Youth Navigators/Coordinators: Engaging Youth at their First YWHO Virtual Visit:

This is a general sample script that can be referred to by YWHO navigators/coordinators (i.e., the first person with whom a youth speaks) to engage and work with youth when they call YWHO for the first time. It serves as a companion document to “Tips for Building Rapport with Youth” and “Tips for Building Clinical Rapport with Family Members.” There is also related information in “Virtual Full MDS - Q&A for Hub Staff.” This script aims to provide some consistency across YWHO staff members and hub networks (although it can complement similar scripts already used at sites). It also aims to ensure young people are appropriately welcomed in a virtual context, and feel comfortable both speaking with hub staff, as well as providing information to help staff best meet youth needs.

Welcome youth virtually, introduce yourself, provide information:

• “Hi! Welcome to the [site] Youth Wellness Hub! Thanks for reaching out! My name is ____, I use __/__ pronouns, and I [describe your role at site]. Would you be okay sharing your name/pronoun with me? So nice to meet you remotely! Can you tell me how I can help you/why you called the hub today? Or would you like me to tell you about some services that we offer here first?”
  • Try to validate and praise youth reaching out (e.g., having insight to recognize they needed a bit of support at this time), and/or recognize anything they are currently doing to keep themselves well.
  • Try to avoid formal jargon when speaking with youth.
  • Can engage in stress-free/non-controversial small talk (“It’s pretty cold out there today.”)
  • Date of birth and last name to be asked later if youth decide they would like YWHO service.

• Provide information to youth if they want information first (or can do this later on): “Here at the hub, we serve young people ages 12-25. We offer services for youth mental health, substance use, physical and sexual health (e.g., we have a nurse practitioner/RN), as well as employment, education, housing and other community support. It’s a new way of providing service to young people - the hub network is a one-stop shop for youth to access this whole range of services. It’s call-in/walk-in or appointment-based, you don’t need a referral from a doctor, it’s free, we offer services in English and French (if some staff speak other languages at your hub, such as Cree, Ojibwe, or Punjabi, for instance, you can mention this), cultural programming, and it’s all focused on young people. All the staff here want to make this a virtual (and physical) space where you - and all youth - can call/video chat or visit in person and feel safe and supported. We also offer a family support program, as well as inclusivity-focused wellness activities, such as…”
  • Please list some wellness activities (see Glossary below) and culturally-based programs offered through your hub network, such as personal fitness, yoga, beading, resumé writing workshop, “chill space,” newcomer program, art, online activities, etc.
  • Please mention the family support program your hub network offers.
  • Please also know when hub opened doors in person and virtually, in case youth ask.
    
  • If Youth Navigator is on-site, can provide virtual tour to youth via video chat if relevant, verbally describe hub layout/location if youth are interested, or direct youth to any hub pictures on YWHO website
    
    
• “Some of our services are currently available through phone or video/Zoom. (Provide list of currently available virtual services, such as mental health, substance use, primary care, employment services, groups offered, etc.). These services are also listed on our website (if relevant) - I can give you the link if you’d like (youthhubs.ca). Some of our services are also currently available in person at this hub (if relevant), if you are interested, or available, to come in. There are also great wellness and social activities on Instagram, Twitter and Facebook (such as movie nights, quizzes; if relevant; provide links).”
  
  
• “In addition to the services I’ve already mentioned, we also have peer support workers who are here to welcome you to our space - virtually and in person. Peer supporters use their own experiences with mental health and/or substance use, and their recovery journeys, to support you while you access our services. Some peer supporters may run groups (if relevant), and others are available to call and chat with you, even if you end up talking with another care provider at the hub. We all work together to help you with what you may be looking for. Do you have any questions so far?”
  
  

Gather information from youth verbally:

• “Would you mind sharing what led you to call in today?” (This part can be done prior to the information provision above)
  • Summarize what youth tell you to ensure clarity, and mention relevant available services.
  • If individuals are seeking any service but Skills & Well-Being activities, then first name, last name, preferred name (optional), date of birth, and client type (youth vs. caregiver) will be needed to create a profile on the data collection platform. Ensure youth understand why this information is needed.
  • If youth are seeking Youth Wellness Teams service and/or Community and Social Support service (e.g., education, employment, housing/community support), the completion of forms on the data collection platform applies (a link will be emailed out to youth with all of the questions, therefore an email address is required^[1]). If youth are seeking a Skills & Well-Being activity, the emailed survey link process does not apply.
  • If youth do not have an email address or device, please collect the remote mini-MDS over the phone if the youth is able and willing. Let youth know that service providers may ask some more questions at their appointment, if feasible. (Please see "Virtual MDS Q&A Hub Staff” document).
  • If Youth Wellness Teams services are requested, let youth know that you can set up an appointment for them with a service provider as soon as possible, ideally to be seen within the next 72 hours, and that they will be asked to complete some brief forms before then through a link that will be emailed to them along with instructions.
  • If youth have a French language preference, the forms can be emailed in French, and you can connect them to a French language staff member for an appointment if possible. If youth prefer service in another language spoken by a staff member at the hub (e.g., Ojibwe), please connect youth with that staff member for an appointment if appropriate.

• Reassure youth that the service provider/support person will be connecting with them very soon, and let youth know they can call you back at the hub at any time with questions.
• You can let youth know you will follow up with a call in the next week to see how things went/are going for youth.
  
  

Measurement-Based Care (MBC):

MBC is defined as a systematic evaluation of symptoms before or during an encounter, and using the results to inform decision-making about treatment at the individual level.

• “Thanks for filling me in a bit about your situation. At the hub, we ask young people to answer some questions, so that we have more information to make sure we provide you with the most appropriate services we can. As a youth-centered hub, we also want to make sure we’re doing things right and meeting the needs of youth at the hub. The questions that will come to you in an email link are just about you, and your thoughts, behaviours, and feelings. You are the expert of your own life, and we do not want to make any assumptions about you. Some questions might seem personal, but it is really important to us that we hear what you have to say about how you’re currently doing and what you might want help with, so that we can provide the best service to you to meet your needs, and then also monitor together how you’re doing over time.”
  
  
• “We also know that everyone experiences services differently, and we want to know more about how we can keep/make our services as inclusive and relevant as possible. So information we collect over time is also important to learning how we can best support young people in the future. If you were in-person at the hub, we would ask you to answer the questions on an iPad (or on paper if you wanted). We’re also able to email out a link to you, and you can answer the questions on your own time, start and come back to them, and they get automatically uploaded onto our system under your own name, so it’s confidential. Then you and the service provider can review them together at your appointment and talk about anything you want to address.”
  • You can also let youth know that answering the emailed questions, although helpful, is optional, and they would still receive service at the hub in the absence of responses.
  • As mentioned, if youth do not have an email address, you can do the mini-MDS (Self-Rated Health and Self-Rated Mental Health questions) over the phone.
    
    
• “The forms were chosen to be as brief as possible while also learning enough about how you’re doing (e.g., mental health, physical health, substance use, work, school, etc.) to be able to decide with you what type of service may be the best fit at the hub. They’re also used by YWHO to learn what concerns young people have, so we make sure we have the most appropriate programs and services in place.”

• In addition, MBC/collecting information from youth using the screening forms allows for:
  • Youth to self-reflect, set goals, and monitor their progress if relevant.
  • More accurate, efficient, and consistent evaluation of youth needs, and determining whether youth would benefit from being ‘stepped up’ to a more intensive form of intervention.
  • Service providers and youth to better track goal achievement and detect symptom changes.
  • Assistance in informing treatment decisions.
  • Easier coordination of care, as circle of care members are working from the same standardized information.
  • Assessment of whether a program/service is achieving its goal or desired change in the youth who access it.
  • Determination of where refinements may be needed to the way a program/service has been implemented, or how resources can be better allocated.

• Moreover, evidence over 20 years, including many randomized controlled trials, supports using MBC in mental health care. It often surpasses usual care, with better outcomes (e.g., response/remission rates) for individuals receiving psychotherapy for depression, anxiety, or other conditions.
  
  
• Minimum Data Set (MDS) – For more specific information regarding explaining the sociodemographic data collection, and rationale for each clinical screener questionnaire, please refer to the documents and videos on the YWHO Knowledge Base.

• “Do you have any questions so far? Is there anything you would like to add that we haven't discussed? I just want to say again how happy I am that you called, and that help is coming. I can definitely email you the survey link and, if you have any questions at all or don’t understand a question, please feel free to call me at the hub and I will do my best to help (provide phone number and hub opening hours). The survey link email will be coming to you from a do-not-reply email address, so it’s good to have the number here, and there is also more information about our hub network at www.youthhubs.ca”

• “The questions in the link that will be emailed to you usually take about 15-30 minutes to answer; This is just an estimate - for some people it might take less time, for some people it may take more time - you can go at whatever pace is comfortable for you. The questions are just about you and there is no time limit. There is also no pressure to finish up in one sitting. You can answer some questions, save your responses, and use the link that was sent with the questions to re-access the forms to finish them at another time before your appointment. The survey will start again where you left off.” (Please see more information at “Virtual Full MDS - Q&A for Hub Staff.”

• “Before I email out the link and contact the service provider who will be a good connection for you based on what you’ve told me, I wanted to go over consent with you.

Please go through the consent form over the phone with youth (if you feel the youth is capable of providing consent; e.g., “There is a consent form we use to ask for your agreement to share information about you with people from organizations who provide service at the hub. We basically all work together as a team to support you”). As per your own lead agency’s policy on consent, explain situations where you are required to report (i.e., limits to confidentiality; can explain that part of the hub staff’s job is to support youth in keeping themselves safe). Please also accurately answer any of the youth's questions and let youth know that the service provider/clinician will review consent again with them at their first session.

At the end of the conversation, thank the youth again for reaching out, let them know you will follow up with them regarding appointment information (if this information has not already been provided), how a service provider will go through the consent form again (once youth have completed it with the link), and will go through questionnaire results with youth as well. You may want to offer supplementary supports in the interim (e.g., online wellness activities, peer support call if relevant). Reassure youth that the service provider/support person will be connecting with them very soon, and repeat to youth that they can call you back at any time with questions.

Glossary

Inclusivity-focused services and wellness activities:

• Recreation Programs (e.g., board games, video games, “chill space,” movies, music, yoga/mindfulness, personal fitness, nutrition programs/community kitchen, sports - swimming, volleyball)
• Cultural Programs (e.g., Ask Kookum, traditional activities such as beading, Ojibwe language group)
• Arts Programs (e.g., art, dance)
• Guest Speakers (e.g., Education advisor, resumé writing, natural and alternative medicine workshop)
• Food provision
• Quiet study space
• Quizzes, riddles, games on social media

Services:

• Mental Health
• Substance Use
• Health/Primary Care/Sexual Health
• Employment
• Education
• Housing and other Community Supports
• Family Support