“We don’t want to see them again”

In her second year of residency, Dr. Carolyn Snider was on a trauma rotation at a major Toronto hospital when she got the call: A 15-year-old male was coming in with gunshot wounds.

She and the trauma team met the ambulance and immediately got to work. The young man’s lungs had collapsed, and he’d been shot through his thoracic spine—an injury that left him paralyzed from the chest down.

Once he had been stabilized, Dr. Snider had a tragic realization.

“I had treated this patient before,” she recalls. “Just a few months earlier, he had come to the emergency department with stab wounds. It was awful to realize he was back again because of violence.”

Dr. Snider, who went on to become an emergency physician and recently completed her term as Chief of Emergency Medicine at St. Michael’s Hospital, began speaking with the young patient about his life. She came to learn about the complex circumstances—poverty, family vulnerability, a community prone to socioeconomic challenges—that had led to his experiences with violence. 

“I started looking into the issue of youth violence further and found that 20 percent of all young people treated in a hospital due to violence will return within a year,” she says.

She decided to do something about it.

While working at a Winnipeg hospital, she launched Canada’s first hospital-based violence intervention program. When she returned to Toronto in 2019 and joined the team at St. Michael’s, she started looking into adapting the model to address our population. 

Her efforts paid off. A year ago, THRIVE—the Toronto Hospital-based Reducing Injury from Violence Intervention and Evaluation program—officially launched at St. Michael’s Hospital.

Developed in close collaboration with community leaders and community-based organizations, THRIVE aims to help young victims of violence address the root causes of their challenges and realize their full potential.

It starts right in the emergency department at St. Michael’s.

When a young person between the ages of 14 to 29 arrives in the emergency department with injuries due to violence, they’re immediately connected with one of THRIVE’s two “coaches”— outreach workers highly trained to support young people experiencing vulnerability and connect them with a wide range of community-based services.

The coaches meet with patients, develop a trusting relationship and learn about their circumstances. They help patients identify short- and long-term goals, then work with them for up to a year to achieve those goals.

Our coaches really walk alongside youth and guide them,” says Dr. Snider. “For our most disadvantaged patients, they’ll help them access housing and mental health or addiction services, and even help them get back on track with their education.”

Since THRIVE launched in 2023, more than 300 eligible patients have arrived at St. Michael’s with violence-related injuries. But due to capacity, the team has only been able to accept 42 into the program so far.

“We want to be able to help every young person in need of THRIVE, but we need more funding and more resources to be able to do so,” says Dr. Snider.

The team’s research—a critical component of THRIVE—shows that the program is already leading to a decrease in the number of violent injuries being treated in the emergency department at St. Michael’s.

With funding from Angels Den 2023, where Dr. Snider and her colleague Deshawn Hibbert pitched the idea, the team is exploring how the program is impacting mental health outcomes for patients living with trauma due to their experiences with violence.

“This research project is critical because it will help us understand what it truly means to thrive, and how our model can be continuously improved to support the best possible long-term outcomes for patients,” says Dr. Snider.

As for what’s next, the future is looking bright. The THRIVE team recently met with all three levels of government to discuss a multi-sectoral plan to help prevent recurring youth violence, and they’re in talks with multiple major hospitals about duplicating the program across the province.

“Our long-term goal is to make this program model available everywhere so that young people injured by violence can access the support they need,” says Dr. Snider. “We want them to live to their full potential. And we don’t want to see them again in the hospital.”

Interested in supporting health equity initiatives like THRIVE at St. Michael’s Hospital? Donate online here, or contact the Foundation office at 416 864 5000 or hello@stmichaelsfoundation.com to learn more.