**Background:** Mental health and substance use (MHSU) challenges affect 1 in 4 youth in Canada, with 50-70% developing during childhood or adolescence and a peak age of onset of 14.5 years. The COVID-19 pandemic has exacerbated these concerns, with young people disproportionately affected by employment loss, social isolation, and school closures. Leisure-based activities have been shown to reduce stress, provide protective health benefits, aid recovery from mental illness, improve self-worth, and promote quality of life. Integrated Youth Services (IYS) are community-based, youth- and family-centred models that provide multidisciplinary care, but little is known about implementing leisure-based activities for health promotion within this model. Foundry, an IYS initiative in British Columbia, Canada, added a Wellness Program of leisure and recreational activities in response to an internal 2019 survey of 10,000 youth identifying a need for such services.
**Methods:** This study was part of Foundry's developmental evaluation. A phased approach was used to implement the Wellness Program at nine Foundry centres over six phases from September 2019 to December 2021: (1) Community asset development (Sept-Oct 2019), (2) Gathering momentum (Sept-Dec 2019), (3) Pilot programs (Jan-Apr 2020), (4) Pandemic pivot (Apr-Dec 2020), (5) Knowledge exchange (Jan-Apr 2021), and (6) Wellness Program Guide and evaluation (Apr-Dec 2021). Quantitative data were accessed from Foundry's centralized platform 'Toolbox' over a two-year period (September 2019-September 2021), including activity type, number of unique youth and visits, additional services sought, how youth found out about the centre, and demographics. Descriptive analyses calculated proportions (n/N, %). Qualitative data came from two semi-structured virtual focus groups conducted via Zoom from April-September 2021 with 9 young people (aged 16-24) who participated in the Wellness Program. Thematic analysis used a blend of deductive and inductive approaches, with coding reviewed by youth peer evaluators.
**Key Results:** Over two years, 355 unique youth accessed the Wellness Program with 1319 unique visits. A total of 384 different programs were offered across five wellness domains: cognitive/intellectual (n=129; 36%), emotional/mental (n=59; 17%), social (n=54; 15%), physical (n=45; 13%), spiritual (n=2; 0.1%), and 64 (18%) unclassified as 'other'. The highest number of unique visits occurred in July 2021 (n=122; 9.2%) and August 2021 (n=119; 9%), with no visits in April and May 2020 (corresponding with COVID-19 lockdowns). Almost half (40%; n=142) of youth identified the Wellness Program as their first point of access to Foundry, and 75% (n=265) accessed other programs at Foundry either before or after. The most commonly accessed additional services were mental health (n=119; 45%), walk-in counselling (n=85; 32%), and physical health (n=76; 29%). Demographics (n=177 responses): 58.2% identified as young girls/women, 22.6% as gender diverse, and 19.2% as young boys/men. Mean age was 19 years, with 43.6% aged 19-24 years. Ethnic/cultural background (n=179): 58.2% White, 19.2% Indigenous, 3.9% Chinese, 3.9% Filipino. Sexual orientation (n=172): 40% heterosexual, 24% bisexual, 9% gay or lesbian, 11% preferred not to answer. When asked where they would have gone if the centre was unavailable (n=173), 32.9% said nowhere/I wouldn't have gotten help. From focus groups (n=9 participants, mean age 17 years), three themes emerged: (1) Program successes — youth valued social connections with peers and facilitators, describing facilitators as 'welcoming, inclusive, accommodating, respectful, open to suggestions'; (2) Desired program improvements — youth wanted more virtual/hybrid options, better communication about programs, and more in-depth discussions; (3) The ideal Wellness Program — youth wanted accessible, educational, fun, arts-based, social activities with a range of options.
**Clinical Implications:** This is the first study to describe the development and implementation of leisure-based activities within an IYS network. The finding that 40% of youth accessed the Wellness Program as their first point of contact suggests these programs may serve as a gateway to other health services, enabling early identification and intervention. The high proportion of gender diverse youth (22.6%) accessing the program is notable given that this population faces greater mental health concerns and unmet service needs. The program's co-design with youth and communities aligns with recommendations to engage directly with young people in creating pandemic response strategies. The Wellness Program Guide developed through this process provides a template for other IYS initiatives internationally to develop tailored programming. Limitations include a small qualitative sample (n=9), underrepresentation of virtual participants in 'Toolbox' data, and challenges with data entry during the pandemic. Future research should explore short- and long-term health outcomes, cost-effectiveness, and potential to reduce wait times for other mental health services.