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At 18, most teenagers have a support system of family and friends who can help them learn the life skills needed for a smooth transition to living as an independent adult. However, many transitioning out of government care may face this next phase on their own because they are no longer eligible for the type of support they received while living in care. Should they not have access to proper support, they can become “instant adults” without the knowledge, resources, support, and system navigation skills needed to access physical and mental health services. Studies across Australia, the UK, the USA, and other countries highlight the importance of structured transition programs that provide mentorship, life skills training, and long-term support. Without these supports, youth transitioning out of care can face significant challenges, including homelessness, social isolation, and increased involvement in the criminal justice system.*
* Assefa, M., Kassam, A., 2025. Connections: Year 7 Evaluation (Report). Child Welfare Institute, Children’s Aid Society of Toronto.
Introduced in 2018, the Connections Program is an initiative designed to improve access to physical and mental health support for youth transitioning out of care, particularly those with complex needs such as severe chronic health conditions, developmental disabilities, or profound mental health issues that require specialized, high-intensity, and coordinated support. These individuals often need interdisciplinary care, involving health, social services, and education to improve their quality of life and safety.
Housed within the Health Services Department at Children’s Aid Society of Toronto (CAST) and funded by Children’s Aid Foundation of Canada (CAFC) with generous contributions from GreenShield and The Peter Gilgan Foundation, the Connections program offers both in-house care and referrals to community services.
Serving youth aged 18-29, each participant is paired with a nurse navigator – a registered nurse who conducts a thorough assessment structured to create a holistic view of the youth’s current situation and develops an individualized plan to address their unique needs. Once the assessment is complete, the nurse navigator provides health advice, advocates on the youth’s behalf, and connects them with community resources. Since its inception, Connections has served nearly 1,300 young people in the last eight years.
Many young people who are referred to Connections are experiencing mental health challenges such as anxiety, depression, PTSD, ADHD, and mood disorders, providing them with full wraparound support makes a big difference in how they cope with those challenges.” – said Mia Vescarelli, Nurse Navigator and Connections Program Coordinator at Children’s Aid Society of Toronto.
In addition to the nurse navigator’s support, Connections also provides key services, including:
- Psychotherapy, where youth receive funding for up to 20 sessions with licensed therapists to address anxiety, depression, trauma, and stress management.
- Psychoeducational assessments to evaluate learning challenges and cognitive strengths.
- Short-term primary care and medication management to ensure medical stability.
- Psychiatric consultations to help youth access appropriate long-term psychiatric care.
Vescarelli emphasizes the importance of the nurse navigator and youth working together as a team to ensure that the support provided recognizes the youth’s trauma and considers the strengths and vulnerabilities of the health care system. She sees how resourceful and resilient these young people can be, but that doesn’t mean that they can all navigate the system on their own. “It’s a big, complex system and you need to walk alongside them and help them understand what their needs are and what services are available to them.”
Youth who have participated in the program have said that having a dedicated caseworker who provided consistent check-ins, emotional support, and accountability was important to them.
“I received support with getting an updated psychological assessment. Since then, I have started the process of getting prescribed the right medication for my ADHD diagnosis,” said one youth participant. Another youth indicated that having someone understand their story and connect them with the right resources was a blessing. “The nurse navigator was very respectful and understanding, she has an approachable, sweet, and patient demeanor that is uplifting for sensitive clients who have gone through trauma.”
The desired outcomes of the program are to ensure that youth transitioning out of care can easily access community-based services in a timely manner that respects their identity and culture.
Vescarelli believes that delivering this type of coordinated transitional mental health program to youth aging out of care helps prevent mental health crises, reduces long-term involvement in the system, and promotes stability. “Most importantly, I think it communicates to young people that they’re not alone in navigating their challenges. Health care barriers are dramatically reduced when someone provides them with the care and guidance they need.”
With continued donor support, programs like Connections can ensure more youth have access to the care and guidance they need to enter and navigate adulthood with confidence.
