“What we often dismiss as ‘extras’, art, music, routine, connection, young people tell us these are treatment.”
When speaking with Dr. Danya Fast, I am struck by both the emotional potency of her work as an academic and her deep knowledge of how policy and services might better support youth facing complex life circumstances. Now working at the BC Children’s Hospital Research Institute and Foundry, she has spent much of her career immersed in academia, pursuing her PhD and conducting research that would eventually become her book, The Best Place: Addiction, Intervention, and Living and Dying Young in Vancouver.
This gripping work is the result of more than a decade of immersed engagement with resilient young people navigating structural inequities as they seek belonging and pursue their dreams in Vancouver. Her conversations with young people lay bare the profound shortcomings in how we support them, from access to education and housing, to opportunities for artistic expression, community, routine, and structure. Taken together, The Best Place illuminates gaps across many of the social determinants of health that underpin both physical and mental well-being.
Dr. Fast is a medical anthropologist by training, and much of her research explores the tension between young people’s dreams and their ongoing struggle with disenfranchisement and its attendant health consequences. The young people she has come to know have not given up. Quite the contrary. Their dreams and aspirations keep them engaged and striving for a better life. Yet the weight of constant adversity leaves them vulnerable to mental health challenges and substance use.
It was the youth themselves who fundamentally reshaped the focus of her book.
“It was young people who insisted on putting their dreams at the centre, taking about how they wanted to belong in the city and who they hoped to become,” she explains. Many had arrived in Vancouver from small towns or reserves and were animated by possibility. They loved the city and saw it as a place to realize their dreams, not merely survive.
As Dr. Fast wove depictions of her interactions and conversations with young people together, a central theme emerged: community and belonging. Like all of us, the young people she interviewed wanted to be part of something larger than themselves. “For young people, inclusion was about belonging, but also about becoming, becoming something else, becoming otherwise than what you are.” Her work reframes exclusion by foregrounding the human need for becoming and by refusing to view youth solely through a deficit lens.
Tragically, over time, many of Dr. Fast’s interviewees were lost to the toxic drug crisis as fentanyl entered the drug supply. The book evolved into something far more than an academic contribution. It stands as a tribute to the young people whose stories it carries, and as a testament to both their lives and the magnitude of the loss experienced by those around them.
“I realized I couldn’t write the book I had planned,” she says. “It had to be about living and dying young in the face of an unprecedented toxic drug crisis.”
One of Dr. Fast’s most important insights lies in understanding what young people say they need, rather than what others assume will help them.
“Housing is essential, but housing alone is not enough,” she explains. Many young people experienced supportive housing as institutional, isolating, and overly medicalized. These environments could be dangerously solitary at a time when using drugs alone was extraordinarily dangerous, with many overdose deaths occurring behind closed doors.
When asked what truly helps, youth consistently point to routines characterized by regular moments of fun and excitement, hobbies and passions, creative outlets like art and music, and opportunities for connection. These are often treated as supplementary within systems of care, yet young people describe them as essential.
“What we often dismiss these as ‘extras’: art, music, establishing rhythms and routines in daily life, making social connections. But young people regularly tell us these are treatment,” Dr. Fast explains. “Sometimes what needs to happen first are these pieces, these kinds of belonging and becoming, before any more conventional medical conversation can truly land.”
Today, Dr. Fast’s work is increasingly action-oriented. At BC Children’s Hospital, she contributes to initiatives in social pediatrics, community-based care, and youth- and family-co-designed overdose prevention guidance. Her approach centres the whole person first, their dignity, strength, and resilience, before narrowing in on clinical intervention.
On International Women’s Day, Dr. Fast also reflects on the importance of women’s voices in research and public health, fields that have historically been dominated by men. As a medical anthropologist, she emphasizes the significance of perspective, recognizing the researcher as a co-creator of narrative rather than a neutral observer. She is clear-eyed about how her own lived experience shapes what she hears and how stories are told.
“As a woman, I’ve heard different stories and made different kinds of connections, and that matters,” she says. Who conducts research influences which stories are told, how trust is built, and what insights emerge.
Despite the heaviness of her work, Dr. Fast remains grounded in hope. She is clear that much of the knowledge we need already exists, drawn directly from youth and families themselves. What remains is the collective will to listen, fund, and co-create systems that reflect what young people are already telling us.
“This work is heavy,” she acknowledges, “but there is real reason for hope. We already know so much about what could work better.”
Order Dr. Fast’s book, The Best Place, here: The Best Place
If you are interested in participating in a future collective to discuss supportive communities for youth, please reach out directly to tassan@spoken-community.com.