Marc Fagan on Youth Voice, Peer Support, and Systems That Actually Work

What really moves the needle for transition-age youth (16–24)? It’s not another program list—it’s engagement. In this episode, Patrick sits down with Marc Fagan, President of YouthCare Illinois, to unpack a new playbook: put youth voice on the mic, design for discovery (not lectures), make peer support core infrastructure, and measure uptake instead of offerings.

Who this is for: Medicaid leaders, child-welfare teams, providers, school partners, policymakers, and anyone building youth programs that need to work in the real world.

You’ll learn:

Why “listening” (for real) is the biggest shift since 2015

How to win the first yes from the least-likely-to-engage population

Where peer support and community fit alongside therapy

How to design discovery-oriented care—healthy risk with real safety nets

The role of virtual touchpoints, SDOH (jobs/school), and what to measure next

Chapters

00:00 Cold open — quick banter & setup

00:27 Who is Marc Fagan & what YouthCare does

01:08 Why Marc chose clinical psychology

01:57 Therapeutic schools: the power of relational work

03:10 From 1:1 therapy to systems design

04:13 Story: a student turns classroom chaos into graduation

06:26 Scaling impact beyond one campus

09:06 Thresholds highlights: youth homelessness program

10:27 Launching First Episode Psychosis care in Illinois

12:14 Why early intervention changes the arc

13:24 Then vs now: outcomes and accountability

14:39 What “transition-age youth” actually need (and don’t get)

16:06 2025’s biggest shift: youth voice leads

17:47 What teens keep telling us (and how adults should respond)

18:15 Discovery-oriented care: learning by doing, with guardrails

20:20 Design for exploration, not lectures

21:21 YouthCare’s population: youth with child-welfare histories

22:51 Virtual touchpoints & continuity across placements

24:00 Beyond therapy: groups, play/animal therapy, peer support

25:07 The pivot: from mostly clinical to mostly social

26:10 Multidisciplinary models that actually stick

27:02 The engagement problem—and how to solve it

28:04 Training staff to earn the first yes

29:10 Measuring what matters: uptake, not inventory

29:37 SDOH in practice: jobs, school, first opportunities

31:25 Early jobs and lessons (including a data-entry horror story)

33:01 Leadership: excitement, ownership, youth focus groups

34:40 Preventing burnout: celebrate small wins

38:05 The next 10–15 years: risk, policy, connection

40:07 Hopes for the future: faster access, shorter time in care

42:02 Biggest levers: tech plumbing + nontraditional care

44:11 Why relationships still beat everything

44:52 Showing up authentically (yes, there was a dance-off)

46:13 What keeps Marc optimistic

48:25 Where to learn more about YouthCare

49:14 One snap: immediate access + one committed adult

50:01 Closing

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