PREPARED BY: Senior Management
DATE: 2025-06-26
SUBJECT: Locally Driven Population Health Model - Youth Mobile Mental Health Project
BACKGROUND/PURPOSE
Locally Driven Population Health Models (LDPHM) in Ontario, formerly known as the High Priority Communities Strategy, are community-based initiatives that focus on improving health outcomes for populations with high needs, such as those with chronic diseases or those experiencing inequities in access to care. These models are designed to be responsive to local needs and are driven by community collaborations, including Ontario Health Teams (OHTs), public health units, and community partners.
Benefits of LDPHM include addressing the social determinants of health and providing tailored interventions, improved health outcomes for high-needs populations, reduced disparities in access to care and improve health equity, enhanced partnerships between various stakeholders, and increased engagement of communities in the design and implementation of interventions.
The WECHU supports the local LDPHM as the co-lead of the Steering Committee for this work with Windsor Essex Canadian Mental Health Association and the Windsor Essex - Ontario Health Team.
DISCUSSION
The 2025-2026 workplan for the LDPHM is divided into two streams. The Interprofessional-Led Outreach Teams (I-LOT) for Priority Neighborhoods and the Youth Mobile Mental Health Strategy. Both projects, are working to co-design and deliver services that are:
- Place-based – grounded in the realities of specific neighbourhoods and communities that represent low income, homeless and other racialized communities.
- Equity-focused – addressing root causes of health disparities.
- Collaborative – engaging health and social service partners, community members, and Indigenous organizations.
- Culturally appropriate – recognizing and valuing diverse identities and experiences.
- Integrated – linking primary care, mental health, social support, and prevention.
The Youth Mobile Mental Health Project is a strategy designed to meet youth where they are, with a primary focus on in-school settings. The flexibility of the mobile model makes it accessible to youth who might not otherwise engage with traditional healthcare settings. Mobile clinics are also well-recognized for their ability to improve access to care, especially in marginalized or at-risk communities. Numerous studies show that they improve health outcomes and reduce health care costs.
Although in Windsor and Essex County there are a number of services and programs available supporting the mental health needs of youth, specifically ages 14-18 (secondary school age), the demand for services and the complexity of interventions continue to exceed the supports available. Wait lists and appointment delays continue to plague our local mental health services system, with specific risk around early intervention.
In collaboration with the Windsor Essex Catholic District School Board, Windsor Essex Canadian Mental Health Association, Regional Children’s Centre (HDGH), and the Lead Agency for Child and Youth Mental Health (HDGH), an in-school based mobile mental health strategy launched at the end of May 2025 in one of three planned local secondary schools. Participating schools are in high priority neighbourhoods and have a demonstrated evidence base supporting high mental health needs within the school and school community. The on-site mobile team includes interdisciplinary health professionals specialized in social work and primary care nursing. The service offers access through several streams including;
- One on one (client) – students can walk in, unscheduled during all hours of operation
- Peer (supportive resource) and client – in support of emerging trends that involve peer disclosures and support systems (encouraging youth who see friends in crisis or pre-crisis to attend for support together)
- School (administrator, educator) Support and client – in support of administrators that have lines of communication open with a student and can provide support and encouragement.
- Parent/guardian (with or without client) – for parents to access with or without client to ask questions, understand referral pathways and get guidance on how best to approach issues.
Key features of the mobile mental health services include a focus on early intervention, prevention of escalating mental health challenges, and providing relatable pathways for youth to access services in supportive environments, ensuring accessible hours and locations, reducing barriers like transportation and stigma, and attaching high risk youth and families to primary care.
Evaluation of this model will include standardized program indicators related to reporting requirements as a part of the LDPHM funding agreement, as well as an assessment of the overall impact and outcome value of this innovative model in Windsor-Essex for high-risk youth. Summer programming opportunities within these school locations and surrounding community infrastructure will also be developed and implemented as a part of an overall community and school mental health institute.