I stood in the hallway of a Victoria youth drop-in center last Tuesday, watching as 16-year-old Marissa (not her real name) spoke quietly with a counselor. Three months ago, she had waited eight weeks for her first mental health appointment. By then, her anxiety had spiraled into something more complex, requiring specialized care she couldn’t access for another three months.
“It’s like they expect us to schedule our crises,” she told me later, twisting the sleeve of her oversized sweater. “Everything’s disconnected. Every new person asks the same questions, and nothing talks to anything else.”
Her experience echoes across Canada, where young people navigate a mental health system that often resembles a maze with missing paths. The consequences are staggering: 70% of mental health problems emerge before age 18, yet most youth don’t receive timely, appropriate care. The pandemic only intensified these challenges, with emergency department visits for youth mental health crises rising sharply since 2020.
But a groundbreaking initiative led by McGill University researchers aims to transform this fragmented landscape through a $3.9 million project called ACCESS Open Minds Youth Mental Health Network.
Dr. Srividya Iyer, Scientific-Clinical Director of the initiative and Associate Professor at McGill’s Department of Psychiatry, has spent years listening to youth describe their frustrations. “Young people have been telling us what they need,” she explains during our video call from her Montreal office. “They want services that are responsive, integrated and don’t make them retell their stories over and over. Our current systems weren’t designed with their needs in mind.”
The project is bringing together researchers, clinicians, youth, and families from across provinces and territories to redesign how mental health care works for people aged 11 to 25. Rather than simply adding more services to an already confusing system, they’re focusing on fundamentally changing how care is organized, delivered, and experienced.
At demonstration sites in six provinces, the team has implemented several key reforms: single-entry points where youth can access services without referrals, guaranteed first assessments within 72 hours, and specialized care within 30 days. Perhaps most importantly, they’ve put youth in decision-making roles throughout the process.
“What makes this approach different is that we’re not just consulting young people—they’re actual partners in designing and evaluating these services,” says Dr. Iyer. “When youth tell us a particular approach isn’t working, we change course.”
In Nunavut, where mental health resources are especially scarce, the team worked with Inuit youth to develop services that respect cultural values and traditional knowledge. At an Uqausivut, a community gathering space in Iqaluit, young people helped design a warm, welcoming environment that feels nothing like a clinical waiting room.
“Our young people needed a place where they felt safe and understood,” explains Sarah Jancke, a community coordinator who collaborated with the McGill team. “Mental health support that doesn’t acknowledge who we are as Inuit isn’t going to work.”
Early results from the initiative are promising. Across demonstration sites, the waiting time for initial assessments dropped from months to days. More importantly, youth engagement with services increased significantly—a crucial metric since many young people traditionally disengage from mental health services after negative first experiences.
The Canadian Institutes of Health Research has taken notice, supporting the project’s expansion to sites in Saskatchewan and other provinces. Statistics Canada reports that about 20% of Canadians aged 12 to 17 have a diagnosable mental health condition, yet fewer than a third receive appropriate care. The economic cost of untreated youth mental illness is estimated at $51 billion annually, according to the Mental Health Commission of Canada.
When I visited one of the Montreal ACCESS sites, I noticed an atmosphere unlike typical clinical settings. The space features art created by youth who use the services, comfortable seating arrangements conducive to conversation, and staff trained specifically in youth engagement.
“We know that first impressions matter enormously,” explains Michel Larue, a peer support worker who experienced his own mental health challenges as a teenager. “If a young person walks in and immediately feels judged or out of place, we’ve already failed. Everything about this space is designed to say ‘you belong here.'”
The initiative goes beyond physical spaces. Researchers are developing digital tools that allow youth to track their own progress and share only the information they choose with providers. They’ve also implemented “no wrong door” policies, ensuring that regardless of where a young person enters the system, they’re connected to appropriate care without having to navigate administrative boundaries between services.
In British Columbia, where I met Marissa, the provincial government is watching the McGill-led initiative closely. The province recently announced additional funding for youth mental health, influenced in part by the project’s early successes.
“We’re seeing evidence that this approach not only improves clinical outcomes but is more cost-effective,” says Dr. Patricia Conrod, a researcher involved with the project. “When young people receive appropriate care early, we prevent more serious and costly interventions later.”
For Indigenous communities, the project incorporates traditional healing practices alongside conventional mental health approaches. “Mental wellness looks different in different cultural contexts,” explains Elder Joseph Naytowhow, who advises the Saskatchewan site. “These services must honor the whole person, including their cultural identity and community connections.”
As Canada faces what many are calling a youth mental health crisis—with suicide remaining the second leading cause of death among young Canadians according to Health Canada—the stakes couldn’t be higher. But Dr. Iyer remains cautiously optimistic.
“System change is hard, messy work,” she acknowledges. “But we’re proving it can be done when we truly center youth voices and experiences.”
Back in Victoria, Marissa is hopeful that initiatives like this might create better experiences for others. “Maybe someday kids won’t have to fight so hard just to get help,” she says, gathering her backpack to leave. “Maybe they’ll just get to focus on getting better.”
