“There comes a point where we need to stop just pulling people out of the river.

We need to go upstream and find out why they’re falling in.” —Desmond Tutu

In 2015, Braden Titus, a 31-year-old son, brother, uncle, nephew, and friend, died by suicide because he couldn’t find the right resources in time to help him when he needed it. To prevent others from experiencing this same devastation, the Titus family founded the Thumbs Up Foundation (TUF) in 2016.

As Kim Titus, TUF Chair, says, “At TUF, we understand because we’ve lived it. Suicide doesn’t have to be the outcome ever. We are not afraid to challenge the status quo. When systems fail people, we advocate for structural change, grounded in evidence and lived experience, until better outcomes are possible.”

TUF is moving years of research into action and creating a future that hasn’t existed: a future imagined by those who have been impacted by existing systems of care. TUF has walked alongside individuals and families who have clearly articulated that existing fragmented systems fall short of meeting their needs. For over a decade, TUF has used that experience to shape how they co-design and test solutions at the community level to improve real-world mental health outcomes.

TUF envisions a world where physical and mental wellness are balanced. Where access to mental, physical, and emotional care is timely and in harmony, and where each person is treated as an individual. Where hope isn’t just a word but a reality. TUF puts the “Connect” in Connection, the “Human” in Humanity, the “Passion” in Compassion, and the “Unity” in Community.

TUF embraces three key philosophies:

Effective systems start with people: No two people’s pathways to care are identical. People have the right to choose and be empowered to take personal accountability and ownership in their journeys. They need time to establish trust and build relationships. Building personal resiliency leads to stronger individuals, stronger relationships, and a stronger community.

Optimum brain health is a lifelong journey, with critical moments along the way: People need to be met where they are at, and services need to be available where and when they are needed. One’s physical and brain health are inextricably connected; complex life issues can lead to one needing more complex care. When one’s brain health declines and isn’t appropriately addressed, it can lead to a decline in one’s physical, social, and economic well-being.

Creating significant change in a community demands a holistic and systematic approach: The true value to the overall system happens when everyone is able to operate at the height of their skillsets, redundancy is minimized, and outcomes are evaluated, monitored, and managed. TUF purposefully designs approaches to be replicated, scaled, and transferable, rather than point solutions that optimize groups at the expense of others. Together, we can.

What We’re Up To

Fragmented systems fail the people they’re meant to serve, at high human and financial cost. The issue isn’t a lack of services—it’s coordination. When we work together to improve flow between providers, we prevent people from falling through the cracks. Adding more services increases complexity. Strengthening what already exists improves outcomes. The key is to connect what already exists. By aligning providers, improving transitions, and reducing silos, we strengthen the entire care ecosystem rather than duplicating it.

Over the last 10 years, TUF has deployed more than $3.3 million to develop Harmonized Health, a made-in-Alberta proprietary, coordinated, person-centred care framework designed to address system gaps by aligning clinical providers, peer supports, community organizations, and evaluation partners around shared care pathways. The approach connects individuals and families to the right services at the right time through structured navigation, comprehensive evaluation, and ongoing community-based continuity of care, improving collaboration between providers while reducing duplication of services. TUF has led two Harmonized Health projects, testing and refining the framework at the community level. After the latest Harmonized Health 2 project, which ended in 2025, an independent evaluator stated that the framework “…is well-positioned for scale-up or spread to new communities, but careful attention to implementation science principles is essential to ensure its success. Scaling the program will require thoughtful planning to adapt its core components, such as the Community Care Coordinator role, provider recruitment, and community resource integration to the unique needs and contexts of each location.”

Sustainable improvement requires a Harmonized Health hub-and-spoke framework that supports coordination, training, evaluation, and replication. Infrastructure protects the integrity of the model while allowing community-specific adaptation. Together, the hub and spokes create scalable and transferable system change.

The Harmonized Health hub is responsible for central coordination, implementation standards, training, spoke oversight, and data and evaluation support. Harmonized Health spokes provide community-based services and context-specific delivery.

TUF is ready to scale what works. System-wide change cannot be achieved in isolation. We are seeking strategic partners—philanthropic, governmental, and academic—who recognize that improving brain health requires collaboration, accountability, and long-term thinking. Next, TUF will further develop the hub and partner with their first spoke organization to advance the Harmonized Health framework.