Framework for Action
Changing Directions, Changing Lives: The Mental Health Strategy for Canada was the cornerstone of the MHCC’s first mandate.
Building on that strong foundation, the Mental Health Commission has collaborated with a diverse group of partners to produce Advancing the Mental Health Strategy for Canada: A Framework for Action.
Changing Directions, Changing Lives: The Mental Health Strategy for Canada (the Strategy) was the foundational work of the Mental Health Commission of Canada’s first ten-year mandate. Looking ahead, our task is now to take action on the Strategy’s valuable recommendations.
In 2015, the MHCC embarked on a series of broad consultations to lay the foundation for accelerating uptake of the Strategy over the next five years. Reaching out across the country to seek the advice of local, regional and national groups, as well as agencies, governments and Indigenous peoples. People with lived experience of mental health problems and illnesses were integral to this year-long dialogue, which set out to glean input around how to make the greatest possible improvements to the Canadian mental health system over the next half decade.
This consultation process went one step further. The MHCC brought together a group of 36 Canadian residents representing the regional, demographic and cultural diversity of the country to form a Citizens Reference Panel. This panel spent a week participating in facilitated discussion reflecting on how best to achieve the goal of advancing the Strategy.
This work resulted in the development of Advancing the Mental Health Strategy for Canada: A Framework for Action (the Framework). In keeping with fiscal realities at both the federal and provincial government levels, the Framework proposes targeted actions and investments in Canada’s mental health system tied to measurable outcomes.
The Framework is comprised of four key pillars:
- Leadership and funding;
- Promotion and prevention;
- Access and services; and
- Data and research.
Each pillar represents a key area for achieving the vision set out in the Strategy.
Pillar 1: Leadership and Funding
Leaders need to be mobilized and collaborate in order to better resource mental health in Canada, increasing the capacity to deliver quality, evidence-based and integrated services across the five tiers articulated in the Strategy and to better meet the needs of diverse populations in all areas of Canada.
Funding alone, however, will not improve access or quality of services. Leaders must also focus on achieving parity between physical and mental health care, better integrating mental health and physical health, and fostering collaboration across the health, social, education and justice sectors.
Objectives of Pillar 1:
- Make targeted investments to mental health within federal, provincial/territorial and regional health budgets, as well as in social spending envelopes such as education, housing and Justice.
- Increase access to evidence-based community mental health service and psychotherapies delivered by qualified providers.
- Improve collaboration for the delivery of service for people living with substance abuse and addictions problems and mental health problems or illnesses.
- Increase initiatives that address the disparities in the social determinants of heath that significantly influence mental health.
- Develop a Canadian mental health human resource plan.
Pillar 2: Prevention and Promotion
This pillar underscores shared aspirations among experts, stakeholders, and governments for an improved focus on upstream efforts at all levels of care.
It encompasses more emphasis on holistic prevention strategies, promotion of mental wellness, increased awareness and education about positive mental health across the lifespan, and a more refined focus on the social determinants of health in culturally competent and safe manners. It also encompasses continued efforts to uphold human rights, improve social inclusion, and eliminate stigma and discrimination.
Objectives of Pillar 2:
- Scale up/increase availability of programs that provide public and front line education and training about mental health.
- Increase the availability of adequate, affordable, and stable housing with related supports that meet the needs of people with mental health problems and illnesses.
- Implement initiatives that promote positive mental health wellness and prevent suicide in a culturally competent and safe manner.
- Scale up the implementation of good practices in prevention in early intervention during the early childhood development years.
Pillar 3: Access and Services
People living with mental health problems and illnesses and their families should be able to expect timely access to high quality, evidence-based services equivalent to that available for people with physical illnesses, regardless of where they live or when they need them.
Involvement of people with lived experience of mental health problems and illnesses and their caregivers has to be integral at all service points and in the policy development process for improving availability and quality of care. To support continuous quality improvement, front-line service providers need tools that translate best available evidence through guidelines, standards, and accreditation requirements. Pillar 1 focuses on system resourcing and capacity building, while this pillar focuses on what needs to be done inside the service system to provide the right combination of mental health services, treatments, and supports when and where people need them.
Objectives of Pillar 3:
- Improve the availability of quality mental health services across the continuum of care and the lifespan.
- Improve collaboration across sectors, including health care, addictions, education, justice and corrections.
- Improve availability of high-quality, culturally competent and safe services for Canada’s diverse populations.
- Increase the availability of recovery-oriented mental health service, treatments, and supports in the criminal justice system.
Pillar 4: Data and Research
Aside from encompassing the creation of benchmarks and the ongoing evaluation of system performance, as well the translation of evidence-based mental health knowledge into policy and practice in order to build a strong system of knowledge exchange and collaboration in Canada, the scope of this pillar includes:
- supporting comprehensive, innovative, interdisciplinary research and evaluation on mental health and illnesses, and mental health programs and treatments;
- facilitating the involvement of people living with mental illness in research;
- improving data collection systems and population-level monitoring to collect comprehensive information on mental health, wellness, illness, service access, and wait times, in an ongoing manner across Canada; and,
- ensuring that publicly-funded data is available to researchers and policy makers.
Supporting comprehensive, innovative, interdisciplinary research and evaluation on mental health and illnesses, and mental health programs and treatments; facilitating the involvement of people living with mental illness in research; improving data collection systems and population-level monitoring to collect comprehensive information on mental health, wellness, illness, service access, and wait times, in an ongoing manner across Canada; and ensuring that publicly-funded data is available to researchers and policy makers.
Objectives of Pillar 4:
- Increase support for interdisciplinary, cross-sectoral research.
- Improve routine data collection, monitoring of, and reporting on, key indicators in the mental health sector
- Develop a framework for regular report cards on mental health system performance across jurisdictions
- Build networks within mental health and other sectors and promote best and promising practices.
In the development of the Framework, the Mental Health Commission undertook an extensive and unique consultation process. These consultation sessions set out to transform complex strategic directions and ideas into concrete actions for uptake, adoption, and implementation, and to identify areas in which a broader approach to mental health could be improved over the next decade of the MHCC’s renewed mandate.
The MHCC reached out to the Canadian population in the following four ways:
Online Survey – which was completed by 1,509 respondents over a two-month period in the spring of 2015;
In-Person Consultations – involving stakeholders in each province and territory as well as specialized and population-specific organizations and individuals;
Citizens Reference Panel – which involved 36 individuals, chosen to reflect the demographic profile of Canada, who were asked to work together to identify mental health issues and actions that are most urgent for Canada, as well as the results that people, organizations, and governments should focus on achieving together in the next five years. Their conclusions were carefully considered and were incorporated by the MHCC into the design and structure of the Framework; and,
National Stakeholders and Key Informants – such as national mental health stakeholders, provincial and territorial of officials, the MHCC’s advisory bodies, as well as a sample of agencies and individuals who participated in the regional roundtable, were asked for their feedback and input on the draft report. A total of 111 organizations and/or individual experts were invited to participate in this phase of consultations through an online dialogue space to discuss their responses with other participants.