title: Engaging civil society through deliberative dialogue to create the first Mental Health Strategy for Canada: Changing Directions, Changing Lives.
abstract: Citizen engagement through deliberative dialogue is increasingly being used to address 'wicked problems' in policy-making, such as the development of national mental health policy. In 2012, the Mental Health Commission of Canada (MHCC), a national organization funded by and operating at arm's length from the federal government, released the first Mental Health Strategy for Canada: Changing Directions, Changing Lives (Mental Health Commission of Canada, 2012). Despite much-needed reform, Canada, unlike most other industrialized countries, had never previously developed a national Mental Health Strategy (the Strategy). This was due to a mix of policy factors, including a federalist system of government where primary responsibility for healthcare resides with provincial and territorial governments and a highly diverse set of stakeholder groups with diverging core ideas for mental health reform that were rooted in deeply held value differences. In this case study, we review the essential role that engagement of civil society played in the creation of the Strategy, beginning with the efforts to create a national body to shine the light on the need for mental health reform in Canada, followed by the development of a framework of specific goals based on core principles to guide the development of the Strategy, and ultimately, the creation of the Strategy itself. We discuss the various approaches to civil society engagement in each step of this process and focus in particular on how deliberative approaches helped build trust and common ground amongst stakeholders around complex, and often contentious, issues. The nature and outcomes of the deliberative processes including the key tensions between different stakeholder perspectives and values are described. We close by highlighting the lessons learned in a process that culminated with a Strategy that received strong endorsement from stakeholders across Canada. Mental Health Commission of Canada (2012). Changing Directions Changing Lives, The Mental Health Strategy for Canada. Calgary, AB: MHCC.
authors.affiliation: DeGroote School of Business, McMaster University, 1280 Main Street West, DSB 426, Hamilton, Ontario, Canada L8S 4M4. Electronic address: mulvale@mcmaster.ca.
authors.forename: Gillian
authors.initials: G
authors.lastname: Mulvale
authors.affiliation: Mental Health Strategy, Mental Health Commission of Canada, 100 Sparks St., Suite 600, Ottawa, Ontario, Canada K1P 5B7. Electronic address: hchodos@mentalhealthcommission.ca.
authors.forename: Howard
authors.initials: H
authors.lastname: Chodos
authors.affiliation: Carleton University School of Public Policy and Administration, 1125 Colonel By Drive, Ottawa, Ontario, Canada K1S 5B6. Electronic address: mary.bartram@carleton.ca.
authors.forename: Mary
authors.initials: M
authors.lastname: Bartram
authors.affiliation: Graduate School of Public and International Affairs, University of Ottawa, Ottawa, Ontario, Canada; Hill + Knowlton Strategies, 55 Metcalfe Street, Suite 1100, Ottawa, Ontario, Canada K1P 6L5. Electronic address: Marypat.mackinnon@hkstrategies.ca.
authors.forename: Mary Pat
authors.initials: MP
authors.lastname: MacKinnon
authors.affiliation: Hill + Knowlton Strategies, 55 Metcalfe Street, Suite 1100, Ottawa, Ontario, Canada K1P 6L5. Electronic address: Manon.Abud@hkstrategies.ca.
authors.forename: Manon
authors.initials: M
authors.lastname: Abud
mesh_terms: D002170:Canada; D003256:Community Participation; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D001523:Mental Disorders; D008603:Mental Health; D008605:Mental Health Services / Q000331:legislation & jurisprudence*; D011050:Policy Making
keywords: Canada; Deliberative democracy; Engaging civil society; Mental health promotion; Mental health strategy; Mental health systems transformation; Policy