care organizations wishing to implement Y-AP initiatives. Y-AP planners should remember that engagement and partnership do not have to be perfect. The key is to stay true to core values and strategies in finding creative ways to reach out to youth. As illustrated by the McCain Model of Youth Engagement, there are many ways to engage youth appropriately and meaningfully, even without extensive resources.