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North West Local Health Integration Network (LHIN)

Share Your Story, Shape Your Care community online dialogue (more…)

Engaging Canadians in a Dialogue to Set the Goals for a Pan-Canadian Mental Health Strategy: Stakeholder Dialogues and Online Public & Stakeholder Consultation

The Challenge

In 2007, the federal government, in collaboration with provincial and territorial governments, announced the creation of the Mental Health Commission of Canada – an organization mandated to be the catalyst for the development and implementation of a mental health strategy for Canada, one that will ultimately lead to a deeply transformed mental health system.

Canada’s lack of a national mental health strategy is in part  a result of our constitutional reality: health care and social services are largely the responsibility of provincial and territorial governments. Given this fact, the Commission though tasked with leading the creation of a mental health strategy for Canada, does not have the authority to implement or evaluate it. Consider therefore the Commission’s challenge: the creation of a consensus-based framework to guide the implementation of a comprehensive, pan-Canadian strategy for mental health promotion, prevention and treatment… while working within the parameters of  Canada’s complex constitutional context and history, and given a vast array of competing interests for limited resources.

The Approach

As it embarked on this journey, the Commission felt it was critically important to engage as wide a range of people as possible, including: people living with mental health problems and illnesses, their families and caregivers, mental health service providers, researchers and policy experts. It also wanted to connect with  people who are concerned about mental health issues, whether or not they are currently involved with the mental health system.

To this end, Ascentum collaborated with the Commission to design and deliver a series of 15 regional stakeholder dialogues, along with a parallel online consultation process open to all individuals and organizations with an interest in this issue:

Regional dialogues

Ascentum designed, facilitated and reported on 15 full-day dialogue sessions, which brought together a diverse mix of individuals and stakeholders, including two sessions dedicated to delving deeper into the specific perspectives, needs and concerns of Canada’s Aboriginal peoples (through their national leadership) and of health and social/community services professionals (through their national professional associations).

These dialogues were designed to provide participants with an opportunity to learn about the proposed strategy Framework (which outlined 8 proposed goals for the strategy) in plenary and small groups, and to provide concrete feedback on what they liked, were concerned about and wanted to change/add to the Framework. The facilitators also used electronic voting keypads to test agreement with each proposed goal and with the Framework as whole  at the beginning and end of the day, to measure shifts in perspectives. A summary of the day’s discussion was posted on the Commission’s blog at the end of each session.

Innovative online participation website: public and stakeholders

Ascentum developed and hosted a customized participation website on its dialoguecircles.com platform. First, an online workbookTM provided a brief overview of the Commission’s proposed Framework and allowed participants to react to each goal through a mix of close-ended and open-ended questions. The online workbook also included pre- and post-test questions to measure shifts in views on the 8 proposed goals as a result of completing the online workbook. Members of the general public and representatives of stakeholder groups completed the same online workbook to facilitate a comparative analysis of their respective perspectives.

Second, each audience was offered the opportunity to provide “free form” qualitative comments -  in the form of personal stories and ideas for members of the public and more formal comments and suggestions for stakeholder organizations. Public participants could choose to register or participate anonymously, and could elect to share their stories and ideas on the website for other visitors to read or submit them for analysis only.

Participation Website: Online Workbook:

Participation Website: Shared Stories

The Results

Over 450 people, from coast to coast to coast, participated in the Commission’s Regional Dialogues, between January and April 2009. In addition, over 1,700 members of the general public and 300 stakeholder groups availed themselves of the opportunity to share their views with the Commission online between February 11 and March 31, 2009, completing some 1,800 online workbooks and providing over 465,00 words of comments (just a few pages short of “War and Peace”!). Moreover, in their evaluations of the process, the majority of participants expressed their willingness to remain engaged in the Commission’s work moving forward.

The Commission’s commitment to active listening was demonstrated by the extent to which it revised the final Framework document to reflect the weight and direction of public and stakeholder input: the Framework document was substantially modified to reflect what they heard, including the insertion of a vision statement, a reframing of the goal statements, the redefinition of key concepts and the elimination of one goal. Most importantly, as it engages in the most difficult portion of this journey – defining HOW to achieve the goals set out in the revised Framework – the Mental Health Commission of Canada can leverage the relationships and trust it has begun to build through this process  – all with a view to catalyze the change hoped for by the one in four Canadians who live with or have experienced mental health problems and illnesses.