ER protocol helps create safe space for youth

August 10, 2018

This year’s International Youth Day on August 12th focuses on ‘Safe Places for Youth’– places that are inclusive and respectful, and where the dignity and safety of youth are assured.  

For the one in four youth aged 15 to 24 in Canada who will experience mental health issues in any given year, finding that safe place to go can be a challenge, especially for youth in crisis. For these youth and their families, the Emergency Room is often seen as the only place to get help.


The ER was a familiar place for Alex Girling, a youth who struggled with mental health issues growing up and in his teenage years. Alex is candid when he says “Some of the ER visits were helpful and some were not”.

Ensuring a safe and reassuring experience for youth, and providing a consistent approach to care, was the goal of the ER Protocol working group of the Child and Youth Mental Health and Substance Use Collaborative funded by Doctors of BC and the BC government through the Shared Care Committee.

Doctors of BC and the power of partnerships

As a youth with lived experience, Alex joined a Local Action Team of the Collaborative in his area, and became involved in the ER initiative, sharing details of his own ER experiences - what worked well, what could be improved, and how to approach conversations with youth in crisis. As a result of the work of the team, including physicians, staff from the Ministry of Children and Family Development, school counsellors and others, an ER protocol was created.

Safety and Follow-up

The protocol comprises five components to ensure youth and families do not fall through the cracks. ER staff receive training on the protocol so they feel skilled and confident to care for youth, from the time of their arrival, through to discharge.

A comprehensive psycho/social assessment tool, and a communication and safety plan ensure follow-up, and the appropriate referrals to care and support after youth leave the ER. More than 30 hospitals have now implemented the protocol, and training continues to take place across the province.

In a training video developed for staff on the ER Protocol, Alex raises awareness of the youth perspective by sharing what he found helpful, as well as factors he felt negatively affected his situation in the ER, that could be prevented. You can listen to his story here.

Short ER Protocol Training Video (18 mins)

ER Protocol Fact sheet & Resources