YSSN program helps people with complex support needs get the right support sooner

Comprehensive tool helps break down system barriers for people who require support for Mental Health and Developmental Needs

At its Annual General Meeting (AGM) on June 25, 2025, Your Support Services Network (YSSN) celebrated the success of its Dual Diagnosis System Navigator initiative—an innovative program made possible through a grant from the Ontario Trillium Foundation’s Resilient Communities Fund. The initiative is helping some of the region’s most vulnerable residents—people who live with both developmental and mental health challenges—get the help they need sooner.

A central component of the program is a powerful redesigned tool: a bio-psychosocial assessment. This tool helps staff understand each person’s full situation—including mental health, developmental, and life circumstances—so they can connect individuals to the right services faster. In many cases, the Navigator was able to help people make sufficient progress that they no longer needed to remain on a mental health or developmental services waitlist - a major benefit for both the people served, and the pressured systems that support them.

“These are people whose complex support needs often leave them challenged to access the right services because they span multiple systems,” said Kimberly Thorn, Executive Director of YSSN. “YSSN’s strength lies in our ability to bridge those systems, align resources, and co-design better outcomes. The Navigator is helping us turn gaps into coordinated, person-centred supports that truly make a difference.”

Caregivers are also seeing the benefits of the program, with clearer guidance and reduced stress as they navigate complex systems on behalf of their loved ones. At a broader level, the initiative has strengthened service planning and coordination across the health and social services system. It has contributed to shorter hospital stays, prevented unnecessary admissions, and helped community partners better understand the full scope of people’s needs. These advances are paving the way for long-term change, including new partnerships to create safe, supportive housing.

As part of its tradition of recognizing community partners, YSSN presented a Community Recognition Award to Mackenzie Health’s Centre for Behaviour Health Sciences (CBHS) at the AGM for its key role in advancing the Dual Diagnosis System Navigator initiative. The Centre contributed significantly by improving hospital discharge planning, helping create clear referral pathways, and working with YSSN to pilot a model that supports family involvement in care.

These efforts have strengthened service coordination and improved outcomes for people with dual diagnosis. The award was accepted by CBHS Program Manager John Clarke. By improving both access and coordination of care, the Dual Diagnosis System Navigator is not only helping people and families today—it’s building a stronger, more resilient support network across York Region and South Simcoe now and for the future.

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