Toronto, ON (September 17, 2025) — Youth living with mental health and substance use challenges can access services faster, and with less reliance on hospital-based psychiatric care, according to a study recently published in JAMA Network Open. The trial found that young people receiving this new kind of community-based care began services nearly three times sooner and required fewer psychiatric resources than those in hospital outpatient programs, providing strong support for integrated care and potentially demonstrating significant cost savings to the health system.
This approach is based on an integrated youth services (IYS) model, which brings together mental health, substance use, primary care, peer, family and social supports under one roof. In the study, the IYS model was delivered through an integrated collaborative care team (ICCT), which offered coordinated, community-based services designed with and for youth. The findings provide the first rigorous evidence supporting the effectiveness of both IYS models broadly and the Youth Wellness Hubs Ontario (YWHO) approach that was inspired by the study and has been scaled across the province.
The study, known as the YouthCan IMPACT project, co-led by CAMH Senior Scientists Drs. Jo Henderson and Peter Szatmari, is the first randomized clinical trial worldwide to compare an IYS model with traditional hospital outpatient adolescent psychiatry services. From 2016 to 2020, youth aged 14 to 17 and their caregivers took part in the study across Toronto. Participants were randomly assigned to receive care through either a hospital outpatient mental health program or an ICCT. Hospital sites included CAMH, Sunnybrook Hospital, Michael Garron Hospital, North York General and SickKids. ICCT sites were located in central Toronto, Toronto East and Scarborough, led by Lumenous Community Services (known at the time as Skylark Children, Youth and Families) and Strides Toronto (known at the time as East Metro Youth Services).
Results showed that while youth in both groups experienced meaningful improvements in mental health and functioning, those in the ICCT group began services within nine days on average, compared to 27 days for the hospital group, and required fewer psychiatric resources.
“This study provides the strongest evidence to date that integrated youth services can deliver care that is both accessible and effective, while also reducing pressure on hospital-based systems,” said Dr. Jo Henderson, who is also Chief Scientific Officer of YWHO. “It was only possible because of deep partnerships between hospitals, community organizations, youth and families. By working together, we showed that it’s possible to redesign the system, so young people get the right supports, in the right place, at the right time.”
The trial laid the foundation for the YWHO network which has since grown to 32 locations across the province. These hubs provide youth-friendly spaces where young people can access integrated services, including mental health and substance use care, primary health services, education, employment, housing, and other community supports—all in one location.
A hallmark of the project was youth engagement throughout the research process, from co-designing the model to interpreting the findings. “Youth were not just participants in this study—we were partners,” said Mahalia Dixon, a youth contributor to the YouthCan IMPACT project. “We helped shape the services, identify the outcomes that mattered, and ensure that the model truly reflects the realities and needs of young people.”
Community partnerships were also central to the study’s success. “This model was built on strong collaboration between hospitals, community agencies, and youth themselves,” said Heather McDonald, who was with LOFT Community Services during the trial. LOFT co-created the YouthCan IMPACT service delivery model, contributed innovations such as a crisis response model and texting protocols, and delivered services across all three hubs. “By working together, we created a system that is more accessible, more responsive, and ultimately more effective for young people and their families.”
“This research underscores the deep need for and value of integrated care for youth both provincially and nationally, said Carole-Anne Chiasson, Executive Director of YWHO. “To date, approximately 72,000 youth have visited YWHO hubs more than 380,000 times, and they have become a cornerstone of youth mental health care in Ontario, providing low-barrier, integrated supports that are co-designed with youth to reflect their needs. The success of this model is evident in the growing demand for hubs across the province, and in the positive outcomes reported by youth and their families.”
The study represents more than 10 years of work and partnership among CAMH, hospitals across Toronto, community service providers, youth and families with lived experience, and philanthropic partners. It was supported by the Ontario SPOR SUPPORT Unit, CIHR, the Province of Ontario, and numerous philanthropic organizations including the CAMH Foundation, the Marilyn and Charles Baillie Foundation, the Graham Boeckh Foundation, and the Schulich Foundation. In addition, Skylark Children, Youth and Families, East Metro Youth Services, and LOFT Community Services made significant in-kind service contributions to develop and operate the ICCT model.
“This research tells a story of what’s possible when hospitals, communities, youth, and families come together,” said Henderson. “It shows that system change is possible—and that it works.”
About the Centre for Addiction and Mental Health (CAMH)
The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital and a world leading research centre in this field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental illness and addiction. CAMH is fully affiliated with the University of Toronto and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit camh.ca
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