The importance of young people having a voice in the decisions and experiences that impact them and in their everyday life has long been recognized both in scholarly literature and in the work of service providers across child and youth serving sectors. The concept of ‘doing with’ rather than ‘doing to’ or ‘doing for’ young people is often cited as a way of distinguishing the construction of young people as subjects versus objects. Inherently, to the extent that treatment approaches are based in medical models of service provision, the risk of continuing the construction of young people as objects exists (AACRC, 2014; Allan et al., 2011; Brendtro & Larson, 2004; Child Fund Australia, 2012).

Government strategic directions, service plans developed by child and youth serving agencies, and previous Panels and consultations have cited the need for a coherent and meaningful strategy to ensure that young people are active participants in their experience in out-of-home care. The Blueprint for Fundamental Change to Ontario’s Child Welfare System (2013), identifies as essential and urgent that the group care system is evaluated to make sure that it focuses on the best outcomes for youth, starting with a process that listens to the voices of youth in and from care. In addition, a recent report from Kinark Child and Family Services (2015) states that empowering youth to be equal decision-makers in their own treatment is particularly important in health-related fields, including residential treatment programs, where traditional structures have created inherent power differentials between youth and caregiving adults. Young people themselves have consistently stated that the opportunity to have a direct involvement and a meaningful role in the decisions that affect them is of critical importance.

The recognition that young people’s voices are important stands in contrast with the expert-driven nature of much of the residential services system. We heard from young people that major decisions that have a direct and often life altering impact on young people continue to be made without their direct involvement, or without a significant weighing of the perspectives presented by young people. A recent draft report from Children and youth mental health Ontario (CMHO, 2015), for example, proposes a significant restructuring of the children and youth mental health system, including residential treatment services, without reference to young people’s voices at all. This in spite of the report acknowledging the critical importance and extensive evidence related to the benefits of youth participation and engagement in their involvement with services (p.9). Young people and CAS-based Children’s Services Workers indicated to the Panel that this often includes placement decisions, where young people often have no role in determining either the type of placement or the specific service provider they may prefer.

Notable contexts in which the voices of young people are key include the development of programs and services for young people in out-of-home care, the governance and accountability frameworks for such services, the design - including the rules, procedures and physical design of programs and services - as well as the treatment, relationships and caring that unfolds in programs and services. Of great importance is the active involvement and joint decision-making between young people, families and professionals in the context of major transitions, such as the transition into out-of-home care, the transition between placements, and the transition out of out-of-home care, including into emerging adulthood.

The Panel was told that the issue of voice extends beyond the participation of young people in their own lives; within the residential service sector, the voices of direct care providers (residential front line staff, foster parents, youth services officers) also have often not found opportunities to be heard and to have their perspectives fully integrated into decision-making. Similarly, the voices of families, including parents, siblings, grandparents and extended family or kin are often very peripheral to the expert-driven approaches in service design and governance.

In spite of shortcomings, the Panel is impressed with several initiatives aiming to ensure the inclusion of young people in the design of residential services and feedback about young people’s everyday experience. A longstanding example of this is the Youth Amplifiers who work with the Office of the Provincial Advocate for Children and Youth to consult with young people in care to ensure that their experiences in care are known by others. Other examples include New Mentality, a youth group and program in the children and youth mental health sector, and YouthCan, a youth group in the child welfare sector that works to represent the voices and experiences of young people in care. The Panel supports these aforementioned initiatives, and moving forward feels that it is important for young people who are not likely to join such groups to be given alternative opportunities to have their voices heard.