What is the system challenge?

In the Four Counties area (Peterborough, Northumberland County, Haliburton County and the City of Kawartha Lakes), as in many places throughout Ontario, transition-aged youth (TAY) with complex mental health and addictions challenges often have poor outcomes when transitioning from youth into adult mental health and addiction services.

TAY and their families face challenges navigating a confusing system, struggle with variations in approaches to care, and experience a lack of coordination and flow of information between youth and adult mental health and addictions services.

What are we doing about it?

To address this system gap, the Four Counties Service Collaborative (which evolved into the YT4CC), with the support of the Provincial System Support Program at the Centre for Addiction and Mental Health, developed the 4Step Process.

The YT4CC adapted the evidence and guidelines from Dr. Swaran Singh’s TRACK study to create a process outlining the necessary elements that ensure the best possible transition from child and youth services to adult services. The process for the preferred transition pathways is for youth who are:

  • aged 14-24;
  • experiencing mental health and/or addictions issues;
  • marginalized due to complex needs; and
  • in need of services or transitioning between services.

The 4Step Process aims to ensure the best possible transition for youth by improving the connections between their service providers. The process improves the flow of information and enhances coordination between youth and adult mental health and addictions services and agencies, helping to strengthen a youth’s transition.

Youth and adult mental health and addictions agencies and organizations in Peterborough County, Haliburton County and the City of Kawartha Lakes approved the use of the Four Common Standards in their approach to transitioning youth. The YT4CC used the Four Common Standards to develop the 4Step Process – a protocol of four key steps to follow when transitioning youth between youth and adult mental health services.

Implementing the 4Step Process requires specific activities:

Connection between agencies

  • Networking and learning about the other agencies in order to prepare youth
  • Becoming familiar with all services, new programs and staff

Connection with youth:

  • Start the conversation as early as possible
  • Discuss the process with youth and their supporters
  • Obtain consent to share information with other services

Agency collaboration

  • Connect with adult services and discuss referral
  • Arrange meeting(s) for youth with both services present
  • Familiarize the youth with the new services and staff

A warm hand-off for the transitioned youth

  • The initial provider continues to support the youth until transition complete
  • Have a discussion with youth about closing their file Allow a period of parallel care, including follow up phone calls

In Haliburton-Kawartha Lakes, the Team Approach to Growth (TAG) Committee, made up of agencies and organizations working with youth, has committed to implementing and supporting the 4Step Process.

?What's this?

Full Implementation

TAG is the oversight committee responsible for the implementation of the 4Step Process in Haliburton-Kawartha Lakes. TAG members include youth and adult mental health and addictions agencies and organizations and will mentor other communities across the Four Counties as needed.

The 4Step Process is early in its full implementation in Four Counties. An evaluation guide was developed to support the continued improvement of effective transitions of youth into adult services and is currently being applied.

How do we know it works?

The entire process of transitioning youth to adult services has brought our adult and youth service providers closer together to better serve our community. It has helped identify changes that could be made to our own system here at Point in Time.”

— Mary Sisson, Youth Mental Health Court Worker

Who is involved?

The oversight committee, TAG, is responsible for the implementation and sustainability of the 4Step Process. During bi-monthly meetings TAG receives detailed updates from co-chairs representing the Haliburton County and Kawartha Lakes working groups, including 24 agencies.

Next Steps

Working groups continue to meet bi-monthly to update their work plan for successful transition of youth to adult services. Co-chairs for the Haliburton County and Kawartha Lakes working groups report on implementation progress and provide status updates to TAG membership. The evaluation tools and processes will be sustained within the 4Step Process to further support improved transitional care of youth from youth to adult services.


  • 4Step Process Brochure
  • Status report template provided to TAG
  • Kawartha Lakes Gathering PowerPoint presentation

For more information, please contact:

Heather Lackner