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MENTAL HEALTH COMMISSION OF CANADA

Formative Evaluation

Final Technical Report

April 29, 2011

Acknowledgements

We, the evaluation team, would like to thank those who have assisted in obtaining and preparing the information needed for this document. Many thanks to the Mental Health Commission of Canada evaluation project team and stakeholders, with special thanks to Sapna Mahajan and Laureen MacNeil who provided documentation, organization history, responsive communication and willingness to assist with all the logistics that go into managing an evaluation of this size and scope. Thanks also to mental health stakeholder experts who participated in interviews and focus groups and provided substantive feedback for this evaluation. Finally, we would especially like to acknowledge the opportunities we had to speak with those who are at the centre of the Commission’s work, Canadians living with mental illness, their families and caregivers. This report would not have been possible without their participation. Prepared by project team: Kate Woodman, PhD Lynn Damberger, MSc Margaret Wanke, MHSA Krista Brower, BA (Honours) Francine Deroche, MHS Tara Shuller, MA Advisors to the evaluation: Patrick W. Corrigan, PhD

Leslie Gardner, PhD Ian Graham, PhD Fay Herrick, BEd

Scott Theriault, MD, FRCPC

Angus Thompson, PhD

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Executive Summary

In 2006, the Senate Committee on Social Affairs, Science and Technology released the report Out of the

Shadows At Last – Transforming Mental Health, Mental Illness and Addiction Services in Canada. This

first national report on mental health and addictions in Canada outlined 118 recommendations to

address gaps and strengthen capacity to provide Canadians living with mental illness new opportunities

to live thriving lives. A key recommendation of the Committee was to create a national body that was

an independent, not-for-profit organization at arm’s length from governments and all existing mental

health “stakeholder organizations,” and would make those living with mental illness, and their families,

the central focus of its activities.

In 2007, the Mental Health Commission of Canada (MHCC) was created with support from all levels of

government and mental health stakeholder communities, to address the vision, expectations and

earnest hopes of the Senate Committee and Canadians. The ten year mandate (2007 – 2017) was

articulated and the MHCC was designed “to act as a catalyst to improve the mental health system in

Canada, develop a mental health strategy for Canada, reduce stigma and discrimination faced by people

living with mental illness and mental health problems and create a knowledge exchange centre.”

To fulfill its mission, the MHCC actively engaged in five key initiatives, addressing areas of core

significance to mental health systems in Canada:

A mental health strategy;

An anti-stigma initiative (Opening Minds);

A homeless research demonstration project (At Home/Chez-Soi);

A knowledge exchange centre; and,

Partners for mental health.

Now in its fourth year of operation, the MHCC initiated a formative evaluation of its work, with a

directive to assess implementation from July 2007 to December 31, 2010. The evaluation is in

compliance with the Health Canada funding framework and Treasury Board evaluation guidelines. The

purpose of the evaluation is to assess: progress towards the MHCC’s five key initiatives; effectiveness of

its policy and/or programs; impacts both intended and unintended; and, alternative ways of achieving

expected results. In October 2010, the MHCC contracted Charis Management Consulting Inc. (Charis) to

undertake a comprehensive evaluation of the organization.

Multiple data collections methods were used to measure perceptions regarding the mandate, structure,

achievements and early impacts of the work completed to date by the MHCC. These perceptions were

elicited through document review, key informant and focus group interviews with a variety of critical

stakeholders, and through an online survey of partners and collaborators of the MHCC across Canada.

Recommendations for the future were sought from all respondents in order to provide focused

attention to those areas not yet developed or realized by the MHCC.

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During its first three and a half years of operation (July 2007 – December 2010), the MHCC focused on

establishing the five key initiatives in accordance with the approved business plan and on developing the

organization’s business functions, processes and infrastructure. All lines of evidence examined progress

made in terms of achieving the assigned mandate, governance structure, supports and processes. Key

developmental milestones and activities are described that indicate steady progress towards

achievement of the mandate as well as the MHCC outputs delivered to date.

Participants in the data collection commented on what they perceived as the early impacts of the MHCC

work on the lives and work of partners and collaborators in the mental health system. There were 463

responses to the online survey; these respondents were a diverse group that, while strongly connected

to mental health programs and services across Canada, were not actively involved with the MHCC.

These respondents provided valuable insight and expert opinion on the MHCC’s activities. Three main

themes emerged from the survey data: 1) a desire for more effective communication, knowledge and

resource dissemination; 2) increased inclusion and partnership with groups heavily invested and or

involved in the mental health sector; and, 3) the ability of the MHCC to effectively catalyze change in

mental health systems in Canada.

The key informant interview and focus group participants (n= 52) were generally well informed and

engaged with the MHCC. Their insights into all matters of implementation and the operational aspects

of the MHCC work suggested an overall positive assessment of achievements to date. Respondents

affirmed the direction of the work but commented on the uneven development of the five key

initiatives: specifically to actualize the Knowledge Exchange Centre (KEC) and Partners for Mental

Health, two under-developed, but felt to be much needed initiatives. Respondents also commented on

the MHCC governance and goal to become a model workplace and had several suggestions for areas of

focus that will assist the MHCC in strengthening their organizational structures and processes to go

forward. Respondents encouraged the MHCC to take seriously the need to address emerging issues in

the workplace and build authentic and inclusive partnerships with stakeholder groups, especially those

that are currently marginalized and/or invisible. Finally, the respondents encouraged the Commission to

manage the growing risks of stakeholder expectations and develop the national function of their work.

The recommendations represent those the evaluators believe are the most critical to position the MHCC

for continued success into the future. It is recommended that the MHCC:

1. Fulfill the pan-Canadian mandate by ensuring focused engagement with all regions,

including those currently less actively involved.

2. Proceed with full implementation of the Knowledge Exchange Centre and Partners for Mental Health initiatives to fulfill the mandate and make certain they develop to the same standard as the other key initiatives.

3. Continue to build collaboration and stakeholder engagement with the groups most

perceived as poorly represented:

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Individuals: people with lived experience; families and caregivers; First Nations, Inuit

and Métis; and, Francophone populations, particularly from Québec.

Grassroots/front line service providers creating meaningful networks with them to

validate their work and catalyze their capacity to impact policy.

National First Nations, Inuit and Métis organizations that work in the health and mental

health sector, for the purposes of forming partnerships and building alliances.

4. Develop a clear communication plan to inform stakeholders of the MHCC’s approach to

actively include people with lived experience and other diverse groups within their staff. 5. Increase communication and promotion about MHFA, to build awareness and mitigate

concerns about its transfer to the Commission. 6. Review evidence based models of governance and structure to inform decisions to be made

regarding the Advisory Committee structure and reporting mechanisms. 7. Focus on building a model workplace:

Fully assess staff skill sets and fully utilize their skills in their work with the Commission;

Provide opportunities for collaboration and encourage cross-cutting discussions to

mitigate the perception that staff work in “silos;” and,

Continue to build the capacity of the Committee of Champions to positively influence

workplace culture.

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Table of Contents 1. Introduction .............................................................................................................................................. 1

1.1 Background...................................................................................................................................... 1

1.2 Organization of the Report ............................................................................................................. 3

2. Methodology ............................................................................................................................................. 4

2.1 Evaluation Design ............................................................................................................................ 4

2.2 Data Collection ................................................................................................................................ 5

2.3 Evaluation Limitations ................................................................................................................... 12

3. Results from Phase 1 ............................................................................................................................... 13

3.1 Logic Models.................................................................................................................................. 13

3.2 Evaluation Questions..................................................................................................................... 15

3.3 Evaluation Matrix .......................................................................................................................... 16

3.4 Data Collection Coverage .............................................................................................................. 20

4. Results from Phase 2 Data Collection ..................................................................................................... 21

4.1 Administration Data Description ................................................................................................... 21

4.2 Administrative Data....................................................................................................................... 27

4.3 MHCC Online Survey ..................................................................................................................... 38

4.4 Key Informant Interviews and Focus Groups ................................................................................ 82

5. Summary and Recommendations ........................................................................................................... 98

5.1 Summary ....................................................................................................................................... 98

5.2 Recommendations ...................................................................................................................... 102

Appendix A: Logic Models, Evaluation Questions, Data Matrix................................................................ 103

Appendix B: Program Utilization Table ..................................................................................................... 114

Appendix C: Survey Instrument and Interview Guides ............................................................................. 128

Appendix D: Organizational Chart ............................................................................................................ 164

Appendix E: Formative Evaluation Summary and Observations for Consideration ................................. 168

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Charis Management Consulting Inc. 1

1. Introduction

1.1 Background In 2006 the Senate Committee on Social Affairs, Science and Technology released the report, Out of the Shadows At Last – Transforming Mental Health, Mental Illness and Addiction Services in Canada.1 A ground-breaking study, this was the first national report on mental health and addictions in Canada. Known colloquially as “the Kirby Report” (named after the former Senator Michael Kirby, who led the Senate Committee), the document outlined 118 recommendations to address gaps and strengthen capacity to provide Canadians living with mental illness new opportunities to live thriving lives. The report states: “what is needed is a genuine system with people living with mental illness at its centre, clearly focusing on their ability to recover.”2 The vision was to transform the sector, its design, implementation and the delivery of services and supports. Initially, the focus was on mental health and addictions as two parts of a single, holistic “system.” 3 During substantive hearings designed to garner the voice of Canadians and develop a consensus vision for a way forward,4 the Senate Committee discovered validation for, “a recovery-oriented, primarily community-based, integrated continuum of care. . . . “5 To that end, and woven throughout the report, is reference to a “Canadian Mental Health Commission” that would work as a catalyst to achieving this vision. Defined in Chapter 16: National Mental Health Initiatives, the report states: “From the very beginning of its study . . . the Committee has heard the call for a national mental health strategy.”6 Stakeholders across Canada identified the need for a mechanism to undertake pan-Canadian work, provide a countrywide focus, and contribute to the development of a national mental health strategy. A key recommendation of the Committee, the proposal to create such a national body was announced in 2005, endorsed by all provincial and territorial governments (with the exception of Québec) at a meeting of Ministers of Health in October 2005. Each of these governments has since confirmed their support for the Commission. The core principles of this new, national body were identified:

Be an independent not-for-profit organization at arm’s-length both from governments and all existing mental health “stakeholder organizations;” and,

Make those living with mental illness, and their families, the central focus of its activities. The Committee recommended the organization be operational by September 2006 and that the Government of Canada provide $17 million per annum to fund its operation and activities. It further defined the central, elemental work of the Commission:7

To act as a facilitator, enabler and supporter of a national approach to mental health issues;

1 Kirby, The Honourable Michael J. and Keon, The Honourable Wilber Joseph. Out of the Shadows at Last – Transforming

Mental Health, Mental Illness and Addiction Services in Canada: Highlights and Recommendations. Standing Senate Committee on Social Affairs, Science and Technology (May 2006).

2 Ibid, p. 5. 3 The report notes, “with regret that the Committee has not been able to devote as much time and attention to substance use

issues as it intended . . . the report focuses primarily on mental health issues” (p. 5). 4 The Committee held more than 50 meetings, comprising more than 130 hears of hearings, involving 300 witnesses, resulting

in a 2,000 page testimonial document. 5 Ibid, p. 13. 6 Ibid, p. 73. 7 Ibid, p. 74.


To be a catalyst for reform of mental health policies and improvements in service delivery;

To educate all Canadians about mental health and increase mental health literacy among them, particularly among those who are in leadership roles such as employers, members of the health professions, teachers etc.; and,

To diminish the stigma and discrimination faced by Canadians living with a mental illness, and their families.

In 2007 the Mental Health Commission of Canada was created,8 with support from all levels of government and mental health stakeholder communities, to address the vision, expectations and earnest hopes of the Senate Committee and Canadians. The ten year mandate (2007 – 2017) was articulated: “To act as a catalyst to improve the mental health system in Canada, develop a mental health strategy for Canada, reduce stigma and discrimination faced by people living with mental illness and mental health problems, and create a knowledge exchange centre.” The MHCC became a much anticipated vehicle to focus national attention on mental health issues, and to improve the health and social outcomes of people living with mental health problems and mental illness. To fulfill its mission, the MHCC is actively engaged in five key initiatives,9 addressing areas of core significance to the sector’s needs:

A mental health strategy: that will help ensure that everyone in Canada, whether or not they are living with mental health problems, has the opportunity to achieve the best possible mental health, by focusing national attention on mental health issues; to set clear targets for transforming the mental health system; and, to promote recovery and well-being. 10

An anti-stigma initiative: Opening Minds is designed to change the attitudes and behaviours of Canadians towards people living with mental illness.11

A homelessness research demonstration project: At Home/Chez Soi is using and studying a Housing First approach to helping people who are homeless and mentally ill. This project assists the homeless with finding and paying for housing, and then helping with other challenges such as mental illness and addictions through the provision of targeted programming. More than two thousand homeless people will participate in five cities across Canada. Through random assignment, 1,325 participants will receive tailored housing and support services, and the remaining group will receive the kind of care normally available in their city.12

A knowledge exchange centre: an initiative that will facilitate the development, uptake, adoption and integration of different types of knowledge. It includes the development of a framework and the exploration of various forms of technologies, tools and resources and to ensure evaluation is built into all levels of the MHCC’s work.13

8 Federal government funding was made available in the 2007 budget; retrieved March 23, 2011:

http://www.mentalhealthcommission.ca/English/Pages/Background.aspx 9 Please note that in February 2011 the MHCC has added a sixth initiative to its work, Mental Health First Aid. However, this

initiative is beyond the scope of this evaluation, which is relevant to December 31, 2010. 10

See On our Way: MHCC Annual Report 2009 – 2010, p. 6; retrieved on March 21, 2011, from http://www.mentalhealthcommission.ca/annualreport/MHCC_AR_2009_2010.pdf.

11 Ibid, p. 8.

12 Ibid, p. 10.

13 Ibid, p. 12.


Partners for mental health program: the MHCC’s initiative for creating a grass-roots social movement that will raise awareness fro mental health issues, through action.14

Now in its fourth year of implementation, the MHCC initiated a formative evaluation of its work, with a directive to assess implementation from July 2007 – December 31, 2010. The evaluation is in compliance with the Health Canada funding framework and Treasury Board evaluation guidelines. The purpose is to assess: 15

Progress towards the MHCC’s five key initiatives;

Effectiveness of policy and/or programs;

Impacts both intended and unintended; and,

Alternative ways of achieving expected results.

In October 2010 the MHCC contracted with Charis Management Consulting Inc. to undertake a comprehensive evaluation of the organization. The evaluation was to identify gaps and challenges and ensure that MHCC achievements and successes were well documented, substantiated and shared. The findings were expected to guide recommendations for both further development and the implementation of current activities. The Commission sought an evaluation approach that would be dialogic and include strategic learning that would impact organizational development. Of note is the fact that the MHCC wanted the inclusion of the homelessness demonstration research project, At Home/Chez Soi, in this formative evaluation. This stand-alone project is both supported by the MHCC and supports the other four initiatives. While a more comprehensive evaluation of At Home/Chez Soi will be required at a later date (under its separate funding agreement with Health Canada), the initiative was included in the current evaluation. It is anticipated that MHCC management team will be able to utilize the evaluation results immediately and as they prepared for the At Home/Chez Soi initiative’s formative evaluation.

1.2 Organization of the Report

The remainder of this report presents the formative evaluation report of the MHCC. It is organized into five main sections:

Evaluation Methodology;

Results from Phase 1;

Methodology workshop

Document review

Key informant interviews

Results from Phase 2;

Administrative data review

14

Ibid, p. 14. 15

Mental Health Commission of Canada (May 2010). Request for Proposals for Independent Evaluation of the Mental Health Commission of Canada (p. 7).


Survey

Key informant interviews and focus groups

Conclusion and Recommendations; and,

Appendices including both detailed results tables and all instruments and the survey used to

gather data, as indicated in the body of the report.

A summary report is available as a separate document.

2. Methodology

2.1 Evaluation Design Comprehensive and inclusive by design,16 the formative evaluation focused on understanding process, and how the MHCC has evolved over the first three years of implementation (2007 – 2010). Too early in implementation to determine longer term impacts, key evaluation objectives were to determine successful/unsuccessful techniques and processes employed during the MHCC’s first three years of activities. Further, the evaluation assessed what progress the organization has made towards implementing services and processes aimed at addressing the five stated initiatives and contributing to achievement of the mandate. The work took place in two phases: Phase 1 concerned the development of the Evaluation Framework; and, Phase 2 concerned activities resulting in implementation of the framework and assessment of the findings. Fundamentally this formative evaluation addressed the following questions:

Mandate: Is the MHCC initiative consistent with the assigned mandate as per the funding agreement with Health Canada?

Inputs/Structure: How are the MHCC’s governance structure, processes and support mechanisms contributing to the achievement of the MHCC mandate and goals?

Achievements: What has been achieved by the MHCC to date in terms of implementation of the assigned mandate?

Early Impacts: How has the MHCC affected the work and lives of partners and collaborators in the mental health system?

Recommendations: What can be learned from implementation to date and are there any recommendations for improvement?

All data collection processes were aligned with the evaluation questions derived from the Level 1 logic

model developed in the first phase of the work. 17

16

This includes language. All data gathering instruments were translated into French, for use if requested by respondents and interviewees. Additionally, the final report s (technical and summary) will also be presented in English and French.

17 Please note: the formative evaluation is not designed to provide data on whether the MHCC has contributed to improved services and a transformed mental health system, and it cannot answer the question of whether the MHCC has contributed


To facilitate the evaluation process and ensure robust data collection and analysis, Charis invited four sector experts to participate in an Expert Evaluation Advisory Panel. This group was selected to provide supplemental guidance, as needed, to the Charis project team. They were engaged at two key points in the evaluation process, providing expert advice on: the logic models and evaluation framework (Phase 1); and, the preliminary findings (Phase 2). The four advisors were:

Patrick Corrigan, PhD, Distinguished Professor and Associate Dean for Research, Institute of Psychology at Illinois Institute of Technology;

Ian Graham, PhD, Vice-President Knowledge Translation, Knowledge Translation and Public Outreach Portfolio, Canadian Institutes of Health Research;

Fay Herrick, BEd, former President of the Schizophrenia Society of Alberta (Calgary Chapter) and mental health advocate; and,

Scott Theriault, MD, FRCPC, Director, East Coast Forensic Hospital.

2.2 Data Collection

2.2.1 Phase 1 Data Collection

Phase 1 of the evaluation concerned the completion of a comprehensive evaluation framework to

inform all aspects of data collection instrument development and the analysis of the results (both Phase

2 activities). To that end, the following data collection methods were utilized in the first phase:

Methodology workshop;

Review of key project documents; and,

Interviews with key informants from specified target audiences.

Methodology Workshop

Charis organized and implemented a methodology workshop to ensure that the evaluation methodology

to be developed would be rigorous and useful to the MHCC. The workshop facilitated understanding of

the MHCC’s development, the programs to be evaluated, and their intersection with the evaluation

questions (and the Treasury Board evaluation criteria). At this time we discussed matters of purposes

for evaluation (e.g., accountability and/or improvement); types of evaluation (e.g., evaluability

assessment, developmental); and, audience expectations (e.g., MHCC decision-makers, Health Canada).

As a result of the workshop, the scope of the evaluation, data collection activities and methodologies to

be utilized for Phase 1 and Phase 2 data collection were finalized and a comprehensive list of required

to improved mental health services for Canadians. These questions concerning program impacts will be addressed and answered in the future, through a summative evaluation.


MHCC documentation was developed. Workshop participants included the MHCC Executive Leadership

Team members, other MHCC senior leaders, and key partners as invited by the MHCC.

Review of Project Documents

Charis conducted a preliminary and targeted document review of internal MHCC administrative data to

further extend understanding of the formal commitments to which MHCC was accountable. To that

end, business plans, funding agreements, early background documents, annual reports and operational

policies and procedures were examined. As well, documents specific to both the five key initiatives and

the eight Advisory Committees were studied to explore further MHCC expectations and commitments.

A document review template was developed as a mechanism to compile consistently key information

needed for the evaluation. Evaluators then populated the templates based on material forwarded by

the MHCC and other sources. Any items the evaluators had noted as missing were requested from the

MHCC. The validated document review tools were used to report on activities and achievements for

each group and to inform the up-coming key informant interviews. The results of a snapshot review of

MHCC document development across time is presented in Table 1. The creation of relevant

organizational documents to inform the governance, structure, processes and procedures for the

organization indicates the trend towards a more robust development of such documents as the

Commission evolves.

Table 1: Snapshot of MHCC document review

2007 2008 2009 2010

Funding Agreements

Business Plans,

Audited Financial

Statements

Annual Reports

FA – 1

BP – 1

FA – 2

BP – 1

AFS - 1

BP – 1

AFS – 1

AR - 1

BP – 1

AFS – 1

AR - 1

MHCC Organizational

documents (org charts,

policies and directives)

T of R – 2

Guides - 1

T of R - 2

Guides – 1

(rev)

Org Charts – 2

Policies – 8

Discussion documents;

summaries and

products/reports of AC

work and other projects

Project précis – 1

Reports/products

– 2

Summaries - 1

Reports/products -

9

Summaries - 1

Reports/produ

cts – 12

Summaries - 3


Key Informant Interviews

In collaboration with the MHCC evaluation project leads, the evaluator identified informants from

among the key stakeholders to be consulted; the participants were purposively selected. The function

of these interviews was two-fold: 1) to gain important information and perspective on the inception

stage of MHCC development; and, 2) to inform and validate the level one and two logic models created

during this phase of evaluation activities. In collaboration with the MHCC, Charis developed an

interview guide (see Appendix C), and collected data from nine key informants to gain information on

MHCC’s programs, policies and activities. The respondents are identified in Table 2.

Table 2: Phase 1 key informant interview participants

Informant group Number

MHCC administrative and management decision-makers 5

MHCC Advisory Committee Chairs 2

MHCC Board 1

Representatives from Health Canada 1

Total: 9

Key informants were invited to participate through an introductory letter sent by the MHCC that

outlined the purpose of the evaluation and introduced the evaluator. Charis then contacted potential

informants to schedule a telephone interview. Topic areas for this interview included:

Proposed logic models;

Upcoming evaluation questions; and,

Observations on MHCC implementation, to date.

The interviews were conducted over the phone, recorded, then transcribed and themed.

As a result of these data collection activities, and in consultation with the MHCC project team, Charis

developed one Level 1 logic model and five Level 2 logic models (see Appendix A). Once developed

Charis hosted a validation teleconference with key MHCC project stakeholders. The logic models were

reviewed for accuracy and validated as accurate program representations. The Level 1 logic model

provides an overview of the MHCC including its assumptions, inputs/resources, processes/activities,

outputs, audience, impacts and ultimate outcomes to which the MHCC contributes. The indicators

proposed in the Level 1 logic model are bigger picture indicators of principal importance to the decision-

makers (Executive Leadership Team (ELT) and the Board of Directors). The five Level 2 logic models are

initiative specific; these present the logic for each one of the five initiatives. These logic models contain


indicators of interest at the program level, including those that may be routinely reported on to the

MHCC CEO. Once validated, the logic models informed the evaluation framework. The resulting

methodology report was submitted to the client for review and approval, before formal adoption as a

guide for Phase 2 activities.

2.2.2 Phase 2 Data Collection

Phase 2 of the evaluation was designed to implement the evaluation methodology approved in Phase 1.

In this second phase of project implementation, the following data collection activities occurred:

Document review;

Data collection tool development and implementation (survey, key informant interview guides,

focus group guides); and,

Interpretation workshop on preliminary findings.

Document Review

This aspect of data gathering provided Charis with a comprehensive understanding of the context,

activities, objectives, and mandate for the MHCC, from both internal and external sources. The review

assessed the degree to which existing policies and procedures fit with the current mandate as well as

the MHCC’s vision, mission and values. Further, it provided a rich context for the history and operation

of the organization and how formal statements of program intention align with the evidence that was

derived from quantitative and qualitative data collection.

In this second phase of the project, documents internal and external to the Commission were consulted.

A full list of documents is provided in Section 4.1 Administrative Data Collection.

Data Collection Tool Development and Implementation

To generate robust data for this formative evaluation, multiple lines of evidence were gathered to

ensure a comprehensive analysis process. It was understood that at this point in MHCC implementation

the measures were to contribute to organizational accountability; for ongoing monitoring and reporting

on progress made in each of the initiative areas; to determine initial successes and perceived challenges;

and, to help determine initial sector impacts. By using both quantitative and qualitative methods of

data gathering, garnering feedback from a wide range of stakeholder types, (and the review of key

MHCC and other stakeholder documents), the data collection provided a comprehensive gathering of

evidence relevant to the assessment of MHCC activities.

Online Survey Instrument

In collaboration with the MHCC evaluation project team, Charis created a 33 question online survey that

was implemented with mental health stakeholders between January 20 - February 14, 2011. The survey


included both closed and open-ended questions and was approved by the client (see Appendix C).

Notice of the survey was provided through multiple methods: the link was sent to over twenty national

mental health organizations selected by Charis and posted on the MHCC Facebook page on January

20th. It was sent to all MHCC newsletter recipients (n=8,000) on February 3rd, to the MHCC Advisory

Committee Chairs on February 7th, as well as all MHCC Staff on February 9th. All of these recipient

groups were asked to send the survey link out to their networks. This sample (n=unknown) resulted in

463 completions. IP addresses were monitored to eliminate duplicate completions from the same

computer.

The survey was drafted in collaboration with the MHCC project team, pre-tested and approved. It was

designed in consonance with the Level 1 logic model and evaluation framework and addressed the

following topics concerning the respondent’s perception of the MHCC concerning:

General awareness;

Opportunities for collaboration;

Key initiatives;

Promotion of programs and products;

Early impacts;

Overall observations; and,

Background information on the respondent.

The survey was translated into French and posted online, for the purposes of facilitating French speaking

respondent participation, resulting in nine surveys being completed in French (of a total, n=463).


Phase 2 data collection included substantive semi-structured interviews with stakeholders central to the

work of the Commission. In consultation with the MHCC, two key informant interview guides were

created: 1) for MHCC partners and staff; and, 2) for people with lived experience, their families and

caregivers. The interview guides were designed in alignment with the evaluation framework and, while

the over-arching structure of these guides was the same, there were differences in some questions, in

order best to access the perspectives of the different respondent types (see Appendix C). The guides

were approved by the client.

The number of informants interviewed by those selected is presented in Table 3. The sample contained

both people purposively selected (based on MHCC contact lists) and randomly selected (from Charis

generated lists). Additionally, some of the individuals interviewed represent more than one informant

group. For example, an individual may be both staff of a service provider organization and a family

member of a person with lived experience, thus representing two informant groups.


Table 3: Phase 2 key informant interview participants

Informant group Number

People with lived experience, family members and/or caregivers 18

12

MHCC Board and staff 8

Representatives of stakeholder organizations 4

Federal/Provincial/Territorial or other governmental representatives 2

Other interested/involved parties (researchers, educators or others) 3

Total: 29

Key informants were invited to participate through an introductory letter sent by the MHCC; it outlined

the purpose of the evaluation and introduced the evaluator. Charis then contacted potential informants

to schedule a telephone interview. Topic areas addressed the following aspects of the MHCC’s

development:

Mandate;

Structure;

Achievements;

Early Impacts; and,

Recommendations and final comments.

The key informant interviews were all conducted by telephone and recorded, to ensure comprehensive

and accurate transcription of the notes.

The key informant interview guides were translated into French and respondents were offered the

opportunity to choose in which language they would like to have the interview conducted; all French

speaking respondents chose to complete their interview in English.

Focus Groups

In order to enrich the qualitative data gathering process, four focus groups were implemented during

Phase 2 of this formative evaluation (see Table 4). Interview questions were prepared to guide the focus

groups and were designed to garner data on the five categories of evaluation questions: mandate,

structure, achievements, early impacts and recommendations. More specific questions and probes

were generated based on responses to these general questions. The guides were reviewed and

approved by the MHCC (see Appendix C).

18 Note – there was some cross-over from this category into other categories as some participants were working in some other

capacity within mental health but were interviewed under the category of PEOPLE WITH LIVED EXPERIENCE/family/caregivers.


The participants were selected from lists provided by the MHCC, and with respect to MHCC

management and staff, were randomly selected. Otherwise all possible respondents were purposively

invited to participate from the Advisory Committees (chairs only) and the Provincial/Territorial

Reference Group. While all four of these groups were originally intended to be conducted in person,

due to a meeting cancellation the Provincial/Territorial Reference Group participants’ session was

conducted by teleconference. It should be noted that Charis made provision to undertake a focus group

session in the French language, but this was not required. Finally, participants were invited to the

sessions by means of an introductory letter sent by the MHCC to introduce Charis as the evaluation

consultant. Charis followed up by phone and email; arranged meeting logistics (in cooperation with the

MHCC project team); and, moderated the groups.

Table 4: Phase 2 focus group locations and participants

Focus group Location Participants

Advisory Committee chairs Vancouver 8

MHCC management Calgary 5

MHCC staff Ottawa 5

Provincial/Territorial Reference Group participants Ottawa

(teleconference)

5

Total: 23

Two Charis consultants were present at each focus group: one moderated the session and the second

was responsible for note taking and logistics. Additionally, the sessions were recorded and the

recordings were utilized as back up for the notes. The focus group notes were then written up and

validated by both Charis consultants.

Interpretation Workshop on Preliminary Findings

The preliminary findings of the formative evaluation were presented by four evaluators at an

Interpretation Workshop of MHCC senior executives and leaders. The timing of this event afforded the

evaluators an opportunity to validate the issues and suggestions heard during the informant interviews

and focus groups, as well as through the online survey responses and document review. Workshop

participants included the MHCC ELT members and other MHCC senior leaders as invited by the MHCC.

Feedback from this workshop was considered in finalizing this report, as evaluators deemed

appropriate.


2.3 Evaluation Limitations

The evaluators recognize several limitations to this evaluation, and caution readers to interpret the

findings presented in this report accordingly. Many of the limitations associated with specific methods

were mitigated by the use of multiple data sources to achieve triangulation of data. Despite the

limitations, the evaluators are confident that the report represents a fair picture of the activities of the

MHCC and the perceptions of key parties, and offers valid findings to the Commission. Concerning

limitations;

First, the timeframe and financial constraints of the evaluation did not permit in-depth review of

the activities and products of each key initiative or project undertaken by the MHCC.

The evaluation spans the overall activities of the MHCC, the five key initiatives and, to

some extent, the work of the eight Advisory Committees. The amount of activity

undertaken over a three year period could only be summarized and reported at a high

level.

This evaluation timeframe involved a total of 7.5 months, with only one month available

for data collection. One impact of this timeline was that the online survey was in field for

only twenty five days. Charis was contacted by several potential respondents, who

discovered the opportunity to participate too late.

Second, while an attempt was made to access all relevant documents, it is possible that some

were inadvertently omitted. The evaluators relied on those received as of January 2011.

Third, the evaluators were somewhat reliant on the recommendations of the MHCC in identifying

potential informants with the greatest involvement with the MHCC. Because of this purposive

sample, there is a possible bias towards favourable perceptions of the MHCC. The evaluators

mitigated this by randomly selecting from the lists of key stakeholders, including representatives

not suggested by the MHCC, such as key national stakeholder groups and partners, and other

people with lived experience and family members who may not have been directly involved with

the MHCC. The random sample of participants increased the validity of the data analyzed in this

report. Concerning the survey, in addition to the sample recommended by MHCC, Charis

disseminated the link to over 20 national organizations and requested that the survey link be

distributed through those organizations’ networks.

Fourth, while detailed notes were taken during interviews and sessions, time and resources did

not permit word-for-word transcription of these recordings. However, two researchers reviewed

the notes and, where uncertainty existed the recordings were accessed and incorporated.

Fifth, although feedback on immediate impacts can be recorded in this evaluation, the MHCC

implementation is not sufficient to measure and report on long term outcomes. This was

appropriate for this formative evaluation.


Despite the noted limitations, we believe the evaluation generated valid and useful information to assist

the MHCC in future planning.

3. Results from Phase 1

To support the development of the evaluation framework that would inform Phase 2 data collection,

Charis undertook four separate activities: 1) organization and implementation of a methodology

workshop; 2) a document review of targeted MHCC administrative data; 3) key informant interviews

with internal and external decision-makers; and, 4) the integration of the data (derived from activities 1

– 3) into the development of an evaluation framework, including Level 1 and five Level 2 logic models,

evaluation questions, and a data matrix. These were compiled into a methodology report, and guided

Phase 2 of the evaluation. The following outlines the results of these activities.

3.1 Logic Models The Level 1 Logic Model (see Figure 1), addressing the higher level indicators of principle importance to

the MHCC’s Board and ELT, is followed by five Level 2 logic models (see Appendix A), presenting the

logic for each of the MHCC’s key initiatives: mental health strategy; anti-stigma campaign;

homelessness research demonstration project; knowledge exchange centre; and partners for mental

health program. The information in the Level 2 logic models is of direct use to the program level

decision-makers. Together, these logic models were developed and validated in discussion with the

MHCC evaluation project team and key stakeholders (key informant interview participants).

While these logic models were newly developed in the framework of this formative evaluation and are

considered accurate as of December 2010, they are fluid documents. That is to say, logic model

timelines vary for the different types of measures (short term – longer term) and should be seen as

responsive documents that evolve with the Commission, as programs, needs and environment changes

are perceived and responded to. Further, logic models are also learning tools; these Level 1 and 2

documents will facilitate continuous feedback that can be integrated into program development,

implementation and subsequent evaluation.

14

KEY ACTIVITIES IMPACT/ INITIAL OUTCOMES

(2 – 4 YRS)

INTERMEDIATE OUTCOMES (5 – 8 YRS) OUTPUTS INPUTS/RESOURCES AUDIENCES

Reach Distribution

(push & pull)

Contribute to: System outcomes

A transformed mental health system and transformed Canadian society as outlined by the 7 goals of the Mental Health Strategy for Canada and evidenced by effective and efficient delivery of services

PWLE outcomes

Active engagement for improved health outcomes/ quality of life and able to live meaningful, productive lives.

Work plans developed for each strategy

Programs or frameworks developed Environmental scans /surveys

completed Nationwide consultations

implemented Production and dissemination of

reports and other materials

Advice and support for the 5 key initiatives

24 Advisory Committees’ projects commenced/awarded

Production & dissemination of reports, frameworks, documents & workshops

Meetings with governments (FPT) & other stakeholders

National/International Conferences/Symposia& Roundtables held

Communication plan in place Data & info through website Info via key communication channels

of partners Info via national, local media and

news media

MHFA trainings provided Adaptation of MHFA curriculum for the

NWT government

Board reports Strategic and business plans Policies and procedures Organizational structure documents Priority projects such as Risk Analysis

Restraint and Seclusion, and others Performance management logic

model developed Evaluations implemented and

reporting on evaluation Funding and other resources secured Code of Conduct developed

Increased:

Awareness and understanding of mental health and mental illness by all people living in Canada

Awareness of the MHCC by partners and collaborators

Dissemination of evidence- informed knowledge to governments and stakeholders

Knowledge base: sharing/exchange of knowledge

Understanding of stakeholders’ views on mental health and mental illness

Positive reporting and decreased negative reporting on mental health and mental illness by the media

Collaboration and participation of service providers, governments, educators and researchers

Stakeholder utilization of MHCC resources and products

Engagement of PWLE and families

Access to voice of PWLE, their families and caregivers

General awareness of stigma and its impacts on PWLE

Involvement of people living in Canada in Partners for Mental Health

Improved delivery of services for individuals who are mentally ill and homeless in 5 selected communities in Canada

Inclusive workplace environment at MHCC

Funding

HC ($130 M over 10 years)

HC for At Home/Chez Soi

($110 /M over 5 yrs)

Other sources

Accountability

Governance Board

Government of

Canada/Health Canada

Human resources

MHCC Executive and staff

Contracted staff and

agencies

Volunteers (Advisory

Committees and others)

Partners/collaborators

PWLE of mental illness

Families and caregivers

Government (FPT)

stakeholders

NGO stakeholders

Service provider

stakeholders

Researchers

Educators

International partners

National and local media

People living in Canada

Local communities

ULTIMATE

OUTCOMES (9-10 YRS)

Reduced stigma and discrimination related to mental illness

Improved collaboration among partners and collaborators

Improved awareness of issues and evidence-informed best practices to address those issues

Increased utilization of MHCC research impacting the development of policy and service delivery

Enhanced integrated and collaborative mental health system

Increased capacity of decision makers to implement policies

The MHCC is responsible to people

with lived experience of mental illness

and their families, service providers,

researchers and governments in

Canada.

The MHCC and the mental health

system have a responsibility related to

the mental well being, mental health

promotion and mental illness

prevention for all people living in

Canada, including children, youth,

adults and seniors.

The implementation of a mental health

strategy for Canada relies not just on

the development of the strategy by the

MHCC but the combined support and

collaboration of all stakeholders to

make this a reality.

People living in Canada support the

work of the MHCC.

Communities and service providers are

responsive to and working

collaboratively to support the work of

the MHCC.

People in the mental health community

(including PWLE, families, caregivers,

mental health service providers and

other stakeholders) who are aware of

the MHCC, have high expectations

including an expectation of real and

concrete deliverables.

ASSUMPTIONS

Researchers/

Academics/

Educators

Minister of Health/Health

Canada

ACRONYMS

GOC Government of Canada

HC Health Canada

MHCC Mental Health Commission of Canada

PWLE People with Lived Experience

FPT Federal, Provincial & Territorial

NGO Non-governmental Organizations

Figure 1. Logic Model for the Evaluation of the Mental Health Commission of Canada – Level 1 (as of December 2010) Vision: A society that values and promotes mental health and helps people living with mental health problems and mental illness to lead meaningful and productive lives.

5 Key Initiatives

Mental Health Strategy for Canada

Opening Minds Anti-Stigma/Anti-

Discrimination Initiative

Knowledge Exchange Centre

Partners for Mental Health

At Home/Chez Soi multi-site mental

health and homelessness research

demonstration projects

Advisory Committees

Implementation of 8 Advisory

Committees (ACs)

Priority initiatives/projects undertaken to

support the 5 key initiatives

Engagement/Raising Awareness/

Communication

Establish, maintain partnerships

Linkages with partners for dissemination

opportunities

Develop communication plan with key

messages, communications vehicles,

priorities and detailed communications

strategies for each strategy

Program Delivery

Mental Health First Aid (MHFA)

Corporate Management and Governance

Board governance

Policies and procedures

Operating model

Organizational structure

Policy and Research team support to -

ACs and other priority projects

Performance management structure

developed

Secure additional funding for initiatives

into the future

Establishing the MHCC as a role model

workplace – a mentally and physically

safe workplace environment for staff and

volunteers

All

People living in

Canada

PWLE (including

homeless)/

Families/

Caregivers

Mental Health

Professionals/Service

Providers/

NFP groups

Federal, Provincial,

Territorial Ministries &

Authorities

Federal, Provincial

Territorial Decision &

Policy Makers


3.2 Evaluation Questions

Upon completion of the Level 1 logic model, it was possible to form the questions needed to implement

the evaluation. Those questions are presented in Table 5.

Table 5. Evaluation questions and sub-questions

Overarching evaluation

question

Evaluation sub-questions

Mandate:

To what extent is the MHCC

implementation consistent

with the assigned mandate?

1.1 Is the MHCC initiative consistent with the assigned mandate as per the funding agreement with Health Canada?

1.2 Is the MHCC meeting the grant agreement requirements?

1.3 Are the 5 priorities set by Health Canada the right ones? Are there gaps?

1.4 What funding resources are in place for the MHCC?

1.5 Is the allocated funding sufficient to implement the mandate?

1.6 How have other jurisdictions’ developed and managed national mental health strategies?

Structure:

How is the MHCC’s

governance structure and

support mechanisms

contributing to the

achievement of the MHCC

mandate and goals?

2.1 How are the MHCC’s governance structure, processes and support mechanisms contributing to the achievement of the MHCC mandate and goals?

2.2 Were the decisions made around governance and leadership effective in meeting the assigned mandate?

2.3 What has been achieved to date in terms of establishing the organization? 2.4 Does the MHCC have appropriate performance measurement and reporting

strategies? 2.5 Are the current organizational structure, processes and support mechanisms

functioning as expected? 2.6 What kind of support should MHCC staff provide? 2.7 Are there the right number and mix of staff, Advisory Committee members

and other volunteers available to achieve the MHCC mandate and goals? 2.8 Is there the right number of Advisory Committees? 2.9 Are the Advisory Committees focused on the right content areas? 2.10 Is the role of people with lived experience authentically a key component of

the MHCC staff and volunteers? 2.11 Who are the MHCC’s critical partners and collaborators? 2.12 Has the MHCC been able to establish effective and collaborative partnerships

with federal, provincial and territorial governments and other stakeholders? 2.13 Has the MHCC established itself as a model workplace in terms of physical

and psychological safety?

Early Achievements:

What has been achieved by the MHCC to date in terms of implementation of the assigned mandate?

3.1 What has been achieved by the MHCC to date in terms of implementation of the assigned mandate?

3.2 What aspects of the implementation of the MHCC 5 key initiatives are working well? What aspects of the implementation of the MHCC 5 key initiatives are problematic? Why?

3.3 To what extent is the MHCC integrating the work of the 5 initiatives toward common goals?

3.4 What is working well in terms of raising awareness of mental health and


mental illness? What factors contribute to success? What are the challenges and issues related to raising awareness and how are these being addressed?

3.5 How effective are the communication strategies utilized by the MHCC? What is working well, what are the challenges and how are they being addressed?

3.6 How effective was the transition of the MHFA Program to the MHCC?

3.7 Is the MHFA program being implemented effectively?

3.8 What products and services have been developed through the work of

the MHCC?

3.9 Are the products and services consistent with the vision and mandate of the

MHCC?

3.10 Are planned activities producing the expected outputs?

3.11 What early examples of success are evident?

3.12 What has been the MHCC most important achievement to date?

Early Impacts:

How has the MHCC affected

the work and lives of partners

and collaborators in the

mental health system?

4.1 How has the MHCC affected the work and lives of partners and collaborators in the mental health system?

4.2 How does the MHCC act as a catalyst for the work that is done?

4.3 What principles and values do you see reflected in the work of the MHCC?

4.4 What are the things that are seen as innovative in the work of the MHCC?

4.5 To what extent are people relying on the output of the MHCC?

4.6 Is the MHCC meeting the broader mental health goals for people in Canada?

4.7 Is the MHCC well positioned for success in achieving its intermediate and ultimate outcomes?

4.8 Is the MHCC going to make a difference for people with lived experience of mental illness or mental health problems and their families or caregivers

Recommendations:

What recommendations can be offered to strengthen the MHCC into the future?

5.1 What can be learned from implementation to date and are there any recommendations for improvement?

5.2 What recommendations are offered to strengthen the MHCC going forward?

5.3 What recommendations are offered to the MHCC in terms of measurement of overall outcomes over their 10 year lifespan?

5.4 What could be the MHCC most important contribution in the future?

What MHCC initiatives should be sustained beyond 2017?

3.3 Evaluation Matrix The Level 1 logic model and high level evaluation questions grounded the development of a data matrix

that included the detailed evaluation questions, indicators and data sources. This key evaluation

information is presented in Table 6. The data matrix in turn, was used to develop the data collection

instruments and guides.


Table 6. MHCC formative evaluation data table

Questions Indicators/metrics Data sources & methods

MANDATE

1.7 Is the MHCC initiative consistent with the assigned mandate as per the funding agreement with Health Canada?

1.8 Is the MHCC meeting the funding agreement requirements?

1.9 Are the priorities set by Health Canada the right ones? Are there gaps?

1.10 Are MHCC funds being leveraged for securing additional funding?

1.11 Is the allocated funding sufficient to implement the mandate?

1.12 How have other jurisdictions’ developed and managed national mental health strategies?

Description of the MHCC organizational structure, leadership, committees and support mechanisms

Description of how content areas of the initiatives were decided and contribute to the mandate.

Description and perceptions of adequacy of the accountability and decision-making structures and processes

Description and perception of appropriateness of the 5 initiatives and any identified gaps

Type and level of funding available

Perception of adequacy of funding

Description of other jurisdictions with national mental health organizations

Document Review

Key Informant Interviews (up to 30)

Focus Groups – MHCC staff, Advisory Committees chairs or co-chairs and 1 member from each, FPT group, people with lived experience

Survey

INPUTS/STRUCTURE

2.14 How are the MHCC’s governance structure, processes and support mechanisms contributing to the achievement of the MHCC mandate and goals?

2.15 Were the decisions made around governance and leadership effective in meeting the assigned mandate?

2.16 What has been achieved to date in terms of establishing the organization?

2.17 Does the MHCC have appropriate performance measurement and reporting strategies?

2.18 Are the current organizational structure, processes and support mechanisms functioning as expected?

2.19 What kind of support should MHCC staff provide to the Advisory Committees?

2.20 Are there the right number and mix of staff, Advisory Committee members and other volunteers available to achieve the MHCC mandate and goals?

2.21 Is there the right number of Advisory Committees?

2.22 Are the Advisory Committees focused on the right content areas?

Description of the MHCC governance structure, processes and support mechanisms

Evidence of business plans and reporting on progress

Evidence of documents and practices put in place

Description and perceptions of MHCC governance, processes and support by staff, Advisory Committee members and other volunteers involved in the MHCC work

Evidence of staffing model implementation and progress

Description and perceptions of Advisory Committee structures, composition and content areas

Description/evidence of products of the Advisory Committees’ work

# of requests for Advisory Committee advice or support by MHCC and other stakeholders

Description of the 24 Advisory Committee projects commenced

# of reports, frameworks, other documents and workshops provided

Perceptions of adequacy or usefulness of products of ACs’ work Description of roles, types of participation and perceptions of involvement of people with

lived experience in the work of the MHCC

List and description of the partners and collaborators

Perceptions of the effectiveness of partnerships to date

Factors that contribute and barriers to effective partnerships

Document review

Focus groups

KI interviews



2.23 Is the role of people with lived experience authentically a key component of the MHCC staff and volunteers?

2.24 Who are the MHCC’s critical partners and collaborators?

2.25 Has the MHCC been able to establish effective and collaborative partnerships with federal, provincial and territorial governments and other stakeholders?

2.26 Has the MHCC developed itself as a model workplace in terms of physical and psychological safety?

Factors that contribute and barriers to collaborative partnerships

ACHIEVEMENTS

3.6 What has been achieved by the MHCC to date in terms of implementation of the assigned mandate?

3.7 What aspects of the implementation of the MHCC 5 key initiatives are working well? What aspects of the implementation of the MHCC 5 key initiatives are problematic? Why?

3.8 To what extent is the MHCC integrating the work of the 4 initiatives toward common goals?

3.9 What is working well in terms of raising awareness of mental health and mental illness? What factors contribute to success? What are the challenges and issues related to raising awareness and how are these being addressed?

3.10 How effective are the communication strategies utilized by the MHCC? What is working well, what are the challenges and how are they being addressed?

3.11 How effective was the transition of the MHFA Program to the MHCC?

3.12 Is the MHFA program being implemented effectively?

3.13 What products and services have been developed through the work of the MHCC?

3.14 Are the products and services consistent with the vision and mandate of the MHCC?

3.15 Are planned activities producing the expected outputs?

3.16 What early examples of success are evident?

3.17 What has been the MHCC most important achievement to date?

Description and perceptions of the 5 key initiatives

Identified facilitators and success factors in implementation per initiative

Challenges and barriers to implementation per initiative

Reporting requirements on results for the 5 initiatives identified

Evidence that the initiatives are collecting outcomes data and reporting on planned results

Identification of performance measurement and reporting strategies

Description and perception of communication strategies used and effectiveness including a description of successes and facilitators of communication, challenges, constraints and barriers to communication and how addressed

Perceptions as to the effectiveness of the MHFA Program’s transition

Successes and barriers in MHCC implementation of the MHFA Program

# work plans, programs, frameworks developed

# and type of environmental scans and surveys completed

# of nationwide consultations completed

# reports and other materials disseminated

# and type of partnerships developed (government, other stakeholders)

# of conferences, symposia, roundtables implemented and participated

website utilization - # unique visitors, # visits, # hits

# reports and documents disseminated/downloaded from website and # copies disseminated/downloaded

# information items distributed through key communication channels of partners

# press releases by MHCC

# media events covered in national, local media

Descriptions and perceptions of examples of early success

Document review

Focus Groups (MHCC, FPT, AC, people with lived experience)

Survey



EARLY IMPACTS

4.9 How has the MHCC affected the work and lives of partners and collaborators in the mental health system?

4.10 How does the MHCC act as a catalyst for the work that is done?

4.11 What principles and values do you see reflected in the work of the MHCC?

4.12 What are the things that are seen as innovative in the work of the MHCC?

4.13 To what extent are people relying on the output of the MHCC?

4.14 Is the MHCC meeting the broader mental health goals for people in Canada?

4.15 Is the MHCC well positioned for success in achieving its intermediate and ultimate outcomes?

4.16 Is the MHCC going to make a difference for people with lived experience of mental illness or mental health problems and their families or caregivers?

Descriptions and perceptions of the affect the MHCC has had on the work and lives of partners and collaborators

Examples of being a catalyst identified, with most effective aspects described

Principles and values are identified

Innovations in the work of the MHCC are identified

Description and perceptions on whether the MHCC is meeting broader mental health goals

Description and perceptions on whether the MHCC is well positioned for success in achieving its intermediate and ultimate outcomes

Perceptions on whether the MHCC is going to make a difference for people with lived experience and their families or caregivers

Document Review

KI Interviews

Focus Groups (people with lived experience, FPT)

Survey

RECOMMENDATIONS

5.5 What can be learned from implementation to date and are there any recommendations for improvement?

5.6 What recommendations are offered to strengthen the MHCC going forward?

5.7 What recommendations are offered to the MHCC in terms of measurement of overall outcomes over their 10 year lifespan?

5.8 What could be the MHCC most important contribution in the future?

5.9 What MHCC initiatives should be sustained beyond 2017?

Learning and recommendations for improvement identified

Perceptions and opinions of ways to strengthen the MHCC

Perceptions and opinions on measurement of outcomes

Focus Groups (MHCC, FPT, people with lived experience)

Survey

Key Informant Interview


3.4 Data Collection Coverage

Finally, the comprehensive data collection coverage that Charis designed into this formative evaluation

is disclosed in Table 7. To ensure valid and robust data, multiple data sources provided coverage of key

MHCC stakeholder perspectives. Each of the stakeholder groups participated in multiple lines of

evidence data gathering, through responding to key informant interviews, participating in focus groups,

and participating in the online survey. Together, the findings provide a thorough understanding of

stakeholder perspectives on the work of the MHCC.

Table 7: Summary of data collection coverage for Phase 2

Data source Methods Number

MHCC:

Board members/Executive Team

Directors and Managers

Other staff

Volunteers

Key Informant Interviews (KIIs)

Focus Group(s)

Survey

8 Key Informant Interviews

2 Focus Groups

Advisory Committee

Chairs or co-chairs

All members

Key Informant Interviews (chairs)

Focus group

Survey

1 Focus Group

Partners and collaborators

FPT partners

Health Canada

Service providers

NGO stakeholders

Researchers

Educators

Others


Focus Group

Survey


1 Focus Group

People with lived experience Key Informant Interviews

Survey


Families and caregivers Key Informant Interviews

Survey 3 Key Informant Interviews

Document review Funding agreements, strategic and

business plans, implementation plans

for each initiative, Advisory Committee

projects and other projects,

communication plans, media releases,

Board reports, organizational policies

and procedures, environmental scans,

surveys and frameworks, web-site hits

Totals


4 Focus Groups

463 Survey Completions


4. Results from Phase 2 Data Collection 4.1 Administration Data Description Following upon discussions with the MHCC evaluation project team, Charis examined both internal and external process reports and related materials in the framework of an extensive document review. The information was assessed and subsequently used in the construction of evaluation tools (e.g., key informant survey, online survey) and also as context for the analysis of data collection results. The information included:

MHCC documents related to the establishment and operation of the organization, including:

Funding agreements;

Strategic plans;

Business plans;

Board reports;

Annual reports;

Organizational policies and procedures;

Communications plans;

Media releases;

Communication data;

Website utilization data; and,

International mental health strategy evaluations.

Documents regarding each of the MHCC’s five key initiatives, specifically:

Implementation plans;

Advisory Committee projects;

Environmental scans; and,

Frameworks.

This information in the report is divided into the following sections, which outline:

Specific milestones that occurred during the MHCC’s inception phase (March 2007 – April 2008);

Overall MHCC milestones and key events for the five key initiatives from inception until December 2010;

MHCC Milestones and key events for the eight Advisory Committees; and,

Description and discussion of other national health strategies and international mental health strategies;

Administration data descriptions and figures including information on:

MHCC newsletters;


Speaking engagements;

Website utilizations;

Public relations; and,

Media coverage.

4.1.1 Inception Stage Developmental Milestones

The creation of the MHCC resulted in the achievement of several milestones of note; the chronology of

the first year of MHCC activities, March 2007 and April 2008 is demonstrated in Table 8. Significant is

the sustained development from the release of Out of the Shadows to sequestered federal government

funding of the Commission. The MHCC rapidly developed from a temporary transition team, with

interim offices in Ontario (Ottawa and Toronto) to an established and multi-year funded organization,

with a corporate office in Alberta.

Table 8: Chronology of MHCC establishment and development from March 2007 – April 2008

Time Activity

Pre

MHCC

February 2003 – The Standing Senate Committee on Social Affairs, Science and Technology began the first-ever national study of mental health, mental illness and addiction.

November 2005 – the Senate Committee first proposes the creation of the Mental Health Commission of Canada.

May 2006 – the Senate Committee tables its final report, Out of the Shadows at Last – Transforming Mental Health, Mental Illness and Addiction Services in Canada and reaffirms the need for a Mental Health Commission to provide an ongoing national focus for mental health issues.

March 2007 – the Government of Canada announces funding for the Mental Health Commission of Canada in the 2007 budget and indicated that the mandate and structure of the Commission would be closely based on the proposal contained in the Senate Committee report.

March

2007

The Mental Health Commission of Canada (MHCC) is established with the appointment of (former Senator) Michael Kirby as Board Chair. The first Board Directors appointed to the Commission were Michael Kirby, Michael B. Decter, (Senator) Wilbert J. Keon and Graham W.S. Scott. All of their appointments, with the exception of the Chair, expired on September 10, 2007.

July 2007 Contribution agreement with Health Canada signed July 4, 2007 with $5.5 million of funding made available to March 31, 2008.

August

2007

Official launch of the MHCC by Prime Minister Stephen Harper.

Septemb

er 2007

First full Board meeting.

Eight Advisory Committee Chairs are appointed and report directly to Michael Kirby and the Board of the MHCC.


October

2007 –

March

2008

Interim offices are established in Ottawa (for Chair of Board and key staff) and Toronto (for interim transition team).

Began development of governance and administrative policies, hired senior staff; conducted consultation sessions with stakeholders across Canada, launched studies and start-up activities; and, developed a five-year business plan.

February

2008

The Government of Canada announces in Budget 2008 the additional $110 million in funding to support a five year initiative with five research and demonstration projects in homelessness.

March

2008

Michael Howlett is hired as CEO.

Calgary office (Corporate) opens.

April

2008

Funding agreements with Health Canada take effect for contributions of $124.5 million over nine years ending March 31, 2017 and $110 million over five years ending March 31, 2013.

The steady achievements highlighted in this snapshot of the first year are sustained in subsequent years.

The MHCC has continued to evolve with intention over the three years, as captured in the milestone

charts below (see Figures 2 and 3). In Figure 2, concerning MHCC development, the time line is from

2006 and pre-MHCC (the launch of the Out of the Shadows report) through to December 31, 2010.

Beneath the timeline, the five key initiative milestones are tracked, by initiative. The following outputs

are noted: reports, meetings/presentations, workshop/training, launch, and other. This document

provides a detailed and visual overview of the core activities undertaken. Figure 3 presents similar data

against the timeline of Advisory Committee milestones. Underneath the timeline are activities and

products produced by each of the eight Committees.

Of consideration is the overall establishment of the MHCC from an initial and interim staff in 2007 to the

over 70 people currently employed in full time or part time positions and working in Calgary, Edmonton

and Ottawa. Also of note are the outputs from the five key initiatives and the eight Advisory

Committees. These activities indicate the depth and breadth of MHCC work—from presentations, to

key notes, to research reports, and project launches.


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Figure 3. Key MHCC Milestones by Advisory Committees

2007 2009 2010

Family Caregiver

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4.1.2 Inception Work on a Mental Health Strategy for Canada

As part of the development design process for a mental health strategy for Canada, the MHCC examined

other selected national health strategies (e.g., concerning cancer, diabetes) as well as international

mental health strategies (e.g., from the USA, Australia, Scotland). Charis reviewed the strategies, as well

as examined the MHCC’s internal review and preliminary conclusions of the same documentation.

Based on the review of MHCC documents, the aspects of interest from both within Canada and

internationally that the MHCC has integrated into the development of Toward Recovery and Well-Being:

A Framework for a Mental Health Strategy for Canada, which was released in 2009,19are as follows

(Table 9):

Table 9: Summary of international/national strategy integration

Key theme Other national strategies/jurisdictions MHCC conclusions

National and

International

Context

Government receptivity for a strategy

Level of responsibility for health by national governments

Different ways to address indigenous peoples

Arms length model well suited to Canada

Prepare for major shifts in politics, economics, health policy

Implementation Strategies followed by implementation plans across stakeholders

Communication and knowledge translation key to bridge strategy to implementation

Shift from measuring performance to outcomes

Joint pilot/research projects used (but sustainability an issue)

Strategic planning shifts over time (with progress and changing circumstances)

Increased attention to implementation planning and outcomes

Mental health outcomes measurement emerging

Unique monitoring challenges in Canada (related to responsibility for health across jurisdictions)

Focus & Scope Diverse approaches (comprehensive/global to specific strategic choices for quick wins)

Evolution from improving quality & access to focusing on the nature of services

Pressure to have comprehensive approach yet imperatives for focused priorities

Those that have made choices use mechanisms such as relevance mapping & alignment with interested partners

Some strategies begin with wide scope with selections made when it came time to do costing

Overall trend to comprehensive strategies

Recognize the need for a few key achievable priorities

Some consensus on the nature of priorities & focus of strategies (e.g. recovery, promotion & prevention, social inclusion, primary healthcare, whole of government, human rights, user/carer involvement)

Stakeholder

Engagement

National infrastructure for consumers & NGOs better developed in other countries

Public pressure

Consumers & carers well integrated into every component of the mental health

Stakeholder engagement is critical

Engagement of consumers/carers at all levels for meaningful

19

To a certain extent these components have cross-cutting impacts on the other four key initiatives, too.


system in some countries

Stakeholder engagement attributed to successful implementation

Indigenous engagement & specific strategies best done in close collaboration with leaders & national organizations

participation

Various models and all can play a role

Indigenous engagement best done from outset, in close collaboration with political leaders and organizations

Funding Those funded nationally have focused on knowledge development & transfer, coordination, measurement systems, innovation

Political receptivity key to securing funding

Provincial/Territorial (PT) funding has been dependent on alignment with PT interests

Mixed results in using economic case as a strategy to secure funding

Change objectives as part of funding agreements

Some focus on increased investment (globally & targeted) while others don’t see more money as the only answer

Federal funding important for implementing national levers for change (e.g., knowledge transfer, coordination, monitoring, innovation)

Increasing pressure to demonstrate return on investment, not just benefits to health outcomes

Spending differently, & incremental approaches critical for implementation

4.2 Administrative Data

A brief description of the MHCC’s outputs over the three year period covered by this evaluation is

provided below. Data for this section of the report was derived from a review of documents, including

products, detailed activity logs, and website utilization statistics. The descriptions are supplemented

with tables and figures to illustrate important data.

4.2.1 MHCC Newsletters

MHCC General Newsletter

The MHCC’s success in meeting its mandate is predicated upon sustained contact and collaboration with

the many individuals, organizations and stakeholders that are invested in the mental health sector. To

reach such a large audience, and attempt to engage them, the Commission developed a newsletter that

provides updates on the MHCC and its ongoing activities. The newsletter is delivered in electronic

format, and is provided in both official languages of Canada. As of 2008, the MHCC released eight

newsletters to stakeholders across Canada.20 It should be mentioned that prior to the summer of 2010

the Commission did not collect distribution data for the newsletter.

20 Information provided by the MHCC Communications Department.


The newsletter released in the summer of 2,010 was sent to 6,168 contacts, and was opened by 33%

(n=2,035) of contacts. The English version received 1,970 views, of which, 1,027 were unique views; the

French version received 235 views, with 154 unique views (see Figure 4).21

Figure 4. E-Newsletter (summer 2010) total and unique views, by language

The articles in the newsletter that received the most attention were articles on the At Home/Chez Soi Project, and Louise Bradley’s new appointment to CEO of the MHCC. Following the immediate release of the newsletter, 28 individuals subscribed to the product; since the summer of 2010, an additional 214 subscribers were noted.22

At Home/Chez Soi Newsletter

The MHCC has created a newsletter specific to the At Home/Chez Soi research demonstration projects. This newsletter targets contacts invested in this homelessness initiative. Between April 1, 2010 and December 31, 2010 the newsletter was distributed in Vancouver, Toronto, and nationally. Concerning the targeted distribution in Vancouver and Toronto, the following is of note:

Vancouver: distributed to 356 contacts including:

Landlords

Provincial Mental Health and Addictions Planning Council

Addictions and Mental Health organizations

Clinical advisors

People with lived experience

MLAs and MP’s

21 Analytics provided by the MHCC Communications Department. 22 Analytics provided by the MHCC Communications Department.

1970

235

1027

154 0

200

400

600

800

1000

1200

1400

1600

1800

2000

English French

# o

f V

iew

s

Version of Newsletter

Total Views

Unique Views


City of Vancouver

BC Housing

Vancouver Foundation

StreetoHome

Academics/researchers

BC Mental Health and Addictions Services Toronto: sent to over 500 contacts including:

Ontario ministries

Municipal government departments

Service providers

Media

Researchers

Community members

In addition to the newsletter, this initiative engages stakeholders and the public by posting information

and news on Twitter, with over 150 followers which are mostly advocacy or service organizations. As

well, the information is posted on the Centre for Research on Inner City Health website, and obtains

more than 12,000 website hits per month.23

4.2.2 MHCC Speaking Engagements

In addition to disseminating information using newsletters, the MHCC consistently participates in

speaking engagements, undertaking presentations that describe the work of the MHCC and/or

addressing other issues of relevance to the mental health sector. The figures below highlight the growth

in opportunities for presentations from 2007 to 2010, showing a steady increase in numbers of events

(Figure 5). Additionally, Table 10 indicates the persons who deliver the presentations, by numbers of

recorded engagements. The MHCC did not track all speaking engagements initially; the trend to more

accurate record keeping developed in 2010.24 In Table 10 is that only one event is recorded as “MHCC

unspecified” indicating the increasing commitment to record the details of MHCC activity.

23

At Home/Chez Soi newsletter data and information provided by the MHCC Communications Department 24

A full listing of the speaking engagements that were recorded is found in Appendix D. Again, it should be noted that the list is not exhaustive and that data collection began more fully comprehensive in 2010.


Figure 5. Total number of recorded speaking engagements by year

As depicted above, there has been an increase in speaking engagements over the years of MHCC

implementation. This is what you would expect to find as a trend for a new organization, and the

volume of speaking engagements indicates the large investment of time on the part of the MHCC to this

aspect of knowledge transfer and increasing public awareness. Additionally, it indicates the interest in

the sector, as the MHCC receives significantly larger numbers of requests each year and points to the

potential for the MHCC to act as a catalyst for the sector.

The speaking engagements were also examined in terms of who was speaking or representing the MHCC

(if recorded). Who was speaking on behalf of the MHCC, and how frequently is demonstrated in Table

10, by year. In some instances, more than one speaker was involved in the presentation, thus the total

values will be slightly different than the number of speaking engagements by year. Further, there were

fourteen instances for a speaker with a total of one engagement, shown in the table as “Other.”

11

58

93 105

0

20

40

60

80

100

120

2007 2008 2009 2010

# o

f e

nga

gem

en

ts

Year


Table 10. Number of recorded speaking engagements by year and speaker category

Speaker # of Recorded Engagements

2007 2008 2009 2010 Total

Louise Bradley, CEO and President 0 0 13 31 44

Jayne Barker, VP Research Initiatives and Mental

Health Strategy

0 9 11 9 29

David Goldbloom, Board of Directors 1 3 1 21 26

Michael Kirby, Chair of Board of Directors 0 3 5 7 15

Michael Howlett, Previous CEO and President (prior to March 2009)

0 5 6 0 11

Geoff Couldrey, VP Knowledge and Innovation 0 0 1 4 5

Patrick Dion, Board of Directors 0 0 1 3 4

Other staff 0 1 1 23 25

MHCC unspecified 10 37 54 7 108

Total 11 58 93 105 267

To understand what types of requests the MHCC was receiving, the speaking engagements were coded by event type:

Conference/presentations, such as presentations, poster presentations and conference attendance;

Lecture/seminars, including lectures, seminars, symposiums, forums, fairs, summits and series attended or spoken at;

Workshop/meetings, comprised of all workshops, meetings, launches, luncheons, showcases, festivals and debates;

Grand Rounds presented at hospitals;

Keynote speeches, at conferences and events;

General, which includes all other mental health related appearances and discussions; and

Other, which includes all other attendances at non-mental health related (e.g., convocations). The data above indicates that 2010 was the most active year to date for the MHCC concerning the

delivery of presentations. The majority of these engagements were conference/presentations, an event

type that shows a steady upward trend for the Commission, from no such opportunities in 2007 to 25 in

2010. Concerning general mental health related speeches, a steady rate of activity was noted in 2010 (7

in 2007, 14 in 2008, 12 in 2009, 14 in 2010).

Another important indicator of relevance is the location of the speaking engagements, given the

Commission’s national mandate. The national presence of the MHCC, concerning requests for

presentations is outlined in Figure 6.


Figure 6. Overall percent of speaking engagements by province (n=267)

The majority of tracked presentations have taken place in Ontario. Alternatively, there have been no

recorded presentations in the Northwest Territories, Nunavut or Yukon over the years, and very few

(less than five per year) in Alberta, Manitoba, New Brunswick, Nova Scotia, PEI and Saskatchewan.

However, it is not simply presentation numbers that are centralized to Ontario; other areas of interest

are as well (e.g., board member representation, research project sites, Advisory Committee chairs,

Advisory Committee projects).

While the data sets are not complete until 2010, the MHCC’s pan-Canadian presence with respect to a

number of key indicators is presented in the map of Canada (Figure 7). The Advisory Committee

projects are mapped based on the location of the research contractor. Once again, there is large

representation in Ontario, followed by Québec, while there is sparse representation in areas of Atlantic

Canada, the Prairies, and the Territories.

ON, 58.8% BC, 8.6%

AB, 5.6%

QB, 6.0%

NS, 4.1%

NB, 3.7%

NL, 4.1%

MB, 1.9% PEI, 1.5%

SK, 0.4%

Unspecified, 1.0%


Figure 7. Map of Canada demonstrating representation of areas of interest

Albertan=5

n=157

n=16

n=4

Territories

Manitoba

Ontario

Quebec

New Brunswick

n=2

n=4

n=2n=2

n=6

n=2

n=1

n=1

n=1

n=2

n=1

n=2 n=2

n=5

n=1

British Columbia Newfoundland

and Labrador

PEI

Nova Scotia

n=11

n=10 n=11

n=23

n=1

n=1n=1

n=1

Saskatchewan

n=12

International

n=1

n=1

n=5

n=3

Unspecified location

Legend

Presentations AC Chairs AC Projects At Home Research Sites Board Members


4.2.3 MHCC Website Utilization

The MHCC website was developed October, 2008 to facilitate information access concerning the

Commission, its activities and resources, general information about mental health, and links to other

organizations.25 The MHCC regularly maintains and updates the website and has been tracking website

utilization data since July 2008, including the number of visits, hits on specific pages, and traffic sources.

The following analysis is based on website utilization data provided by the MHCC.

Website Visits

Since the creation of the MHCC website, there have been almost a quarter of a million visits to the site.

The amount of traffic to the site has increased substantially each year, and almost half of all visits are

new visits.26 Although 2008 website data collection began in July, there was a large number of website

hits (114,444 in total) recorded for that partial year. Website utilization has increased steadily over the

years; in 2009, the amount of new visits was greater than the amount of returning visits, indicating an

increasing awareness about the site in the larger community.

Figure 8. Number of website hits per year, by type

*Indicates a partial year of data collection.

25

The MHCC website is located at: http://www.mentalhealthcommission.ca. 26

The data could not indicate if an individual could be described as a “new” visitor more than once/month. Therefore, we are operating under the assumption that “new visit” can occur only once, and after that visit, the individual is classified as a “returning” visit.

11444

86941

127027

5749

41063

69276

5695

45878

57751

0

20000

40000

60000

80000

100000

120000

2008* 2009 2010

We

bsi

te V

isit

s

Year

# Visitors

# Returning Visits

# of New Visits


There is a steady pattern in the 2009 and 2010 data that discloses lower website hits from December to

March, an increase through March and April, a decrease through the summer months and a larger

increase through September to November. This pattern is relatively stable, and other fluctuations can be

attributed to increased participation in events such as speaking engagements and presentations (i.e.,

see Figure 9 and 10 below).

Figure 9. Website visit fluctuations over 2009

Figure 10. Website visit fluctuations over 2010

0

2000

4000

6000

8000

10000

# Visitors/Month

# Returning Visits

# New Visits

0

2000

4000

6000

8000

10000

12000

14000

16000

# Visitors/Month

# Returning Visits

# New Visits


Website Page Visits

Website utilization data are recorded, related to the most visited pages include the homepage,

information on employment, background information about the Commission, and the At Home/Chez Soi

Research Demonstration Project. This data is presented in Table 11.

Table 11. Top ten most visited pages on MHCC website

Source/medium Visits

1. Homepage 140,023

2. Employment 33,714

3. About the Commission 31,059

4. Homelessness 25,094

5. Mental Health Strategy 24,410

6. Introduction to the MHCC 18,723

7. English/Pages/default.aspx* 18,601

8. Research Contract Opportunities 16,005

9. The MHCC (history and mandate) 15,748

10. News releases 12,539

*Indicates the selection of the English language version of a text.

Finally, it is important to know how visitors access the site (e.g., through search engines, links from

another website). Data concerning the priority access points to the MHCC website is presented in Table

12.

Table 12. Top ten most traffic sources to MHCC website

Source/medium Visits

1. Direct 115,711

2. Google 43,276

3. Bing 2,392

4. MentalhealthCommission.dialoguecircles.com/referral 1,657

5. MentalhealthCommission.ca/referral 1,556

6. Yahoo 1,346

7. Mentalhealthresearch.ca/referral 674

8. Commissionsantementale.ca/referral 641

9. Mhccintranet.igloocommunities.com/referral 577

10. Ontario.cmha.ca/referral 572

The large majority of visitors access the site directly; visitors type the website address into their internet

browser. The next largest group accesses through Google; visitors search for the MHCC through Google,

and follow the link. Others utilize other search engines (e.g., Bing, Yahoo) or are referred through other

websites (e.g., Ontario CMHA).


Finally, in the “Communication Plan for the MHCC” (October 7, 2010) the Commission targets 2011 as

the year for their website to be an easily accessible portal for trusted information on mental health, the

MHCC and its work.27

4.2.4 Media Coverage

Media coverage is a key access point for building capacity and raising awareness about mental health

issues in Canada. Data collection on media activities began being collected in April 2009 and Charis was

provided with summary information through to December 2010. In the entire time period (April 2009 –

December 2010), the MHCC was featured in 477 pieces of media coverage.

From April to September (2009), the MHCC was most often covered in print media (58%); followed by

radio (18%), television (17%) and website references (7%) (see Figure 11). For the remainder of the time

provided (up to December 2010), they were also most often covered in print media (75%), followed by

television (12%), trade publications (8%), and web site references (3%).

Figure 11. Media coverage April 2009 - September 2010 by source

The provinces in which the MHCC has received the most media coverage are Ontario (20%), British

Columbia (12%), Alberta (9%), and Québec (5%).28 Ontario’s media coverage correlates to the larger

proportion of speaking engagements occurring in that province. Additionally, provinces without

speaking engagements (Saskatchewan, Manitoba, Northwest Territories, Nunavut, Yukon) are not well

represented in their media coverage of the MHCC.

Since inception of the MHCC, 29 news releases were issued to the media. These releases (e.g.,

newspaper articles, television reports, radio reports, and online references) were sent to multiple types

27 See “Communication Plan for the MHCC,” Final Draft, (October 7, 2010), pg. 13. 28 Data for April 2009 – September 2010.

58.00% 18.00%

17.00%

7.00%

Print Media Radio Television Website References


of media at the local, provincial and national levels. Three of the MHCC’s project launches are described

below to indicate media coverage.29

The launch of the Homelessness Initiative (At Home/Chez Soi) involved a large media presence

(November 23, 2009). This initiative involves five project sites (Vancouver, Winnipeg, Toronto,

Montreal, and Moncton) and the launch resulted in extensive media coverage and spikes in MHCC

website analytics. Media coverage included:

Thirty nine television stations in attendance, resulting in 19 broadcasts on local news and 20 as national reports;

Eight French television stations in attendance;

Sixteen English and Eight French newspapers; and,

Twenty three English and 2 French radio stations.

The opening of the Bosman Hotel in Vancouver included media guests invited by the MHCC (August 2010). The media coverage included:

Four television reports including one French;

Two radio reports;

Four newspaper articles (one editorial); and,

Two online references.

The release of Tracking the Perfect Legal Storm report, by the MHCC’s Workforce Advisory Committee, garnered substantive media attention. Highlighting employer responsibility to provide psychologically safe workplaces, and released in Vancouver (2010), media coverage included:

Two television reports;

Six radio reports;

Seven newspaper articles; and,

Articles in six trade publications.

4.3 MHCC Online Survey As part of the evaluation, Charis designed an online survey with input from the Expert Evaluation

Advisory Panel and the MHCC. The survey was created using Survey Crafter, and was launched in both

official languages of Canada on January 20, 2011 (please refer to Appendix C for the full survey). The

survey was in the field for 25 days and was closed on February 14, 2011.

To engage as many individuals as possible, Charis sent the survey to 20 stakeholder organizations in

Canada (e.g., Schizophrenia Society, Canadian Mental Health Association). The organizations were sent

an email outlining the evaluation process, containing a link to the survey and an invitation letter from

29 Data provided by the MHCC Communications Department.


Louise Bradley, CEO of MHCC. The organizations were asked to forward the survey link to their

networks, thus creating a consumer driven route for the survey. MHCC inserted the link to the survey in

their newsletter that was sent to organizations, partners and stakeholders (n=8,000). Approximately

2,000 of the newsletters were opened. The MHCC also sent out an email to their staff inviting them to

participate in the survey. In addition, every key informant interview and focus group Charis conducted

was used as an opportunity to inform participants about the survey and invite them to contribute.

The survey itself was comprised of seven sections that were used to evaluate the areas of inquiry

developed in the evaluation framework. Participants followed the link to the online survey and were

taken to a cover page where they chose their preferred language (English or French). They were then

directed to the appropriate version of the survey and were presented with a page that outlined the

evaluation process, the five key initiatives of the MHCC and the instructions for completing the online

survey.

Each of the seven sections of the survey was comprised of questions pertaining to that topic. The first

section, awareness of the MHCC, included questions regarding respondents’ awareness of the MHCC in

the community, and of the collaboration between the MHCC and their work. The next section, five key

initiatives of the MHCC, was concentrated on the initiatives of the MHCC and whether the Commission

should be focusing on those particular areas. The section regarding the promotion of the MHCC included

questions about the Commission’s ability to communicate and disseminate information, and asked

participants how they received information about the MHCC. Impacts of the MHCC included questions

about the ability of the MHCC to achieve its goals and impact the community. This section also included

questions regarding the impact of the MHCC on various groups of people, and the mental health sector.

The overall observations section included questions focused on what is working well, what could be

improved upon, and which initiatives should be sustained. The background information section asked

respondents information on their background and association with mental health and MHCC. Finally, the

last component of the survey was the optional information section which asked participants their

demographic information if they wished to provide it.

In many of the questions, participants were asked to indicate their level of agreement or disagreement

with statements provided to them. They responded on a five point scale which included: “strongly

agree”, “agree”, “disagree”, “strongly disagree” and “don’t know”. Questions were also asked in other

formats, which will be described along with the results for that question. While the demographic

information is presented first, all other results are organized in the survey sequence, using illustrative

graphs and a short narrative commenting on the results. The results are presented in the order in which

they occurred on the survey using illustrative graphs and a short narrative commenting on the results.

For many of the questions, the narrative provides collapsed results by placing “strongly agree” and

“agree” together for an overall agreement percent and “disagree” and strongly disagree” together for

an overall disagreement percent.30

30 Where relevant, the data was separated into three different results sections: overall roles (includes all individuals who

indicate they were a part of that role); prioritized categories for ‘people with lived experience’ and ‘family-caregivers’ (if


4.3.1 Results

Respondents Characteristics and Roles

As a result of the decision to allow a user driven survey (by way of individuals forwarding the survey to

their networks) an overall response rate, margin of error and confidence level are unable to be

calculated (except in estimate form).

The background information section was developed to better understand the characteristics of the

individuals responding to the survey. It was comprised of five questions. The first three were rated on

the five point scale and asked participants: how knowledgeable they felt about mental health; how

involved with the MHCC they were; and, if they interacted with people with lived experience, how often

they heard about the MHCC from them. The other two questions asked about their role in relation to

mental health, and for a description of the work that they do.

Figure 12: Respondents indication of their knowledge of mental health (n=463)

In terms of the knowledge of respondents, 62% rated themselves as very knowledgeable, 29% as fairly

knowledgeable, and only 9% as “a little” knowledgeable, or “not at all” knowledgeable. This finding

highlights that 91% of respondents would count themselves as knowledgeable about mental health and

mental health improvement, thus further supporting the responses and opinions of respondents.

When separated by role it is very apparent that most roles would rate themselves as “very” or “fairly”

knowledgeable. The groups that rated themselves as most knowledgeable (highest percent of “strongly

agree” and “agree”) were: health service providers (100%), media (100%), educators (99%), researchers

(99%), and AC chairs/members (96%). The groups that indicated a lower level of knowledge (highest

percent of “a little” and “not at all” responses) were: MHCC staff (21%), government officials/staff

(11%), MHCC volunteers (11%), and family members (10%). Interestingly, MHCC staff had the highest

percent of both “a little” (17%) and “not at all” (4%) ratings.

people indicated ‘people with lived experience’ they were included in that group and no others), and discrete categories for ’people with lived experience’ and ‘family-caregivers’ (with no overlap between categories and no individuals who selected multiple roles). The differences are noted only for applicable questions and where the difference is significant.

62% 29% 7% 1%

0% 20% 40% 60% 80% 100%

How knowledgeable do you feel about mental healthand mental health improvement?

Very Fairly A little Not at all


Figure 13: Respondents indication of their knowledge of mental health (n=463)

Figure 14: Respondents indication of their level of involvement with the MHCC (n=463)

In reference to involvement with the MHCC, the majority of participants (69%) indicated they were only

“a little” involved with the MHCC (33%), or “not at all” involved (36%). Only 28% of participants

indicated they were more heavily involved (10% “very” involved, 18% “fairly” involved), and three

percent of respondents indicated they did not know their level of involvement with the MHCC.

When disaggregated by role, we can see that for many roles, they are “a little” or “not at all” involved

with the MHCC. This finding speaks to the diversity of respondents and provides a good contrast to the

63%

40%

73%

78%

69%

72%

72%

58%

67%

58%

58%

78%

38%

65%

38%

60%

26%

20%

27%

24%

21%

35%

24%

32%

32%

11%

42%

23%

1%

2%

4%

5%

6%

5%

8%

9%

11%

11%

17%

11%

1%

1%

1%

1%

4%

2%

0% 20% 40% 60% 80% 100%

Health Service Provider (n=48)

Media (n=5)

Educator (n=80)

Researcher (n=46)

AC Chair/Member (n=52)

Mental Health Service Provider (n=211)

NGO (n=109)

Caregiver (n=96)

Person with Lived Experience (n=175)

Family Member (n=217)

Government Official/Staff (n=38)

MHCC Volunteer (n=9)

MHCC Staff (n=24)

Other (n=57)

Very Fairly A Little Not At All Don't Know

10% 18% 33% 36% 3%

0% 20% 40% 60% 80% 100%

How involved are you with the MHCC?

Very Fairly A little Not at all Don't Know


key informant interviews and focus groups, where the participants were highly involved with the MHCC.

The groups that indicated the most involvement (highest percent of “very” of “fairly” involved) were:

MHCC volunteers (88%), MHCC staff (79%), Advisory Committee chairs/members (64%), and researchers

(50%). Interestingly, volunteers indicated they were more involved with the Commission than MHCC

staff. Those groups that indicated the least amount of involvement (highest percent of “a little” and “not

at all” responses) were: health service providers (84%), government officials/staff (76%), family

members (71%), and people with lived experience (71%), mental health service providers (70%) and

‘other’ (70%). If you will recall, the majority of people who indicated ‘other’ had a comprehensive role

within mental health. It is fair to say that some of the groups that should be providing input to the

MHCC (government, mental health service providers, people with lived experience and their families)

indicated that they are just “a little” or “not at all” involved.

Figure 15: Respondents indication of their level of involvement with the MHCC (n=463)

44%

46%

35%

20%

20%

13%

11%

10%

9%

7%

9%

13%

6%

9%

44%

33%

29%

30%

20%

21%

23%

22%

19%

18%

16%

11%

10%

16%

11%

4%

19%

24%

60%

43%

28%

38%

34%

37%

32%

39%

42%

40%

4%

15%

26%

21%

39%

26%

36%

34%

39%

37%

42%

30%

13%

2%

2%

4%

1%

3%

3%

5%

0% 20% 40% 60% 80% 100%


MHCC Staff (n=24)


Researcher (n=46)

Media (n=5)

NGO (n=109)

Educator (n=80)

Caregiver (n=96)






Other (n=57)



Figure 16: Respondents indication of how often they hear about the MHCC from people with lived

experience, family members or caregivers (n=463)

For those that interact with persons with lived experience, they were asked to indicate how often they

heard about the MHCC from them. Results indicated that the majority of respondents did not hear from

them at all about the MHCC (56%), 27% heard about it “a little”, and only 10% indicated they heard

about the MHCC from them “very” or “fairly” often. In addition, 8% of respondents indicated they did

not know, likely a result of being in roles that would not involve interacting with people with lived

experience.

Figure 17: Respondents indication of how often they hear about the MHCC from people with lived

experience, family members or caregivers (n=463)

4% 6% 27% 56% 8%

0% 20% 40% 60% 80% 100%

If you interact with persons with livedexperience, family or caregivers, how often doyou hear about the MHCC from them?

Very Fairly A little Not at all Don't Know

17%

11%

8%

6%

6%

5%

4%

5%

4%

4%

3%

7%

17%

13%

20%

10%

9%

7%

6%

6%

5%

6%

5%

5%

2%

21%

28%

60%

38%

24%

27%

35%

28%

30%

21%

33%

21%

67%

32%

25%

39%

38%

59%

56%

48%

58%

56%

63%

55%

58%

22%

47%

21%

9%

20%

6%

2%

5%

6%

3%

4%

6%

2%

13%

11%

12%

0% 20% 40% 60% 80% 100%

MHCC Staff (n=24)

Researcher (n=46)

Media (n=5)




NGO (n=109)


Educator (n=80)


Caregiver (n=96)



Other (n=57)

Strongly Agree Agree Disagree Strongly Disagree Don't Know


When separated by role, the groups that heard about the MHCC most often (selected “strongly agree”

and “agree” the most) were: MHCC staff (34%), researchers (24%), media (20%), and AC chairs,

members (18%). Those groups that heard about it the least (selected “disagree” and “strongly disagree”)

were: MHCC volunteers (89%), caregivers (88%), mental health service providers (86%) and educators

(86%). In general, it appears that few people are hearing about the MHCC from people with lived

experience, family members or caregivers.

Interestingly, when the roles were prioritized, both people with lived experience and family-caregivers

indicated more frequently that they had heard about the MHCC. Of people with lived experience, 33%

indicated they had heard about the MHCC “very” or “fairly” often, and 6% “a little”. For family-

caregivers, 37% indicated they had heard about the MHCC “very” or “fairly” often, and 4% “a little”.

These are much larger percents than the overall sample (n=463), likely indicating that those individuals

who are more heavily invested in the sector (by way of lived experience or being a family member) are

hearing about the MHCC more often from people they come in contact with that have similar lived

experience. The same trend emerged when the data was separated into discrete categories (22% of

people with lived experience indicated “very” or “fairly” often, 32% of family-caregivers indicated “very”

or “fairly” often).

Immediately following the selection of their roles, participants were asked to describe their work or

their organization’s work if it were applicable. There were 211 people who replied to this question. The

vast majority (87%) work in some manner in mental health. Presented below is a graph depicting the

main sectors in which respondents work.


Figure 18: Areas of work for survey respondents (n=211)

For those that responded, the results mirror the roles that the respondents indicated for themselves.

Organizational or service provider work is well represented in the survey sample, as well as a variety of

other areas which overlap with the mental health sector.

A total of 463 individuals completed the online survey. The survey asked them to indicate their roles vis-

à-vis mental health. Respondents were able to select multiple roles that they may hold in relation to

mental health, as the sector contains diversity and crossover between roles. These individuals

comprised a large group with diverse roles and interests: 31

Family members (n=217);

Mental health service providers (n=211);

People with lived experience of mental illness (n=175);

Non-governmental organizations (n=109);

Caregivers (n=96); and,

31

Note: respondents were able to select multiple roles they were a part of, as the mental health sector contains a lot of diversity and crossover.


Educators (n=80);

Advisory Committee chairs or members (n=56);

Health service providers (n=48);

Researchers (n=46):

Government officials and staff (n=38);

MHCC staff (n=24);

Volunteers (n=9); and,

Media (n=5).

Fifty-seven (57) individuals selected “other” to describe their role, as follows:

Comprehensive role within mental health (x20): 20 people said they work comprehensively in the mental health sector, e.g., sitting on boards, peer education, volunteering, are recipients of the MHCC funds or are current/retired professionals;

Specific role with the MHCC (x12): 12 people work in specific roles with the MHCC, or are contractors of the organizations;

Police/justice system (x6): six people are members of the police force or work in the court system;

Professional (x6): six respondents said they work as health professionals (e.g., social worker, RN, peer support worker) or are connected to the MHCC through a professional association;

Government (x4): four people mentioned they hold positions in the government, three in the provincial governments and one in an unspecified parliament;

Lived experience (x3): three respondents said they have lived experience of mental illness;

Caregiver/family (x2): there were two people who indicated they were part of the family of a person with mental illness, and another who is an advocate for people with lived experience; and,

Other (x7): seven people indicated roles that do not fall into other categories, specifically: they are friends of people in mental health organizations, members of the concerned public, two are writers of unspecified materials and one is a student.


Figure 19. Distribution of roles selected by respondents (n=463, able to select multiple roles)

Interestingly, when the data from the survey was examined more closely concerning the roles, it was

evident that most respondents hold more than one role. For example, 71% of the sample (n=463)

indicated that they hold more than one role; 44% of the sample indicated they hold three or more roles.

This information speaks again to the diversity and crossover that occurs in the mental health sector.

Please see Table 13 for more detailed information.

Table 13. Number of roles for MHCC survey respondents

Number of roles Frequency Percent

1 134 28.9

2 124 26.8

3 97 21.0

4 60 13.0

5 30 6.5

6 10 2.2

7 4 0.9

8 2 0.4

TOTAL 463 100.0

Family Member, 217

Mental Health Service Provider, 211

Person with Lived Experience, 175 NGO, 109

Caregiver, 96

Educator, 80

Other, 57

AC Chair/Member, 52

Health Service Provider, 48

Researcher, 46

Government Official/Staff, 38

MHCC Staff, 24 MHCC Volunteer, 9

Media, 5


The MHCC online survey captured a sample with demographic characteristics similar to those of the

population of Canada who were expected to complete the survey (working professionals, health care

and service providers, family and caregivers). Generally speaking a sample size of 400 or more is

sufficient to represent the opinions of the general population, and that number was achieved (n=463).

The sample was predominantly female (76%), which according to the most recent Canadian Census, is

similar to the pattern found in the health service industry (see Table 14), also largely female.

Table 14. Gender of individuals in the health industry in Canada (%)

Occupation % of Males % of Females

Health occupations 20% 80%

Professional occupations in health 46% 54%

Nurse supervisors and registered nurses 6% 94%

Technical and related occupations in health 23% 77%

Assisting occupations in support of health services 12% 88%

Concerning age, results demonstrated the largest percent of respondents were aged 45-64 (61%),

followed by 25-44 (31%).32

Figure 20. Distribution of age as reported by survey respondents (n=454)

32

For more information, reference the 2006 Canadian Census data on “Industry and Selected Demographics” which can be found at: http://www12.statcan.gc.ca/census-recensement/2006.

2%

31%

61%

4% 2%

15-24

25-44

45-64%

65-74

75+


Awareness of the MHCC

This section included five questions regarding awareness. All questions in this section were formatted in

statements that participants rated on the five point scale of “strongly agree” to “strongly disagree” with

the option to select “don’t know”. Detailed results per question are presented below.

The awareness questions posed to participants included those about the MHCC and its work, the

mandate of the MHCC, knowing what they want to know about the MHCC, the MHCC sharing

information, and the reputation of the MHCC.

Figure 21: Percent rating awareness of the MHCC (n=463)

The vast majority of respondents (85%) indicated that they were aware of the work of the MHCC and

understands the mandate of the organization (81%). However, a large percent (61%) indicated that they

do not know as much as they would like to about the MHCC. Thirty-seven percent believe the MHCC

could improve on sharing information, which likely would increase the amount of individuals who know

as much as they would like to about the organization. As well, 67% of respondents believe that the

MHCC has a positive reputation. However, a substantial percent (18%) do not know, which may be a

result of not having enough information about the MHCC and its work.

41%

39%

10%

8%

23%

44%

42%

27%

42%

44%

10%

13%

48%

29%

11%

4%

3%

13%

8%

4%

2%

3%

3%

12%

18%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

I am aware of the MHCC and its work.

I understand the mandate of the MHCC.

I know as much as I want to know about the MHCC.

The MHCC does a good job of sharing information.

I believe the MHCC has a positive reputation.



Figure 22: I know as much as I want to know about the MHCC (n=463)

Results indicate that half or more of all roles want to know more about the MHCC. The roles that most

want to know more about the MHCC are: media (80%), MHCC volunteers (67%), “other” (66%), family

members (64%), and people with lived experience (64%). It should be noted that the “other” category

was mostly comprised of individuals who had a comprehensive role within mental health, or a specific

role with MHCC.

21%

14%

23%

9%

12%

17%

9%

16%

9%

11%

10%

6%

12%

27%

33%

23%

37%

30%

25%

32%

21%

25%

22%

22%

26%

20%

16%

40%

41%

42%

41%

44%

50%

48%

50%

46%

67%

49%

48%

60%

54%

13%

10%

12%

11%

13%

9%

11%

17%

15%

16%

20%

12%

3%

2%

1%

8%

2%

3%

3%

4%

4%

5%

0% 20% 40% 60% 80% 100%


Educator (n=80)


Researcher (n=46)

NGO (n=109)

MHCC Staff (n=24)



Caregiver (n=96)




Media (n=5)

Other (n=57)



Figure 23: I believe the MHCC has a positive reputation (n=463)

It is evident that the large majority of survey respondents feel the MHCC has a positive reputation. In

some cases (e.g. family member) there is a relatively substantial percent that “don’t know”, which could

be attributed to not knowing enough about the MHCC to make a judgment. It is also interesting to note

that among MHCC volunteers (n=9), 33% disagree that the MHCC has a positive reputation (in

comparison to 16% of MHCC staff), which is the largest percent among the varying roles.

The collaboration questions in the survey asked respondents about their understanding of the

collaboration between the MHCC and their work, and if they have adequate opportunities to provide

input to the MHCC.

40%

27%

18%

26%

33%

24%

30%

22%

27%

24%

22%

25%

21%

60%

56%

55%

46%

40%

46%

40%

48%

40%

67%

41%

42%

38%

56%

13%

8%

9%

15%

14%

10%

9%

10%

22%

9%

10%

8%

9%

3%

2%

3%

5%

11%

6%

11%

6%

6%

8%

4%

4%

16%

16%

13%

14%

15%

11%

17%

20%

21%

21%

11%

0% 20% 40% 60% 80% 100%

Media (n=5)





NGO (n=109)

Educator (n=80)

Researcher (n=46)

Caregiver (n=96)




MHCC Staff (n=24)

Other (n=57)



Figure 24: Questions regarding collaboration and percent response of opinion (n=463)

In terms of collaboration, a smaller percent of respondents responded positively to the questions. Just

over half of respondents indicated that they understood how their work contributed to the MHCC, and

32% did not understand how. It should be noted that there is a larger percent of “don’t know”, likely

because some roles are not directly related to the MHCC (e.g. media or educators). Half of respondents

(50%) indicated that they understood how the MHCC contributes to their work, while 32% did not

understand the connection, and 17% did not know. Another important point to take note of is that

almost half of respondents (46%) indicated that they did not have adequate opportunities to provide

input to the MHCC. This finding indicates an area for improvement for allowing more individuals to be

involved in collaborating.

For the collaboration questions, the Charis evaluation team thought it was important to disaggregate

the data by role to determine if there were differences between certain groups of people (e.g. family

members and NGO’s). The results for each of the individual collaboration questions are listed below, in

detail.

14%

12%

8%

38%

38%

34%

26%

26%

35%

6%

6%

11%

16%

17%

13%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

I understand how my work contributes to the MHCC.

I understand how the MHCC contributes to my work.

I have adequate opportunities to provide input to theMHCC.



Figure 25: I understand how my work contributes to the MHCC (n=463)

When disaggregated by role, it is clear that most respondents understand how their work contributes to

the MHCC. You will notice larger categories of “don’t know” (e.g. media) which is likely a result of

individuals working in positions that are not directly linked with the MHCC. It is important to note,

however, that more than a third of government officials/staff (45%), Advisory Committee

chairs/members (35%), mental health service providers (35%), people with lived experience (34%), and

non-governmental organizations (33%) do not know how their work contributes to the MHCC. One

would expect that individuals in these roles, especially the government officials and Advisory Committee

members linked with the MHCC, should be aware of how their work contributes to the MHCC.

38%

11%

11%

31%

16%

18%

15%

20%

16%

17%

12%

9%

16%

21%

46%

67%

57%

33%

45%

43%

46%

40%

39%

37%

39%

41%

26%

37%

8%

22%

20%

33%

21%

27%

32%

26%

23%

27%

42%

19%

4%

2%

2%

3%

7%

2%

3%

6%

5%

7%

3%

5%

4%

11%

2%

15%

15%

10%

40%

10%

14%

20%

17%

13%

18%

0% 20% 40% 60% 80% 100%

MHCC Staff (n=24)


Researcher (n=46)


Educator (n=80)

Caregiver (n=96)


Media (n=5)


NGO (n=109)




Other (n=57)



Figure 26: I understand how the MHCC contributes to my work (n=463)

When separated by role, most respondents indicated that they understood how the MHCC contributes

to their work. Again, there are a slightly larger percent of individuals selecting “don’t know”, probably a

result of being in positions that are not directly linked with the MHCC. The roles that most understood

how the MHCC contributes to their work (highest percent of “strongly agree” and “agree”) were: the

media (80%), MHCC volunteers (78%), AC chairs/members (71%), and MHCC staff (67%). The largest

percent of those who responded they did not understand how their work contributes to the MHCC

(‘disagree’ and ‘strongly disagree’) were from the following roles: government officials/staff (37%),

health service providers (37%), caregivers (35%), family members (34%) and people with lived

experience (33%).

29%

29%

15%

14%

16%

13%

18%

8%

10%

9%

10%

9%

80%

78%

42%

38%

43%

44%

39%

39%

32%

40%

35%

37%

35%

42%

22%

21%

8%

28%

27%

26%

27%

32%

35%

27%

25%

24%

21%

4%

4%

4%

5%

4%

5%

5%

2%

7%

8%

11%

5%

20%

4%

21%

9%

10%

15%

17%

13%

15%

20%

21%

19%

23%

0% 20% 40% 60% 80% 100%

Media (n=5)



MHCC Staff (n=24)

Researcher (n=46)


Educator (n=80)

NGO (n=109)





Caregiver (n=96)

Other (n=57)



Figure 27: I have adequate opportunities to provide input to the MHCC (n=463)

For the most part, agreement and disagreement with the question was split relatively equally across

respondent groups. However, large percents of individuals from all roles indicated that they did not

have adequate opportunities to provide input to the MHCC. The highest percents came from the

following roles: researchers (50%), educators (49%), NGO’s (45%), family members (45%), people with

lived experience (44%), and MHCC volunteers (44%). It should be noted that these groups involve

individuals who are involved heavily with either the Commission or the mental health movement and

have indicated they do not have adequate opportunity to provide their voice.

Five Key Initiatives of the MHCC

This section of the survey included a brief reminder of the MHCC’s five key initiatives and was comprised

of five questions about the importance of each of the initiatives. The section also included a question

about the initiatives being the right ones for the MHCC, and whether there were issues the five key

initiatives were not addressing.

23%

9%

13%

10%

17%

13%

9%

7%

7%

7%

6%

7%

44%

56%

40%

35%

35%

29%

32%

35%

36%

34%

31%

27%

20%

42%

25%

44%

35%

35%

27%

29%

32%

39%

39%

32%

33%

38%

40%

25%

4%

8%

15%

14%

17%

5%

10%

6%

12%

12%

10%

12%

4%

9%

2%

14%

8%

18%

8%

12%

15%

16%

19%

40%

14%

0% 20% 40% 60% 80% 100%




Researcher (n=46)

Caregiver (n=96)

MHCC Staff (n=24)


Educator (n=80)

NGO (n=109)




Media (n=5)

Other (n=57)



Figure 28: Importance of five key initiatives - “It is important for the MHCC to…”(n=463)

When survey respondents were asked about developing the five key initiatives, the large majority

agreed that the initiatives were important. The initiatives, in order of agreed importance (as indicated

by survey respondents) were: mental health strategy for Canada (98%), anti-stigma initiative (94%), KEC

(92%), research project on homelessness and mental illness (88%), and partners for mental health

(87%). The vast majority of respondents agreed with developing the five key initiatives, however, the

“research project” question garnered a disagreement rating of 9% and “partners of mental health,” 8%.

In addition, participants were asked to indicate whether they thought the five key initiatives were the

right ones, and whether they believed there were issues that were not being addressed. Responses on

these two questions are below.

Figure 29: Questions regarding the five key initiatives overall and percent response of opinion (n=463)

84%

79%

54%

67%

67%

14%

15%

34%

25%

20%

1%

3%

7%

5%

5%

2%

3%

1%

2%

2%

3%

5%

0% 20% 40% 60% 80% 100%

...develop a mental health strategy for Canada.

...develop an anti-stigma initiative.

...carry out a national research project on homelessnessand mental illness.

...develop a Knowledge Exchange Centre.

...develop Partners for Mental Health.


32%

25%

48%

41%

10%

17%

2%

1%

8%

16%

0% 20% 40% 60% 80% 100%

The five key initiatives of the MHCC are the right ones.

There are issues that are not being addressed in the five keyinitiatives.



For the majority of respondents (80%), the five key initiatives are the right ones. Twelve percent (12%)

of respondents did not agree with the statement, and 8% did not know. In addition, 66% feel that there

are not any issues that are not being addressed in the five key initiatives, which is further supportive of

the MHCC’s focus. It should be noted, however, that 18% of respondents did feel that there were issues

not being addressed, and 16% did not know. The qualitative data sources delve more into what

respondents felt could be examined in the five key initiatives. The relatively large percent of

respondents who indicated they did not know if there were issues not being addressed in the five key

initiatives supports an underlying thread of increased communication and wanting to know more.

Participants who responded “don’t know” likely were not familiar with all the initiatives and could not

comment.

Promotion of the MHCC

The promotion of the MHCC section of the survey included three questions. Two questions were

presented as statements to be rated against the five point scale: one question regarding the MHCC

communicating effectively, and one on the MHCC disseminating information effectively.

Figure 30: Questions regarding the promotion of the MHCC and percent response of opinion (n=463)

When asked about communication and dissemination of information and the MHCC, less than 50% of

respondents strongly agreed or agreed with both questions. For communication, 43% of respondents

did not think that the MHCC effectively communicated its activities, and 13% did not know. Regarding

dissemination, 42% of respondents did not agree that the MHCC effectively disseminated information,

and 17% did not know. It is important to note that the percents for disagreement were large, likely

indicating that participants wanted to know more about the MHCC and its activities.

Participants were also asked to choose how they receive information about the MHCC, its products and

services from a pre-set list, and could check all that apply. Options included: newsletter; newspaper;

brochures; press releases/media coverage; emails; project reports; annual reports; formal

presentations; television; MHCC website; social media; word of mouth or “other”.

6%

4%

38%

37%

35%

34%

8%

8%

13%

17%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

The MHCC effectively communicates its activities.

The MHCC effectively disseminates its resources andinformation.



Figure 31: How information is received (n=463)

Survey respondents indicated that the most frequent ways they receive information about the MHCC

was through emails (n=291), MHCC website (n=215), word of mouth (n=181), media (n=160) and the

newsletter (n=130). Least frequently cited were brochures (n=35), television (n=29), and social media

(n=24). Forty-eight (48) selected “other,” with 8 indicating they are not connected to a source of

information about the MHCC. Of those who do receive information, the following sources were cited:

Health organizations (x15): several people said they receive information from health organizations such as Canadian Mental Health Association, professional associations and NGOs;

Colleagues/direct contact with people (x12): others said they receive information about the MHCC from colleagues, coworkers, or discussions with MHCC staff; and,

Electronic media (x10): some receive information from emails, e-newsletters, listservs and websites.

Impacts of the MHCC

The impacts section was comprised of seven main questions. The questions were designed to assess the

impact of the MHCC to this point, the potential for the future, what products from the MHCC

stakeholders are using, and where survey respondents would go to influence change to the mental

health system. The first question asked respondents if, to this point, the MHCC’s activities, products and

resources contributed to the achievement of the MHCC’s immediate objectives.


Figure 32: The impacts of the MHCC, “To this point, the MHCC’s activities, products and resources

contribute to…” (n=463)

For the most part, participants indicated they agreed that the MHCC’s activities, products, and resources

contribute to the above topic areas. However, there is a large percent of individuals who selected the

“don’t know” category. This again, could be indicative of respondents not being familiar with all of the

MHCC’s initiatives or focuses. The “don’t know” category was selected by approximately one third of

survey participants for improving collaboration among people with lived experience, families and

caregivers, and increasing the use of MHCC research to impact the development of policy and service

delivery. The areas with the most agreement were: reducing stigma and discrimination related to

mental illness (66%), and improving awareness of issues and evidence-informed practices to address

those issues (69%). The areas with the most disagreement were: enhancing integration and

collaboration in the mental health system in Canada (29%), improving collaboration with people with

lived experience and their families or caregivers (25%), and improving collaboration among partners

(24%).

The second question included identical statements as the first question, but respondents were asked if,

in the future, the MHCC is structured and resourced to contribute to achieving its immediate outcomes.

15%

9%

10%

11%

8%

11%

51%

40%

34%

48%

35%

38%

12%

17%

17%

15%

23%

12%

4%

7%

8%

4%

6%

5%

19%

27%

30%

22%

28%

33%

0% 20% 40% 60% 80% 100%

...reducing stigma and discrimination related to mentalillness.

...improving collaboration among partners.

...improving collaboration with people with lived experienceand their families and caregivers.

…improving awareness of issues and evidence-informed practices to address those issues.

…enhancing integration and collaboration in the mental health system in Canada.

…increasing the use of MHCC research to impact the development of policy and service delivery.



Figure 33: The impacts of the MHCC, “Looking to the future, the MHCC is structured and resourced to

contribute to …” (n=463)

In looking to the future, more than half of all survey respondents agreed that the MHCC is structured

and resourced to contribute to the above statements. Again, there were a large percent of respondents

who indicated they did not know. The two statements that were most agreed upon were: reducing

stigma and discrimination (66%), and improving awareness of issues and evidence-informed practices to

address those issues (64%). The statements with the most disagreement were: enhancing integration

and collaboration (18%), improving collaboration with people with lived experience and their families or

caregivers (17%) and improving collaboration among partners (16%).

These results demonstrate the belief of the survey respondents that the MHCC has, and will contribute

the most to both reducing stigma and improving awareness. In addition, the results show that

respondents saw least contribution to this point in the areas of enhancing integration and collaboration

in the mental health system in Canada, improving collaboration with people with lived experience and

their families or caregivers and improving collaboration among partners. However, when looking to the

future, percent of those agreeing that there would be contribution in these three areas increased.

The next question asked participants if they relied on the products, information, and activities provided

by the MHCC. Respondents indicated their choice of response on the five point scale.

25%

18%

18%

21%

19%

20%

41%

38%

34%

43%

35%

41%

8%

12%

10%

7%

12%

6%

2%

4%

7%

3%

6%

3%

23%

28%

31%

26%

29%

30%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

...reducing stigma and discrimination related to mentalillness.

...improving collaboration among partners.

...improving collaboration with people with livedexperience and their families and caregivers.

…improving awareness of issues and evidence-informed practices to address those issues.

…enhancing integration and collaboration in the mental health system in Canada.

…increasing the use of MHCC research to impact the development of policy and service delivery.



Figure 34: Reliance of information from the MHCC (n=463)

Forty-three (43) percent of respondents indicated agreement that they rely on the products, whereas

47% indicated disagreement. In addition, 9% indicated they did not know.

Figure 35: Respondents opinion on reliance of information from the MHCC (n=463)

When disaggregated by role, the groups that are most reliant (selected ‘strongly agree’ or ‘agree’) on

information from the MHCC are: media (100% of respondents), AC chairs/members (65%), health

service providers (55%), MHCC staff (55%), government officials/staff (52%), and researchers (50%). The

groups that are least reliant (selected ‘disagree’ or strongly disagree’) on information were: MHCC

10% 33% 37% 10% 9%

0% 20% 40% 60% 80% 100%

I rely on the products, information, and activities provided bythe MHCC.


40%

23%

13%

13%

13%

15%

11%

9%

12%

12%

20%

13%

11%

9%

60%

42%

42%

42%

39%

35%

38%

39%

36%

34%

26%

29%

22%

40%

25%

33%

25%

29%

37%

36%

37%

39%

34%

38%

38%

56%

37%

6%

4%

13%

5%

11%

7%

8%

7%

8%

9%

12%

9%

4%

8%

8%

13%

2%

7%

7%

6%

12%

8%

9%

11%

5%

0% 20% 40% 60% 80% 100%

Media (n=5)



MHCC Staff (n=24)


Researcher (n=46)

Caregiver (n=96)


NGO (n=109)


Educator (n=80)



Other (n=57)



volunteers (56% of respondents), people with lived experience (50%) government officials/staff (48%),

educators (47%), and NGOs (46%). In most cases, (except for media and AC chairs) over a third of all

roles indicated they are not reliant on information from the MHCC. It should be noted that government

officials/staff fall into both categories, half are reliant on information from the MHCC and the other half

are not. This finding is perhaps indicative of different types of government officials responding to the

survey – those that are involved with the Commission and those that are not.

The following question asked participants what products they relied on in their work for sources of

information. Participants were presented with a pre-set list of responses and were asked to “check all

that apply”. The options included: newsletters, fact sheets, annual reports, brochures, speeches,

interviews, news reports, reports and articles, and the MHCC website. They were also provided with an

“other” option where they could indicate other products they relied on that were not listed.

Figure 36: Frequency of selected products and information for the question: “In my work, I rely on the

following products for sources of information”

Results indicated that the most frequently selected sources of information were: the MHCC website

(n=236), newsletters (n=229), reports and articles (n=225), fact sheets (n=209) and news reports

(n=194). Less frequently cited were speeches (n=112), interviews (n=105), and “other” (n=88). For those

respondents that selected “other”, there were 96 open-ended responses:

Journals, textbooks and other research material (x21): some people said they receive information from peer-reviewed journals, textbooks, newspapers;

236 229 225

209 194

152 137

112 105

88

0

50

100

150

200

250


Colleagues/word of mouth (x18): there were responses indicating information is received directly from colleagues, MHCC staff, clients, doctors, counselors, family members or otherwise through word of mouth;

Health organizations (x17): some indicated they receive information from other health organizations (CMHA, Schizophrenia Society, and other NGOs);

Email (x14): some said they receive additional information through emails and one person mentioned listservs; and,

Websites (x7): a few participants mentioned they receive information from the internet without specifying the websites.

The next question on the survey asked participants to rate whether the MHCC is having a positive

impact on a variety of groups. The question asked respondents to focus on the progress made to date,

and the list included a range of groups (Figure 37).

Figure 37: Percent agreement the MHCC is having an impact on various groups (n=463)

10%

8%

10%

7%

4%

10%

7%

8%

7%

12%

4%

3%

36%

31%

42%

40%

33%

37%

30%

30%

33%

44%

25%

30%

18%

18%

16%

19%

15%

6%

14%

14%

11%

12%

22%

24%

7%

7%

5%

6%

6%

3%

4%

6%

4%

3%

6%

6%

30%

35%

27%

29%

42%

43%

44%

42%

45%

29%

42%

37%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

People with lived experience of mental illness


Mental health professionals

Service providers

Non-governmental organizations

Researchers

Educators

Government decision and policy makers

Health Canada

Media

Employers

Members of the general public



There is a large percent of “don’t know” responses, which suggest that the respondents were not

familiar enough with the MHCC’s work, or the above groups, to comment on the impact of the MHCC.

For those that did answer, the groups that were thought to have been receiving the most positive

impact were: media (56% of respondents indicated “strongly agree” or “agree”), mental health

professionals (52%), researchers (47%), service providers (47%), and people with lived experience (46%).

Respondents selected “disagree” and “strongly disagree” the most for: members of the general public

(30%), employers (28%), people with lived experience (25%), families and caregivers (25%), and service

providers (25%).

Participants were also asked to indicate (on the five point scale) their level of agreement or

disagreement with the statement that the MHCC is making a difference in the mental health sector.

Figure 38: Percent agreement with the MHCC making a difference in the mental health sector (n=463)

More than half of participants indicated that they thought the MHCC was making a difference in the

mental health sector (57%). Only nineteen (19) percent of participants did not agree with the statement,

and 24% of participants selected the “don’t know” response. This finding supports the work that the

MHCC has done, and continues to do, as survey respondents feel that the MHCC is are making a

difference.

11% 46% 13% 6% 24%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

The MHCC is making a difference in the mental healthsector.



Figure 39: Percent agreement with the MHCC making a difference in the mental health sector (n=463)

When disaggregated by role, most respondents felt similarly, but there are a few differences to note.

First, 100% of the media group felt the MHCC is making a difference in the mental health sector. As well,

over 50% of all roles except for MHCC volunteers “strongly agreed” or “agreed” that the MHCC is

making a difference in the mental health sector. It is notable that only 33% of the MHCC volunteers felt

the MHCC is making a difference, 22% did not agree, and a large percent, 44%, did not know. For most

categories, there is a relatively substantial “don’t know” category. The groups that were most in

agreement that the MHCC is making a difference (selected the highest percent of “strongly agree” and

“agree”) were: the media (100%), AC chairs/members (71%), ‘other’ (70%), and health service providers

(67%). As a reminder, the group that most categorized ‘other’ was individuals with a comprehensive role

in the mental health sector. The groups that had the least agreement with the MHCC making a

difference in the sector (largest percent of ‘disagree’ and ‘strongly disagree’) were: researchers (26%),

MHCC volunteers (22%), caregivers (22%), and people with lived experience (20%).

The final question in this section provided participants with a pre-set list and asked them to indicate

whom they would be most likely to talk with if they wanted to influence changes to the mental health

system. Possible responses included: Mental Health Commission of Canada; Canadian Mental Health

Association; general practitioner/family physician; mental health professional; elected government

20%

21%

15%

9%

9%

11%

13%

10%

8%

10%

12%

13%

19%

80%

50%

52%

54%

54%

52%

45%

48%

50%

46%

42%

42%

33%

51%

12%

13%

14%

11%

15%

15%

15%

16%

12%

11%

8%

22%

7%

4%

2%

2%

5%

11%

3%

7%

3%

7%

9%

4%

7%

13%

19%

21%

21%

11%

23%

20%

24%

25%

26%

33%

44%

16%

0% 20% 40% 60% 80% 100%

Media (n=5)



NGO (n=109)

Educator (n=80)

Researcher (n=46)


Caregiver (n=96)




MHCC Staff (n=24)


Other (n=57)



official; Health Canada; Provincial/Territorial health department; local health authority; and, “other”

where respondents could indicate and describe other options that were listed.

Figure 40: Frequency of selected responses for, “If you wanted to influence changes to the mental

health system, with whom would you be most likely to talk?” (n=463)

Results indicated that the most frequently selected locations were: their elected government official

(n=245), the Canadian Mental Health Association (n=203), the Mental Health Commission of Canada

(n=197), or Provincial/Territorial or local health authority (n=186). Less frequently selected were a

mental health professional (n=107), Health Canada (n=101), general practitioner (n=47), and ‘other’

(n=72).

For those individuals who selected ‘other’, there were 77 responses. Nine responses were not clear or

did not respond to the question. Of those who provided a response, their suggestions are presented

below, in descending frequency of mention.

Health organizations (x21): some respondents said they would be most likely to talk with health organizations such as NGOs, local non-profit organizations, or community and grassroots entities. Some named specific organizations (i.e., the Canadian mental Health Association, Canadian Alliance on Mental Illness and Mental Health, National Network for Mental Health, Alberta Alliance on Mental Health, Children’s Mental Health Ontario, Schizophrenia Society, and Dunara);

Patient groups (x19): other respondents said they would speak with patient groups, consumer groups (e.g., National Consumer Advisory Council, New Brunswick Consumer Network) survivor groups, patient advocates, and people with lived experience and their families;

245

203 197 186 181

107 101

47

72

0

50

100

150

200

250

300


Media (x7): a few people indicated they would speak more to the media;

Professionals and professional associations (x6): Others mentioned they would connect with professional associations, and a few offered specific examples (i.e., Professional Paramedic Association of Ottawa, provincial/national psychology associations);

Educators/academia (x5): a few people mentioned educators, medical schools, professors and researchers as likely people to speak with; and,

Justice system (x5): a few respondents indicated they would talk to people involved in the criminal justice system (e.g., police or court workers).

When the results were separated into discrete groups, people with lived experience (n=19) chose

mental health service providers, CMHA, and government as the top three, and MHCC was second last.

These results demonstrate an individual’s role influences with whom they would talk to influence the

mental health system, likely a result of whom they have previously contacted.

Overall Observations of the MHCC

The overall observations section included questions focused on opinions, recommendations, and

suggestions for the MHCC. The first three questions were open-ended and allowed respondents to write

a response. The first asked what aspects of the MHCC were working well, the second asked what aspects

were not working well, and the third asked if they had recommendations to strengthen the MHCC going

forward. The results include only the comments that garnered five or more respondents. Although a

response rate of five or less constitutes less that 1% of respondents, the quality and nature of the

responses are captured. As response rates of less than five have been removed, the numbers of

responses will not add up to the total “n” for each open ended question.

There were 599 responses offered to the first question, what aspects of the MHCC are working well.

Some respondents (x126) indicated they had insufficient knowledge about the MHCC or otherwise had

no response. A small number of people (x10) voiced their support for the MHCC without describing why

they felt this way. Of those who did describe what aspects they perceive are working well, their

responses are clustered into three main themes: communication and collaboration; initiatives and

programs; and organizational aspects. Each is described below in decreasing frequency of mention.

Communication and collaboration (x209): Overall, 45% of respondents thought that

communication and collaboration was working well. While about 70 indicated partnerships,

collaboration and information are working well without specifying the context, others provided

more detailed information, specifically:

Public awareness (x79). A few respondents perceived a change in public awareness and

attitudes and indicated that activities undertaken to change public awareness are

beneficial and to be continued. This includes media events, e.g., celebrity

spokespeople, newspaper articles and TV advertisements;

Government advocacy (x20). A few people think the communication and influence

gained with the provincial and federal governments is working well;


Communication tools (x18). A few respondents indicated they think some of the

communication materials are working well, such as the MHCC website, newsletters

(both the MHCC and other health organizations), and printed materials (brochure and

handbook);

Health professionals (x8). Very few people said they see the communication and

collaboration working well with health professionals and service providers;

Patients (x6). A small number of people think the collaboration with people with lived

experience and their families is working well; and,

Other (x5). Other aspects of the MHCC that are working well include communication

with employers, police and the self-promotion work of the organization.

Initiatives and programs (x165): some people feel MHCC initiatives are working well. While a

small number (x19) think all initiatives are working well in general without identifying a particular

program, others did specify, as follows:

Opening Minds Anti-stigma Campaign (x55);

Homelessness initiative (At Home/Chez Soi) (x44);

The Mental Health Strategy (x26);

Peer support activities (x7);

Knowledge exchange centre (x6); and,

Other (x6): a small number of other programs were identified, each mentioned only

once (i.e., recreation, bullying, depression, youth, occupational, and academic

programs).

Organizational aspects (x42): a few people described aspects of the MHCC organization that they

perceive as working well. Some of these respondents provided general comments regarding the

positive benefits of the MHCC organization (x15), and others were more specific, as described

below:

Skill and knowledge of MHCC staff (x15);

Funding (x5). Obtaining and granting funding; and,

Other (x7). Two positive comments were made about the working groups, and certain

structural elements were each mentioned once (i.e., governance, fluid work processes,

committees, management, and administrative structure).

Research (x33): a few people mentioned that the volume and quality of research being

undertaken is excellent.

Advisory committees (x10): a few respondents think the advisory committees are working well,

e.g., they make meaningful contributions and the members are well informed.


There were 614 responses to the second question of what aspects about the MHCC are not working

well. Many respondents (111) stated they had no response or provided unclear responses. Two people

felt all aspects of the MHCC are working well and a small number of respondents (x16) commented that

the MHCC is generally not working well or that it is too early to tell if there have been benefits. The

remaining responses provide more detail into the areas people think are not working well, and these are

presented below in decreasing frequency of mention.

Communication and collaboration (x239): In contrast to those that thought communication and

collaboration was working well (45%), 49% indicated that they thought it was an aspect that was

not working well. The difference refers mostly to specifics, for example, those that thought

communication and collaboration was working well were generally referring to the effort the

MHCC is making to engage and communicate with other groups. Those that indicated they

thought communication and collaboration was not working well want to see increased

communication with specific groups of people. Some respondents (x69) described a general need

for more communication and collaboration with unspecified stakeholders. The others provided

more details in their reasons for this, as presented below:

Public awareness (x38). A few people described a perceived need for more public

awareness and education, to get the message out regarding mental health. This includes

for more media events, high-profile spokes people, etc;

Patients (x36). A few respondents think more effort should be made to communicate

with people with lived experience and their families, and to include their voice in the

work of the MHCC;

Other organizations (x34). Other respondents see a need for more partnerships with

organizations already active in mental health (e.g., Canadian Mental Health Association,

NGOs, regional staff and programs, volunteer groups, researchers from the west, front-

line workers). Two people identified the competitiveness among stakeholder

organizations as a barrier to collaboration;

Professionals (x21). Other respondents said they perceive poor communication and

collaboration with health professionals and other service providers on the front-line,

(e.g., mental health workers, psychologists, researchers);

Government advocacy (x20). A few people feel the MHCC ought to do more

communication to build influence and align policy with governments at federal,

provincial, regional health authority levels;

External enquiries (x7): A very small number of people expressed dissatisfaction with the

responsiveness of MHCC staff to external enquiries; and

Clearer communication materials (x6). A very small number of people think that MHCC

reports should be less technical and presented in plain language for the lay population.

Others think the MHCC website is not very good.


Organizational aspects (x49): a few people think certain aspects of the organization of MHCC are

not working well, specifically:

Staffing (x19). Some respondents perceive issues relating to staff, such as: workplace

conflicts; a negative corporate culture; staff with stigmatizing attitudes; high staff

turnover; perceived conflicts of interests; heavy workloads; a need for more diversity in

the leadership; and role confusion between Board and staff;

Internal communication (x10). A few people said there exists poor internal

communication and collaboration, and a lack of bilingual communications;

Too bureaucratic (x6). A small number of respondents feel the organization is too

bureaucratic (e.g., heavy time demands for paperwork, and it is distanced from the

front-line); and,

Mandate (x5). A few people think the mandate is not focused enough and that it may

be too large for current organizational capacity.

System issues (x45): a few people perceive issues at the system level in mental health, and a

small number (x4) said they feel the health system needs to be improved, but did not specify how.

Others provided more detailed responses, for example:

Access (x20). Some people see the need for improved access to quality services, with

more high quality front-line services and facilities;

Funding (x10). Others feel that funding for mental health services is insufficient

throughout the system;

Government action (x6). A few respondents think federal and provincial governments

need to take more committed action to improve system issues; and,

Integration (x5). A small number perceive the need to integrate health services, as the

system is very complex.

Initiatives (x44): respondents indicated some areas specific to the initiatives, including:

Opening Minds Anti-Stigma Campaign (x25). Many respondents had comments

regarding the success of the anti-stigma campaign, for example, it is slow to start, and

stigma still exists in the health system and society at-large;

Knowledge Exchange Centre (x10). Some people mentioned problems or

disappointment with the KEC, for example, the delayed start-up, and the need for

support in knowledge translation; and,

Mental Health Strategy (x5). A small number of respondents feel the development of the

national strategy is not working well, for instance, some doubt that the MHCC will be

able to produce it by 2017, and others see a lack of research integrated into the

strategy.


Gaps (x41): a few people identified gaps they perceive in the MHCC scope of work to meet the

needs of groups and certain areas, including:

Front lines services and hospital settings (e.g., wait times, hospital beds) (x9);

Children and youth mental health (x6);

Homeless people. (x5) A small number of respondents indicated a continued need for

housing; and,

Other (x5): community long-term follow-up, recreational and occupational training,

serious mental illnesses, the mentally ill in prisons.

Efficiency and effectiveness (x31): a few people think the MHCC efficiency and effectiveness

could be stronger in some areas, for example:

Initiative impact (x18). Many respondents said they see little or no impact on the front

lines and patients. A few said there is a lack of clarity of how the MHCC measures

program impact;

MHCC spending (x7). A few people felt the MHCC organization does not represent an

efficient use of taxpayers’ dollars, particularly regarding executive salaries and travel

budgets; and

Lack of action (x6). A small number of respondents see the need for more action instead

of conducting consultations and research. A couple of people feel the extensive

consultations have led to delays in programs and initiatives.

Framing (x16): a small number of people think the way the mental health issues are framed by the

MHCC could be improved, as described below:

Too strong bio-medical framing (x6). Some respondents say the approach should move

away from the biomedical model based on medical expertise and drugs; and,

Need stronger biomedical framing (x5). In contrast to the point above, some people

argue that serious mental illnesses require biomedical care and that anti-psychiatry

arguments are not helpful to people in need.

Education (x11): there is a need for education and capacity building among professionals, with

one person suggesting changes to the university curriculum for health professionals.

Research (x7): a small number of people see some issues in research activities, e.g., there is a lack

of clarity, uncertainty about how findings are used and disseminated, who is included in research,

and repetition/overlap in research.

There were 468 responses to the third question concerning respondent recommendations for the

future. Some respondents (95) were unclear or “did not know”. There was a small number (x11) of

comments encouraging the MHCC to continue as it has been doing. Other people provided further

comments, as presented below in decreasing frequency of mention.


Communication and Collaboration (x265): 73% of the 362 respondents who made a specific

suggestion recommended that there be improved communication and collaboration. If you will

recall, 45% indicated they thought communication and collaboration was working well, and 49%

thought it was not working well. It is clear that on all fronts, although it may or may not be

working well depending on who you are engaging, the majority would like to see more of it. A few

respondents (x39) indicated a need for increased communication and collaboration, with no

specific groups mentioned. Others identified groups or areas to undertake further work to

strengthen the MHCC, and these are presented below.

Public awareness (x50). Some respondents suggested that the MHCC continue work to

increase awareness in the general public, using media (e.g., using television, celebrity

spokes persons, social media websites) and other information dissemination avenues;

Patients (x45). A few people suggested to further include the perspectives of people

with lived experience, their families and caregivers in the work of the MHCC;

Professionals (x35). A few people thought more communication and collaboration could

be done with medical professionals, service providers at the local and community levels,

and professional organizations. Respondents mentioned the need for information

dissemination to these groups, but also to provide the opportunity for them to provide

input to MHCC work;

Other organizations (x34). A few people suggested the MHCC partner with other

organizations already active in mental health such as the Canadian Mental Health

Organization, CAMIMH, and other national groups, but also the many community and

grass-roots organizations. According to respondents, this would help avoid “reinventing

the wheel”, improve efficiency and effectiveness of MHCC work, and also help ensure

the continuation of community-level organizations;

Government advocacy (x32). A few respondents expressed the desire for the MHCC to

build stronger connections to engage government at the national, provincial, regional

and health authority levels. This would increase awareness and collaboration with

governments to influence policy and place mental health higher on these decision

makers’ agendas; and,

Other (x6). A small number of additional comments were mentioned one time each,

namely: the need to use lay language in communications, to produce an annual report

for dissemination, and engage with other groups (i.e., volunteers, international

organizations, the justice system, Western and Northern Canada).

Organizational aspects of the MHCC (x60). Some people offered suggestions to strengthen the

organization of the MHCC, as presented below.

Mandate (x11). A few respondents commented on the mandate, for instance: the need

to focus more on action although there are barriers to service provision (since provinces

have autonomy here); the budget is too small for the mandate; possibly reduce mandate


(e.g., remove housing component or knowledge exchange) to make room for other

work;

Internal communications (x11). Many people suggest improving the communication and

collaboration within the MHCC, e.g., to educate staff on official MHCC positions and to

explain decisions. Communications should also be bilingual, according to a couple of

people;

Leadership and management (x9). A small number of people suggest that leadership

and management could be strengthened, to reduce micro-managing and improve

efficiency, ensure staff feel valued, reduce the stratified organizational structure, and

three people expressed the desire to change the leadership (unspecified as to Board, ELT

or other) in the organization;

Staff (x9). Respondents suggestions were to: value staff more, overcome territoriality,

overcome the geographic disparity of staff, continue to employ people with lived

experience, and ensure there are sufficient capacities to fulfill mandate;

Accountability and transparency (x7). A couple of comments related to improving

accountability within the organization through staff follow-up and evaluations like this

one, and increased transparency in governance and staffing. A small number of people

perceive a conflict of interest for some board members, and the roles between staff and

board need to be clarified; and,

Other (x5). Other comments included: the need to inform the public of job and

volunteer opportunities, to undertake organizational review to harmonize staff vision,

for the MHCC to become a part of Health Canada, and add more details to annual

reports.

Gaps (x39). Many people feel an increased focus on the needs of the following groups and areas

would strengthen the MHCC:

Homeless people (x6);

Rural and remote (northern) populations (x6);

People with multiple and concurrent diagnoses including addictions (x5); and,

Other groups (x6): Each of these groups was mentioned once each: dementia, autism,

low income people, serious illness, suicide, youth.

System changes (x29): a few respondents commented on the need for changes in the health

system. A handful (x4) indicated they wished to see changes without specifying them. Others

provide more detail, as follows:

Access (x17). Many people suggested the MHCC take more action to help improve

access to services for people; and,


Funding (x6). A few respondents saw a need to increase the funding to mental health

services.

Efficiency and effectiveness (x22): People commented on the efficiency and effectiveness of the

MHCC and had the following comments:

Action (x13). A small number of people are calling for more action by the MHCC to make

a difference, to affect change and improve the lives of people with lived experience;

and,

Impact (x6). A very few see the need for the MHCC to have a greater impact on those

people who need it most, and to measure this impact.

Initiatives and programs (x17): a few people offered suggestions to strengthen the MHCC

initiatives, as follows:

Opening Minds Anti-Stigma Campaign (x6) should be continued, perhaps expanded to

target youth, promote equality in workplace, or change it to be based on human rights,

and evaluate the impacts; and,

Other (x7). Additional comments were made regarding the need to measure outcomes,

to continue those initiatives that are effective, provide clear rationale and roles in

programs, and bring back some programs (e.g., Into the Light).

Research (x10): a few people suggested an increase in the funding and focus on research in

general. Others suggest conducting more research in the criminal justice system, and others

suggest reducing research in areas where there is enough in existence (e.g., homelessness).

Education (x9): a small number of respondents wanted to provide training for mental health

professionals, youth and workers in the justice system.

Framing (x6): framing changes vary in the data, for example, some want to change the paradigm

towards recovery and wellbeing, with less reliance on medication. Others want to remove the

anti-psychiatry groups, rely more on the medical model, and concentrate on the severely ill.

The final question in the overall observations section asked participants which of the five key initiatives

should be sustained beyond 2017. Participants were provided with a list of the five key initiatives and

could check all that apply. Immediately following, participants were asked to provide any comments

they had concerning the question above. This was provided to allow participants the opportunity to

explain why they indicated (or did not indicate) certain initiatives.


Figure 41: Frequency of initiatives selected by respondents to be sustained after 2017 (n=463)

As demonstrated above, all of the initiatives were selected to be sustained beyond 2017. However, the

mental health strategy for Canada, and anti-stigma initiative were selected most frequently. Least

frequently selected were Partners for Mental Health and research on homelessness and mental illness.

In regards to the open-ended question that asked for participants to indicate any comments regarding

their selection of initiatives, there were 319 responses to this question with 36 “do not know” or unclear

replies. There were a small number of people (x17) who commented that all initiatives should be

continued as they are seen to be of equal importance or it is too early to tell if an impact has been

achieved. Comments on specific initiatives are presented below.

Research on homeless and mental illness (x28):

Stop research on homelessness now (x13). A few respondents indicated there is

sufficient research on the link between homelessness and mental illness, and that

resources should be put towards other areas;

Positive comments (x7). A small number of people made positive comments to

encourage the fight against homelessness through research. Some see the program

making good progress and hope homelessness will not be a problem in 2017; and,

352 332

267 243

204

0

50

100

150

200

250

300

350

400


Stop research on homelessness in 2017 (x5). A small number of respondents noted that

by 2017 the research mandate should be fulfilled.

Anti-stigma/Anti-discrimination initiative (x23):

Positive comments (x16). A few positive responses were provided, such as: the anti-

stigma initiative is very important and should be continued; it is a priority issue due to its

prevalence; and it is a root-cause of many related problems; and,

Negative comments (x5). A very small number of people commented that they feel, for

example, the anti-stigma campaign is not effective, that access to services is a bigger

issue, and the focus should shift to anti-discrimination.

Knowledge exchange centre (x13):

The comments under this section were all response rates less than five and equally split

between being positive/recommending continuation and negative /recommending

discontinuing or transferring the Knowledge Exchange Centre to other organizations.

Mental Health Strategy for Canada (x13):


between positive/recommending the continuation of the Mental Health Strategy of

Canada and negative/recommending the completion by 2017.

Partners for Mental Health (x7):


between positive/recommending the continuation of Partners for Mental Health and

negative/recommending completion immediately.

In addition to comments above pertaining to specific programs, respondents also provided feedback in

other areas (i.e., gaps, organizational aspects, communication and collaboration, health system issues,

and research). These comments are presented below in decreasing frequency of mention.

Gaps (x56):

Employment (x10). A few people called for increased focus on employment support for

people with lived experience, and also for the education of employers in dealing with

mentally ill employees;

Addictions and concurrent conditions (x9). A small number of people felt that

addictions, trauma and other concurrent conditions should be combined, whereas

others felt that mental illness and addictions should be kept separate;

Other illnesses (x9). A few respondents feel that people with serious illness should

receive higher priority, as should those with autism, developmental delay and Obsessive

Compulsive Disorder;


Children and youth (x7). A few people would like to see more focus on mental health

issues in children and youth; and,

Social supports (x5). A few people identified other gaps including: the needs of families

and caregivers, peer support, psychosocial support and education opportunities for the

mentally ill.

Organizational aspects (x34). There were also a few comments about the MHCC as an

organization. A few people (x8) provided positive general comments supporting the work of the

MHCC, encouraging them to keep up the good work. Other, more specific, suggestions included:

MHCC should change role or cease operation in 2017 (x12). A few people commented

that by 2017 the mandate should be fulfilled and therefore the organization should

cease; others say it is an ineffective organization and should be stopped immediately;

and a few others feel that in 2017 the MHCC should offload the programs to existing

organizations or be integrated into Health Canada; and,

Funding (x9). A small number of people see the need for more money to support

implementation and ensure sustainability.

Communication and collaboration (x24):

Awareness (x8). A few respondents called for continued media events to improve public

awareness;

Government advocacy (x5). A small number of people commented regarding the need

for more advocacy with governments to affect changes and influence policy; and,

People with lived experience involvement (x5). A small number of people suggest that

people with lived experience and their families should be more involved in MHCC

planning and programs.

Health system comments (x14):

A very small number of people (x10) commented on the need for improved access to

mental health services, e.g., decreasing wait times, more patient-focused care, more

facilities, and integrated services.

Research (x10):

There were some general comments about research; all in response rates less than five

across six different theme areas.


4.3.2 Summary

The following section summarizes the detailed information provided previously. It is focused on key

themes and ideas, and important trends that emerged from the survey data, and includes the

observations of the evaluation team.

Concerning respondents, it is clear that individuals who completed the survey were very diverse. There

were a lot of overlapping roles and diversity of roles. Most individuals involved in the sector are

invested for many reasons, often a friend, family member, or they as an individual, are impacted by a

mental illness. The survey respondents often held more than one role, and thus had very unique and

insightful comments and responses. These individuals provided a good contrast to the respondents who

were included in focus groups and key informant interviews as many survey respondents were removed

from the day to day Commission work. Survey respondents rated themselves as very knowledgeable

about mental health, yet few of them indicated that they hear about the MHCC from other groups.

Finally, respondents indicated that they work in a variety of different areas, but the majority is involved

with organizations or service providers.

Communication

One of the themes that emerged from the survey data was a desire for more information and more

communication with the MHCC. Many people are aware of the MHCC, but would like to know more

about the Commission, its activities and products. When asked if they had adequate opportunity to

provide input to the MHCC, almost half of respondents (46%) indicated that they did not. In many cases,

groups that are heavily involved in mental health (e.g. people with lived experience, mental health

service providers) felt they do not have an opportunity to provide their voice. This question further

illustrates the perception from survey respondents that communication could be improved. The

communication theme followed through the entire survey, where less than 50% of respondents agreed

that the MHCC was effectively communicating and disseminating information.

With a national mandate, it is difficult to engage all stakeholders in Canada, but likely easier to

disseminate information and resources. In an age where social media is accessed by an extensive

population, these types of outlets can assist in disseminating information easily, cost effectively, and

well.33 However, survey respondents indicated that they are receiving information mostly through

emails, the MHCC website, and word of mouth. There were less that received information through

television or social media, which can both be very effective in garnering attention and passing on

information.34 Respondents also indicated that they relied the most on the MHCC website, newsletter,

reports and articles.

33

Kaplan, A.M., & Haenlein, M. (2010). Users of the world, unite! The challenges and opportunities of Social Media. Business

Horizons, 53, 59-68. 34

Kaplan, A.M., & Haenlein, M. (2010). Users of the world, unite! The challenges and opportunities of Social Media. Business

Horizons, 53, 59-68.


The survey question that asked respondents if they thought the MHCC’s activities, products and

resources contribute to a variety of areas (e.g. reducing stigma and discrimination, enhancing

integration and collaboration in the mental health system in Canada), and the question that asked if the

MHCC in the future will contribute to the same areas garnered a high neutral response. In most cases, a

third of respondents chose the ‘don’t know’ category. The same trend occurred for the question that

asked respondents if the MHCC was having a positive impact on certain groups (e.g., people with lived

experience, families and caregivers, researchers). In this case, between 27% and 45% of respondents

selected the ‘don’t know’ category. One interpretation is that the respondents do not feel informed

enough about the MHCC to make a comment. This interpretation speaks again to the increased desire

for communication and dissemination of information by the MHCC.

In the open-ended questions that asked survey participants what aspects of the MHCC were working

well, were not working well, and what recommendations they had for the MHCC, communication was

the most predominant theme for each question. Forty-five (45) percent of respondents thought that

communication and collaboration was working well, 49% responded that communication and

collaboration was not working well, and 73% of respondents offered recommendations on

strengthening communication and collaboration.

The strong responses for all three questions has been broken down previously, but the general

observation is that individuals feel the MHCC has done a great job in attempting to build bridges and

engage in communication and collaboration with stakeholders. In addition, they feel the presence of the

MHCC is increasing public awareness of mental health, and providing useful materials and resources. For

those that feel communication and collaboration is not working well, in general, respondents want to

see more effort to increase public awareness of mental illness, and to engage more specific groups

affected by mental illness (e.g. people with lived experience, other organizations, professionals and

government). In this way, an individual can be both positive and negative about the communication and

collaboration mechanisms of the MHCC.

Concerning recommendations to strengthen the MHCC, 73% of respondents cited issues of

communication and collaboration. Suggestions offered by participants ranged from: using media to

increase public awareness of mental illness; including the perspectives of people with lived experience

in the work of the MHCC; collaborating with medical professionals; and, partnering with other

organizations already active in mental health. The suggestions were very perceptive, and again

demonstrate that communication and collaboration is a double edged sword in the sense that you can

engage as many people as you can possibly think of, but there will always be a desire for another voice

to be included.


Inclusion and Partnership

Along with increased communication, one of the other main themes from the survey results was one of

inclusion and partnership. Survey respondents indicated in many forms that they would like increased

partnership and collaboration with the MHCC, but also that they would like to see other groups more

included in the process.

Almost a third of survey respondents indicated that they did not understand how their work contributes

to the MHCC, and the same percent did not understand how the MHCC contributes to their work. The

message through these two questions is that some respondents do not understand the partnered

relationship between their work, themselves, and the MHCC. This partnering may be a very faint

partnership, for example, between the media and the MHCC. In this collaboration, they may not be

directly involved in the Commission but realize that a component of the success of the MHCC is

information dissemination and media awareness. Some groups that are directly linked with the MHCC

(e.g. Advisory Committee members, government, and MHCC staff) indicated that they do not

understand how their work contributes to the MHCC, or how the MHCC contributes to their work.

Individuals residing in these roles should be very much aware of the partnering relationship between

their work and the MHCC.

Concerning inclusion, 25% of respondents disagreed that the MHCC’s activities, products, and resources

to this point have contributed to improving collaboration with people with lived experience and their

families or caregivers. In addition, 24% of respondents disagreed (to this point) that the MHCC has

contributed to improving collaboration among partners. The responses indicate that participants feel

that more partnership and inclusion could have been achieved over the past three years. However,

when respondents were asked if the MHCC would contribute to those areas in the future, disagreement

levels decreased, and agreement levels increased. Overall, 52% indicated agreement for improving

collaboration with people with lived experience, their families and caregivers, and 56% agreed the

MHCC would improve collaboration among partners.

Survey respondents also indicated some disagreement that the MHCC is having a positive impact on

some of the most heavily invested groups (e.g., people with lived experience, families and caregivers,

mental health professionals, and service providers). For example, 25% of survey respondents did not

think the MHCC was having a positive impact on people with lived experience, families and caregivers,

or service providers. In addition, 21% disagreed there was a positive impact for families and caregivers,

for mental health professionals. The results indicate that although survey respondents feel the MHCC is,

and can make a difference, a portion do not feel that they are having a positive impact on those that the

MHCC was designed to benefit. It may be too early in the evolution of the MHCC for impact to be felt

substantially at the front line. Their efforts have largely (and understandably) been directed to getting

the organization up and running, setting a vision and strategy and it is too early to be held accountable

for results.

Survey respondents also indicated that they were not very involved with the MHCC (which could be for a

variety of reasons, not necessarily exclusion), they do not often hear about the MHCC from people with


lived experience, family members or caregivers. They also commented in the open-ended section on

recommendations to strengthen the MHCC, that there are gaps in the MHCC scope of work to meet the

needs of certain groups for example, front lines service staff; children and youth; homeless people;

people in rural areas; and, various cultural groups. These comments speak to the increased desire for

more inclusion and partnership between individuals, organizations, and other stakeholders.

Catalyzing Change

The final main theme that emerged out of the data was consistently that the MHCC is, and will continue

to make a difference in the mental health sector. Regardless of comments with suggestions on ways to

improve the MHCC, most survey respondents were positive about the creation of the MHCC and the

idea behind the organization, but wanted more information about it. For instance, 67% of respondents

indicated that they believed the MHCC had a positive reputation. This is the majority of respondents,

and when the ‘don’t know’ category is removed, 82% of respondents thought the MHCC had a positive

reputation. It should be noted however, that when the people with lived experience and family-

caregiver groups were examined discretely, there was less positivity. This likely could be attributed to

two main themes discussed previously regarding increased communication, inclusion and partnership.

Regarding the initiatives chosen by the MHCC, very high percents of people thought it was important to

work in those five core areas. The areas with the most support were: the mental health strategy for

Canada, and developing an anti-stigma initiative. Least supported were the homelessness research

project and partners for mental health, although both agreement percents were above 85%. In addition,

most respondents thought the five initiatives were the right ones, and for the most part, there are not

any issues outstanding that are not being addressed in the five key initiatives. In addition, large

frequencies of respondents indicated that if the MHCC were to pursue activities beyond 2017, they

should continue work on the five key initiatives. The initiatives with the most support were the mental

health strategy and anti-stigma initiative.

Most participants indicated positively that to this point, the MHCC’s activities, products, and resources

contribute to: reducing stigma; improving collaboration among partners, people with lived experience

and their families/caregivers; improving awareness of issues; enhancing integration and collaboration;

and increasing the use of MHCC research to impact policy and service delivery. Even better, the

percents increased for all of the areas when participants were asked to think about the future. The

results help demonstrate that survey respondents feel quite strongly about the MHCC, and the

difference that it can, and will make in the mental health sector.

Survey respondents also indicated that the MHCC was having a positive impact on various groups

(agreement ranging from 29% for employers to 56% for media). The groups indicating positive impact

the most were: media; mental health service providers; and researchers. As mentioned, there were a

large category of ‘don’t know’ responses, which could be changed by increasing the communication,

inclusion and partnership as previously discussed. Over half the respondents thought the MHCC was

making a difference in the mental health sector, but when the neutral category is removed, this number


increases to 75%. This result summarizes the general perception about the MHCC, that respondents

remain positive about the possibility of change in the sector.

4.4 Key Informant Interviews and Focus Groups Qualitative data does not, nor is meant to provide information that is representative of the full

population under study. Rather, this research technique is meant to explore issues in greater depth

than would typically be allowed through the use of quantitative data collection. Qualitative data must

be reported on in a defensible manner and with other lines of evidence to ensure accurate analysis.

Using the principles of content analysis, Charis reviewed the qualitative data and identified key themes

and areas of concurrence or areas of divergence within the data. We reported the data in the

framework of the following touchstones:

Determine who and how many informants expressed the same opinion/assessments;

Identify areas where there appears to be no agreement/alignment in qualitative

opinions/assessments;

Ensure that qualitative data results were verified, cross-referenced and integrated with results

from other components of the research; and,

Report only those findings that fall within the scope of key informant knowledge/expertise and

the scope of the evaluation.

Phase 2 qualitative data collection took place in the months of January and February, 2011. This section

presents the integrated qualitative data from the key informants and focus group participants. The

guides created for this data collection queried respondents (both internal and external to the

Commission) about the specific impacts in the five areas of inquiry:

Mandate: Is the MHCC initiative consistent with the assigned mandate as per the funding agreement with Health Canada?

Inputs/Structure: how are the MHCC’s governance structure, processes and support mechanisms contributing to the achievement of the MHCC mandate and goals?

Achievements: What has been achieved by the MHCC to date in terms of implementation for the assigned mandate?

Early Impacts: How has the MHCC affected the work and lives of partners and collaborators in the mental health system?

Recommendations: What can be learned from implementation to date and are there any recommendations for improvement?

Confidential interviews were held with 29 individuals noted as key informants to the work of the MHCC.

The four focus group interviews were held with members of selected core groups, and focused on the

same questions, but with an opportunity for discussion and the development of synergy between


participants. Copies of key informant interview and focus group guides and the interview questions for

all methods can be found in Appendix C.

Individual and group interviews were recorded, transcribed and coded for common themes by the

evaluation team under each of the relevant evaluation indicators. In general, at least three individuals

had to express a similar comment before it was considered to be a theme or sub-theme35.

Finally, upon completion of the qualitative data collection process, Charis implemented an

interpretation workshop with key stakeholders from the MHCC, including the evaluation project team,

members of the ELT and others, as well as the Charis team. Preliminary findings were discussed and

where relevant, the discussion was integrated into this report.

4.4.1 Results

This section provides a synthesis of the key findings from the individual and group interviews. It includes

comment on the degree of continuity among the two data sets of respondent opinion/assessment.

Additionally, where it clarifies understanding, quantitative data sets are referenced. Results are

reported by the five areas of inquiry and their associated questions. Response prevalence was

categorized, where possible. Focus group responses were themed by each focus group and counted as

one response when reporting by key themes.

When reporting key themes and/or perceptions, the following qualitative content analysis descriptors

have been used:

No/None: refers to instances where no individual identified the particular issue.

Few/Very Few: refers to instances where fewer than one-tenth of individuals have expressed a particular opinion.

Some: refers to instances where between one-tenth to one-third of individuals interviewed expressed a particular opinion.

Several: refers to instances where between one-third to one-half of individuals interviewed expressed a particular opinion.

Many/Most: refers to instances where between one-half to three-quarters of individuals interviewed expressed a particular opinion.

Majority: refers to instances where more than three-quarters, but not all, interviewees were of the same opinion and/or held similar perceptions regarding an issue or topic.

Almost All: refers to instances where all but one or two individuals expressed a particular opinion.

All: reflects consensus across all individuals within a stakeholder group. All interviewees questioned on the topic expressed the same view or held the same/similar opinion.

35 When coding themes for the open ended questions from the online survey, there had to be at least 5 individuals

express a similar comment before it was reported as a theme or sub-theme.


The detailed results from the individual and groups interviews as well as the open-ended survey

questions are provided in Appendix C.

Mandate

All individual and group interview respondents as well as survey respondents were reminded of the

MHCC Mandate and the five key initiatives that were being examined as part of the formative

evaluation. Results are reported by the specific question.

To what extent the MHCC is meeting its assigned mandate and are the five key initiatives the right

ones?

Respondents were generally consistent in their opinions regarding the MHCC’s congruence with the

assigned mandate. While most of the respondents indicated the five initiatives were the right ones and

the majority observed the initiatives are aligned with the mandate, some inconsistency was indicated.

The area of divergence concerned the perceived service delivery function of the At Home/Chez-Soi

Homelessness Research Demonstration initiative. In this case, provision of service was seen to be

beyond the scope of the Commission’s mandate. Additionally, there was concern expressed that the

Knowledge Exchange Centre and the Partners for Mental Health initiatives were not developing at the

same pace as the other initiatives. The MHCC was seen to be entering a phase in implementation that

would really need these initiatives to be functioning. Finally, respondents were typically agreed that the

scope and expectations associated with the mandate were very high.

Are there any gaps in the five key initiatives?

Interview respondents who noted gaps in the realization of the mandate and initiatives offered specific

examples. The themes that emerged included:

The specific initiatives of Knowledge Exchange Centre (KEC) and Partners for Mental Health are not progressing as well as the others.

The MHCC is not sufficiently achieving inclusiveness. People with lived experience, family and caregivers, First Nations Inuit Métis, and Francophone representatives (particularly from the province of Québec) are not being fully integrated into the work of the Commission.

The sector’s expectations for advocacy, especially among community organizations, are not being realized. These groups anticipate that the MHCC will be their advocate. The Commission is seen to be privileging health ministries and not as actively engaging other relevant departments (e.g. Justice, Immigration, and Employment).

The connections are weak between the MHCC and front line service delivery organizations.

Linkages are missing with addictions stakeholders and primary health care service delivery providers.


Is the allocated funding sufficient to implement the mandate and is the funding being used to

leverage additional funding supports?

Respondents had diverse opinions as to funding sufficiency for mandate implementation. Many respondents stated the MHCC has received sufficient funding. Respondents both internal and external to the Commission indicated that better efficiencies, and not more funding, would ameliorate perceived problems and insufficiencies. For those respondents who queried return on investment, lack of easy access to financial documentation was seen to be a key to this perception. Some respondents suggested that the funding level is inadequate to implement the mandate and noted the funding allocations recommended in Out of the Shadows have not been realized and this impacts results. However, most believe that some leveraging of funding is occurring (e.g. leveraging of funds and in-kind resources for At Home/Chez-Soi). Some further noted that in order to adequately leverage funding with provinces and territories, better alliances need to be formed with these groups. These respondents saw the need to build targeted linkages with all levels of government to insure MHCC sustainability.

Structure

Respondents were asked specific questions about the MHCC governance, organizational structure and

processes. Appendix D presents the organizational chart that was relevant to this evaluation and

against which respondents’ opinions/assessments were analyzed by Charis.

Are the MHCC’s governance structure, processes and support mechanisms contributing to the

achievement of the MHCC’s mandate and goals?

Several respondents (between one third and one half) think the governance/structure contributes to the

achievement of goals. These respondents were generally satisfied that the structure facilitates the

MHCC’s work and that the development process has been evolutionary and changing for the better.

These respondents cite the way the Commission began, and its many different executive leads, but

nonetheless acknowledge an overall trajectory to a more solid and better organized system. However,

other respondents provided a divergent opinion, noting that the governance of the MHCC has become a

barrier to mandate achievement. Often, these observations were noted in the context of organizational

change—that in the past the MHCC’s structure was more effective. These respondents offered the

following reasons as to why the Commission is less effective today than previously:

Restructuring was noted as a barrier (on-going organizational change and the complexities of this was diminishing capacity to achieve goals);

Increased hierarchy and bureaucracy over time reduces organizational effectiveness; and,

Lack of transparency in decision-making is proving to be a barrier to success.


Are organizational structures, processes and support mechanisms functioning as expected and are

they congruent with the (implied) organizational values of the MHCC?

Most key informants believed that the MHCC work is congruent with (implied) organizational values.

These respondents note the passion of the leadership team, the commitment of the staff and the

involvement of people with lived experience in various components of the Commission’s work. These

respondents see the Commission as engaged in sustained dialogue with stakeholders to ensure the work

moves forward.

Several respondents identified gaps and barriers in structure and function, with the following four key themes emerging:

Staffing retention and attrition issues, including all levels of staff;

Internal communication moving from clear communication to the introduction of barriers through complex reporting and unclear decision-making processes. Additionally, this impacts capacity to be cross-cutting across project areas and weakens internal organizational awareness;

Increased bureaucracy and infrastructure adding layers to communication and internal procedures; and,

Funding issues related to the scope of the mandate and the impossibility of contributing to all that is required, given the current level of funding.

Are the Advisory Committees the right ones, focused on the right content areas and with the right

people involved?

First, respondents were reminded of the eight functioning Advisory Committees (ACs), organized around

the following content areas:

Child and Youth

Family Caregivers

First Nations Inuit Métis

Mental Health and the Law

Science

Seniors

Service Systems

Workforce

When respondents were asked if the current ACs were the right ones, focused on the right content

areas and with the right people involved, the following themes emerged:

The majority of respondents believe that the ACs are the right ones, focused on the right content areas and involving the right people. These committees are seen as thriving environments with very engaged volunteers who have strong subject area expertise.


The majority of respondents noted changes in AC reporting and their capacity to engage decision-makers (Board and ELT) are seen as a loss. These respondents note that previously, AC chairs had more direct access to decision-makers and knew how to engage the MHCC structure and provide their expertise to these leaders. Changes in the MHCC’s structuring have impacted reporting functions and access to decision-makers. This has led to perceptions of the ACs being “working committees” rather than “advisory committees”.

Concerning AC research and projects, several respondents noted the MHCC is at a phase now where it is necessary to ensure that AC projects are in alignment with the MHCC mandate and scope. Additionally, there was a perceived need to address structural components of the AC work, facilitating a move towards using “cross-cutting” methods across content areas and work less in “silos”. In consonance with this theme is the observation that ACs need to better integrate First Nations Inuit and Métis peoples, francophone people (particularly from Québec) and people with lived experience into their committees’ memberships. Finally, the degree of research independence related to the AC projects is valued.

Respondents observed the need for the KEC to begin functioning, to facilitate the knowledge exchange/transfer of information derived from AC research and project work. Respondents noted that there are many projects coming to completion and many products/reports that will rely on the KEC to assist in dissemination and knowledge translation.

Is the role of people who have experienced mental health problems either directly or as family

members or caregivers, authentically involved with the MHCC (as staff; volunteers; consultants)?

Respondents were invited to discuss their opinions as to the authentic inclusion of people with lived

experience, their families and caregivers. To that end, many informants (half to three-quarters) believe

that these groups have been authentically involved. These informants, who work closely with the

Commission, believe it has achieved success in providing processes and structures to facilitate an

inclusive environment. They cite as evidence the Hallway Group, the Youth Council and membership on

ACs.

Alternatively, several respondents (less than half) do not believe that people with lived experience, their families and caregivers have been authentically involved. For these, specific concerns were cited:

There are challenges related to the lack of a “Consumer Council” and a sense that affirmative action36 is still a legitimate way to design systemic inclusion. Further, intentional inclusion would risk manage the perception of “tokenism” that is present with some respondents.

The same people with lived experience and family members are involved repeatedly and the MHCC is not recruiting different representatives, but relying upon the access they have to this select group.

MHCC staff recruitment is not observed, by respondents, as based on an affirmative action policy. This is seen to result in the lack of a critical mass that would provide energy and voice to bringing about a truly “model workplace” environment.

36 In this context, affirmative action refers to a policy based targeting of an under-represented group, that has is typically

excluded from the workplace. Historically, this has referred to the hiring of women and minority groups, but has been extended, in this case, to include persons with lived experience.


There was an observation that the MHCC needs to build its capacity to work with people with lived experience in alignment with the principles of “recovery orientation” that was so central to the Mental Health Strategy Framework document.

Has the MHCC been able to establish effective and collaborative partnerships?

Many respondents indicated that the MHCC has worked very hard and successfully in developing

partnerships and nurturing collaborations. Informants refer to the short period of time during which the

MHCC has been operational and note that much has been done, nonetheless. While respondents noted

a large number of developments in terms of partnerships/networking, several were mentioned with

some frequency. Of importance is the influence and reach of the ACs, who have brought extensive

partnerships with them, to the Commission. Additionally, At Home/Chez Soi is cited as a good example

of working/partnering with service providers and building relationships. The development of the

Provincial/Territorial Reference Group was cited as a success. For these respondents there have been

many partnership wins created, through the growing links with media, all levels of government, the

private sector, and researchers across Canada and internationally. These partnerships are seen to be a

core factor of MHCC sustainability.

Alternatively, many participants also indicated that the MHCC needs to improve their partnerships and

capacity for collaboration. Several of these observed the lack of intentional engagement with service

provider organizations; these groups are seen to be less involved with the Commission than is wanted.

In consonance with this group are the Non-Governmental Organizations (NGOs). These two groups are

of concern, as respondents assess as inadequate the Commission’s acknowledgement of their work.

Further, many of these groups are experts in service provision and have been working long, hard and

effectively in the sector. Their perceived lack of inclusion is prominent and in some cases, the MHCC is

seen as a destabilizing influence in the sector. Similarly, the MHCC is not assessed by these respondents

as successfully engaging people with lived experience, their families and caregivers, nor the

Francophone community (particularly from Québec), nor the First Nations Inuit and Métis groups. While

these respondents describe impacts to sustainability, they further see that without a thriving KEC, the

Commission’s work will not be made available to these groups and nor will their participation be present

in the research and projects.

Has the MHCC established itself as a model workplace?

Very few informants (less than 10%) identified the MHCC as a model workplace; in fact, this area emerged as one of the central concerns to those interviewed and participating in the focus group sessions. While many felt unable to assess the Commission on this indicator, the remainder believed the MHCC was “not yet,” or was not, a model workplace.

Respondents were probed as to what barriers they identified as impeding the goal of becoming a model

workplace. The following core themes emerged:

Recruitment/retention/attrition practices have created concerns for respondents both internal and external to the Commission. For instance, they note that staff are fired and there is no


notice; they simply are no longer there. Others commented on people being hired and quickly moving on.

Lack of work-life balance and capacity for self-care for staff are noted as serious impediments to the work of the MHCC, by respondents both internal and external. They observe a growing culture of affirmation for those who work too long hours and neglect a healthy life balance. This is seen as an increasing and counter-productive trend that will impact MHCC sustainability and reputation.

Lack of accountability and transparency in Human Resource processes are identified as growing concerns. Changes in MHCC structure, noted above, are included in this concern. These respondents look for a return to simple reporting structures and increased capacity to share their expertise with the Commission in an authentic and affirming way. Further, they noted that there is incapacity of staff or partners to work to the full scope of their skill set and remarked that there are perceptions that staff/partners’ skills and knowledge are not valued or known.

Internal and external respondents perceived the MHCC workplace as “silo-ed.” This was identified as counter-productive and inhibiting the work of the MHCC, the creativity and expertise that could cross-pollinate the work.

Several internal and external respondents who had expressed concerns about the MHCC workplace observed that in spite of perceived corporate culture issues, there are thriving relationships between colleagues and/or the volunteers or partners with whom they work. The horizontal communication, collegiality and respect are strong and there is acknowledgement of the expertise and skill sets of one another. The wish here is for this culture that is emerging at the grassroots level of the organization to impact the larger structures.

Early Achievements

While it is early in the life of the MHCC and only possible to address immediate achievements, this

section of questions focused on those aspects of their work that can be identified as emerging examples

of success. Additionally, Charis asked the interview and focus group participants about the transition

and implementation of Mental Health First Aid (MHFA) to the Commission’s work, and any barriers and

challenges to the overall work of the MHCC that are evident.

Concerning all aspects of the MHCC’s activities, products and services, what early examples of success

are evident?

Many respondents spoke to the early achievements of the Commission, with enthusiasm and citing

concrete examples. Overall, three over-arching themes emerged as core components that have

facilitated MHCC success:

The developing capacity within the Commission for clear communication and collaboration, particularly in terms of raising public awareness, engaging the media, the emerging role of the Commission as a trusted advisor to all levels of government, and the skillful development of effective communication tools.

The level of expertise that has been brought to the MHCC through internal and external connections and their contribution to establishing the organization as a centre of excellence. The


reputation of the MHCC as a credible organization providing credible products and information was of note.

The innovation and creativity of the Commission, for example in the establishment of the Youth Council. The engagement of youth and foregrounding their voice and experience is seen to be a significant achievement.

Participants were asked what have been the MHCC’s most important early achievements. They

grounded their observations in the concrete achievements gained, most significantly by the three

initiatives of Opening Minds, At Home/Chez Soi, and the Mental Health Strategy. These initiatives were

seen to be the front runners in garnering attention and producing early results in the sector. For

instance, the At Home/Chez Soi project was noted as facilitating structured and measurable

demonstration projects that will provide best practice results to the intersection of homelessness and

mental illness. As well, Opening Minds was cited as innovative in having fields added to the Statistics

Canada survey that will provide, for the first time, benchmark data on mental illness and stigma; in

garnering interest in the business community; and generating a positive and engaged public awareness

campaign. Concerning the Mental Health Strategy, respondents spoke to the development of a

framework that has acceptance across the country and with all levels of governments. The tactics used

to generate this support (e.g., public consultations, focus groups) were seen to be well-managed and

inclusive. The framework is described as generating hope in a sector where making policy shifts is

experienced as difficult.

In addition to the three initiatives outlined above, some respondents commented upon the work of the

ACs, the value of their networks and the level of their experience. Of note were the achievements of

the Workplace (A Perfect Storm) and the Child and Youth Committees (Evergreen Project) and the

emerging results these projects have produced. The ACs capacity to generate a Pan-Canadian dialogue

on the issues and to take recommendations produced to the decision-makers was observed as strength.

How effective was the transition of the Mental Health First Aid (MHFA) program to the MHCC? Is the

MHFA program being implemented effectively?

As the MHFA was first added to the MHCC work in April 2010, respondents were asked to discuss a

program that is very new to the Commission. Given how recent these developments have been, it is

not surprising that essentially, most respondents (half to three-quarters) did not know enough to

comment about MHFA and the transition. The few (less than 10%) who did know about the program

were equally divided as to whether the MHFA was effective in its implementation. While some saw

congruence between the MHFA and, for instance, the anti-stigma initiative (both empower public

engagement and build capacity for public response), others affirmed the potential of the MHFA as a

Canada-wide program. However, other respondents expressed concern. Two themes emerged:

The lack of transparency at the time of the program’s transition to the MHCC. Perceived

communication lacks created concerns as to why other effective mental illness awareness

programs were not also explored for MHCC adoption.


MHFA is viewed as service provision and, as also noted about the At Home/Chez-Soi initiative, this

type of programming was perceived to be beyond the scope of the MHCC mandate.

What have been the key challenges and/or barriers to the work of the MHCC?

Concerning early achievements, informants were asked to identify the challenges and barriers to MHCC

success. The following themes were indicated:

Communication and collaboration – although identified as an early success by many, just as many

respondents felt this was an area where the MHCC could continue to improve, particularly with

respect to the perceived lack of transparency of decisions taken (e.g. project approval) and the

perceived lack of capacity to have input/influence on the direction and focus of the MHCC’s work.

Organizational aspects – included human resource issues such as limited ability of

staff/volunteers/ACs to contribute to decision making; perceived limited engagement with the

community, service providers and people with lived experience; and internal silos.

Managing expectations – there were challenges identified related to the MHCC having a national

scope combined with the provinces/territories having the responsibility for the operation of most

components of the mental health system. Many respondents have high expectations and hopes

for what the MHCC can achieve.

Systemic issues – advocacy (expectations and ability/inability to act on these) and the fact that the

mental health “system” has been “built as we go” over multiple decades, with multiple

stakeholders within and outside of health (e.g. housing, employment, justice) and that systemic

change will require time and a comprehensive approach.

MHFA – the lack of transparency and knowledge about this program is cited as a barrier to

success.

Early Impacts

It is early in MHCC implementation to discuss anything but the most emerging impacts of their work.

Guided by the Level 1 logic model and the anticipated early impacts outlined in this program tool, Charis

framed questions that invited respondents and focus group participants to consider what initial impacts

MHCC implementation has produced. Respondents were asked a series of questions related to how the

MHCC has affected the work and lives of partners and collaborators in the mental health system. They

offered the following self-identified impacts.

Is the MHCC a catalyst for the mental health sector in Canada?

At inception the MHCC was designed “to be a catalyst for reform of mental health policies and

improvements in service delivery.”37 Thinking of a catalyst as a spark that initiates and accelerates an

action, respondents noted new levels of government engagement with mental health issues and policy

37 Kirby, et al. Out of the Shadows at Last, p. 74.


impacts. Others spoke of the KEC’s capacity to facilitate this “catalyst” role, once it begins to work.

Many indicated that they believe the MHCC has begun to fulfill this role, citing effectiveness in:

Mobilizing resources and people, and especially in engaging people with lived experience;

Building awareness and the extending the profile of mental health;

Establishing national communication and collaboration; and,

Emerging as a provider of valid and useful information and research.

A few informants believe that it is still too early in the mandate to assess if the MHCC has been a

catalyst.

What principles and values do you see reflected in the work of the MHCC?

Respondents were invited to identify any principles or values that they thought were reflected in the

work of the MHCC. In this case, they were being probed for an organic response; no principles or values

were provided to the respondents, who were free to identify any that they thought were most relevant.

For comparative purposes, the MHCC Guiding Principles concern (located in the “Code of Conduct

”2011): improving the lives of Canadians with mental illness; integrity and public scrutiny; respect for

people; openness and transparency; stewardship; accountability; and, application (the code applies to

all). Additionally, the guiding principles in the 2010/2011 – 2014/2015 Business Plan are an important

reference for this discussion.38

In the framework of this evaluation, most respondents identified the following three principles and

values:

Inclusiveness: citing the inclusion of people with lived experience, the Canada-wide scope, the place created for families and caregivers, the level of public consultation, the respect for the issues.

Value of systemic change: mentioning the vision to transform the mental health system to improve lives; to design and implement a national strategy; to facilitate individuals and organizations that work in the sector and build their capacity to impact systems.

Collaboration: indicating the value of team work, the collaborative processes that are embedded in programs and approaches, the hard work and dedication evident in the MHCC “family.”

Is the MHCC innovative?

While many respondents believe that the MHCC has been innovative, some either do not assess the

MHCC as innovative or do not know. For those many that have experienced the early impacts as

bringing innovation to the sector, the following themes emerged:

38 See MHCC Business Plan 2010/2011 – 2014/2015, pgs 71 – 72.


Raising awareness of mental health: for instance, the launch of the Into the Light conference; Partners in Mental Health with its goal to establish a national social movement to engage public support; others mentioned adapting MHFA to Aboriginal contexts; and, the inclusion of people with lived experience in raising awareness and public engagement.

Linking health and mental health: respondents commented upon this transition in thinking and its capacity to generate new and effective responses to the issue, by seeing mental health in the larger continuum of health. Additionally, respondents mentioned the focus on recovery and wellness as opposed to mental health as a medical problem, particularly in the approach used with the Mental Health Strategy Framework

Innovative projects: At Home/Chez-Soi; Partners for Mental Health; and, in general, providing focused research attention on the Canadian experience of mental illness/mental health.

Supporting others to do their work: respondents mentioned the role of the MHCC to act as a catalyst and build the mental health sector’s capacity to respond and provide services that will make a difference.

A learning organization: respondent’s observed that the MHCC has been well positioned to learn from national strategies implemented elsewhere (e.g., Australia, New Zealand) and adapt those learning’s to the Canadian context.

Do you rely upon the MHCC’s products and services?

Through the individual interviews and focus groups, approximately half of respondents indicated that

they rely on the MHCC. These respondents mentioned a growing expectation that the MHCC will

provide sector stakeholders with valid and usable resources and tools; will take the lead in garnering

national attention to the issues; will move agendas and facilitate policy shifts; and, will build

collaborations and provide support and direction. Others indicated that they partially rely on the MHCC.

Several respondents (one third to a half) noted they did not rely on the MHCC at all.

Keeping in mind that key informants and focus group participants were recruited from groups engaged

with the MHCC, their rate of reliance on the Commission is generally higher than that of the survey

respondents (engaged in mental health but rarely with the Commission). Survey respondents rate of

reliance was overall lower (43% indicated they rely on the MHCC) but when examining the results by

respondents’ roles, those survey respondents who were more informed and involved with the MHCC

(staff, AC chairs or members or government officials) had more than 50% reliance on the MHCC.

Survey respondents outlined what aspects of the MHCC’s work and products they rely upon:

Documents;

Website;

Policy ; and

Best practice knowledge.


Is the MHCC making a difference to the sector?

Many informants believe that the MHCC is making a difference for people with lived experience, families

or caregivers whereas some believe it is too early to tell or they didn’t know. Core themes of what was

making a difference were identified by key informants and focus group participants:

Anti-stigma and awareness: the MHCC is seen to be clearly building national awareness about the issue of stigma; respondents anticipate that this campaign is beginning to produce systemic change in the workplace, schools and in homes.

Policy: respondents attribute new interest in mental health issues, among all levels of government, in part to MHCC presence and engagement with policy makers.

Programs and services: respondents spoke to MHCC internal programs that are having an impact, citing At Home/Chez Soi’s early achievements in the homelessness sector, and Opening Minds similar emerging success within the anti-stigma sector. More respondents identified the Commission as making a difference to external programs, in this case citing emerging transformations in service delivery (both in the way people with lived experience are treated and receive treatment); new indicators of systemic/structural impacts; media programs; and, the provision of a national strategy to the sector.

To further clarify what the respondents said about the emerging impacts of the MHCC on the mental health sector in Canada, some specific examples they offered are outlined in Table 15. Table 15: Respondents provide specific examples of ways the MHCC is making a difference

MHCC activities Examples of early impacts

Opening Minds

Anti-stigma and Awareness/Programs and Services:

Identified some high functioning and effective programs – e.g. Ontario Shores Mental Health Centre and their Talking About Mental Illness (TAMI) program for youth was linked to a group of territorial government leaders to assist them in providing help to youth in the north.

Identified an Ontario organization that appeared to be the only one across the country with a program to reduce stigma among hospital staff; it was used recently in all of the interior BC hospitals.

Mental Health Strategy Framework

Policy:

Inspired Nova Scotia, Manitoba and other provinces to work on a provincial mental health strategy.

Programs and Services:

Ministry in Québec has used it to inspire 72 school boards to develop tools for teachers and students.

At Home/Chez-Soi


The consumer panel and their work for At Home/Chez-Soi could be transferred or used in other initiatives. For example, they did their own training and development of “telling your story”.

Advisory Committee Projects

Policy:

Service Systems AC – recommendations from the “Making the Case for Peer Support” is being used in some jurisdictions to further the work and inclusion of peer support within mental health services.


Workforce AC – documents developed and the Leadership Framework for Advancing Workplace Mental Health has led to partnerships with large corporations such as Canada Post and Bell Canada.


Mental Health and the Law AC - policy advice on police training in mental health awareness has been picked up by policing groups across Canada and is being included in their curriculum.

AC chairs brought their own, well developed networks to the MHCC, and many of the expert committee members have leveraged their own networks for the work of the MHCC. This has been an easy, but substantive achievement for the organization.

Finally, the following survey respondents (57%) identified the MHCC as “making a difference to the

sector:” media (100%); Advisory Committee chairs/members (71%); other (70%); service providers

(67%); NGOs/educators (63%); caregivers (58%); people with lived experience (56%); and, family

members (56%).

Recommendations:

Respondents were asked what could be learned from the implementation of the MHCC to date and

indicated the following themes:

Specific strategies, such as Opening Minds and the Mental Health Strategy Framework, developed best practice dissemination techniques that should be replicated.

Several observed that leadership is integral to the successful implementation of the initiatives. The sector is identified as complex and with ingrained practices. MHCC leadership needs to continue to develop its capacity to effectively mitigate these realities and build on and develop strong relationships in the sector.

Some noted that there were specific initiatives that merited more focused attention:

Partners for Mental Health: this initiative is needed and should be brought into implementation.

Organizational growth: MHCC governance and organizational issues need focused attention and management to mitigate perceived lacks and to manage the rapid growth in numbers of staff.

Managing expectations: the great expectations to which the MHCC is held by the sector and that there needs to be intentional management of this, to mitigate risk.

Are there recommendations for improvement?

Respondent data resulted in six themes concerning recommendations for MHCC improvement:

Communication and collaboration, specifically:

Build greater public awareness;

Expand partnerships with people with lived experience, professionals and service providers, provincial/territorial governments and other organizations;


Improve internal and external communication for specific project information so more stakeholders are better informed about upcoming research projects. This may increase internal and external partner participation;

Organizational aspects of the MHCC:

Increase stakeholder understanding of the MHCC’s mandate and boundaries, to clarify stakeholder expectations;

Build capacity to work as a catalyst, with the focus on developing stakeholder programs;

Mitigate perceptions of micro-management, blurred Board boundaries and the increasing bureaucracy of the MHCC structure;

Increase transparency in key functions, such as hiring, financial reporting, and decision making;

MHCC as model workplace:

Implement processes that enable staff to work to their full scope, including acknowledgement of their expertise;

Attend to imbalances within the organization that impact workload, reporting processes and the transparency around decision making;

Focus attention on matters of workplace wellness, such as work-life balance;

Improvements for specific initiatives:

Operationalize the Knowledge Exchange Centre and Partners for Mental Health initiatives;

Continue to expand Opening Minds to target youth and promote equality in the workplace;

Build evaluation into the initiatives to track progress on the outcomes;

Ideas of what should be sustained in the future:

There was no consensus in the responses and responses were split as to whether the initiatives and the MHCC as an organization should be sustained beyond the 10 year mandate;

The most important contributions for the future:

Many respondents indicated that the anti-stigma and public awareness campaigns could be the most important contribution;

Several respondents identified that the Mental Health Strategy could be the most important; and,

Other themes identified by some respondents were the At Home/Chez-Soi research projects, partnerships with others, and the ACs’ work/projects.


Summary

Key informants and focus group participants provided a rich data set of qualitative information to this

formative evaluation. While the sample of respondents was far reaching in terms of role, all of them

were engaged with the MHCC in some capacity. Their level of engagement, experience in the mental

health system, and in many cases, lived experience, ensured a robust and comprehensive response to

the evaluation questions. Together, there was solid consensus on several key issues. These informants

see the MHCC as in alignment with its mandate and undertaking the work the organization was

intended to do; they assess the governance and structures as functioning to ensure MHCC sustainability;

they are clear-headed about the early achievements, as well as the early impacts. In short they are

hopeful that the MHCC is performing in a way that ensures an effective and efficient long term impact

on the mental health system in Canada.

Further, the respondents are in agreement as to where the MHCC is up against barriers and provided

keen insight into the impacts of on-going structural changes on corporate culture commenting on the

role of the Board, the ELT and the staff in contributing to current challenges; the losses in terms of the

perceived lack of affirmative action in hiring and the engagement of people with lived experience, their

families and caregivers; and the strong recommendation that the MHCC produce results through the

initiatives of KEC and Partners for Mental Health, which are understood to be initiatives whose time has

come. As well, the informants provided wise insight into increasing expectations for the Commission

and the need for this to be risk managed. Finally, the Commission needs to be authentically pan-

Canadian in its work, and collaborate with the groups that are currently invisible, such as stakeholders in

Québec, the North, and the First Nations Inuit and Métis.


5. Summary and Recommendations

5.1 Summary Results from this formative evaluation of the first four years of the MHCC’s implementation have proven

to be rich in information. Respondents to the multiple lines of data gathering have provided a

comprehensive set of data to the five lines of evaluation inquiry: questions on the mandate, the

structure, the early achievements, the early impacts and recommendations for the future.

The survey respondents were a diverse group that provided valuable insight and expertise to the survey

questions. For the most part, respondents were positive about the ability of the MHCC to effectively

catalyze change in the mental health system in Canada. Two main themes related to areas of

improvement emerged throughout the data: a desire for more communication, knowledge and resource

dissemination on the part of the MHCC; and, increased inclusion and partnership with groups heavily

invested, or actively involved in the mental health sector. The themes indicate a direction for future

projects and decisions by the MHCC; and, although there are always ways to improve, most survey

respondents stood behind the MHCC as a positive force to catalyze change in the mental health sector.

The key informants and focus group participants were generally well informed and engaged with the

Commission. Their insights into all matters of implementation and operational aspects of MHCC work

were solid and resulted in an overall positive assessment of achievements to date. These respondents

affirmed the direction of the work but challenged the Commission to actualize the KEC and Partners for

Mental Health—the two under-developed, but much needed, initiatives. They identified key values, but

exhorted the MHCC to take seriously the need to address emerging issues in the workplace and build

authentic and inclusive partnerships with stakeholder groups that are currently perceived as

marginalized and/or invisible. Finally, they encouraged the Commission to manage the growing risks of

stakeholder expectations and actualizing the national function of their work.

Based on the evidence derived from this formative evaluation, and grounded in the evaluation questions

developed, the following summary is presented in Table 16.


Table 16: Summary and Conclusions Presented by Evaluation Question

Evaluation Question Summary and Conclusions

Is the MHCC meeting the assigned mandate that has been set out in their funding agreements with Health Canada?

Consensus that the work of the MHCC has been consistent with the assigned mandate.

Consensus that the five key initiatives are the right ones and that these are aligned with the mandate. Exceptions:

· At Home/Chez-Soi Homelessness Research Demonstration projects are perceived as service delivery and beyond the scope of the mandate;

· Knowledge Exchange Centre and Partners for Mental Health initiatives not developing at the same pace and with the same level of early success as the other initiatives; and,

· The scope and expectations associated with the mandate are very high and attention needs to be paid to mitigating these expectations.

Concern about the extensive mandate with restricted and time-limited funding. Some leveraging of funding is occurring and it is recommended that in order to adequately secure provincial/territorial support, better alliances need to be formed.

How are the MHCC’s structures, processes and support mechanisms contributing to the mandate and goals?

The MHCC was successful in establishing:

· A governance structure that generally contributes to MHCC outputs;

· Offices in Calgary and Ottawa;

· Five key initiatives, in varying stages of development and implementation;

· Strong Advisory Committees in eight different content areas with expert chairs and members contributing to a multitude of successful projects;

· A passionate Executive Leadership Team, an expert and committed staff and involvement of people with lived experience, families and caregivers in various components of the Commission’s work;

· A business and strategic planning process for measuring and reporting on performance over time;

· Numerous and effective communication tools for raising awareness of mental health and illness (i.e. newsletters, speaking engagements, media releases and website); and,

· Linkages with provincial, territorial and national partners.

Consensus that the organizational structure facilitates the MHCC’s work and the development process has been evolutionary. With the growing size and complexity of the organization over time, comments were made that increasing hierarchy and bureaucracy combined with lack of transparency in decision making is proving to be a barrier to success.

Advisory Committee structures are working well and have produced excellent products and reports. There is need to clarify the role (advisory vs. working) and reporting of the Advisory Committees. Additionally, the Advisory Committees depends upon the Knowledge Exchange Centre’s implementation to ensure the dissemination of their outputs.

Respondents were uneven in their perceptions of MHCC inclusiveness and many encouraged the authentic involvement of several marginalized groups, such as people with lived experience.

There are emerging relationships with governments and selected service providers, educators and researchers, but improvements are needed in engaging front line service providers and marginalized populations (i.e., First Nations, Inuit and Métis people, Francophone populations, people with lived experience, families and caregivers). Also, respondents cited the need for the Commission to build relationships evenly across Canada and continue to strength work with governments.

Process of developing an inclusive and model workplace has begun with the establishment of policies, directives and an internal working committee (Committee of Champions) but the MHCC needs to put into practice what is theoretically in place.


What has been achieved to date in terms of implementation of the assigned mandate?

The most important early achievements to date have been:

· The establishment and implementation of the three successful initiatives: Opening Minds, At Home/Chez-Soi, and the Mental Health Strategy;

· High level of expertise made available through internal and external relationships, contributing to the reputation of the MHCC as a credible organization providing credible products and information;

· The work of Advisory Committees and linkages to their networks;

· Capacity for clear and effective communications and collaborations;

· Utilized products and research products;

· Innovation and creativity in establishing the Youth Council and the Hallway Group; and,

· Creation of an emerging role of the MHCC as a trusted advisor to all levels of government.

Challenges to success:

· Communication and collaboration were cited as areas in which the MHCC could continue to improve;

· Organizational aspects including human resource issues, limited engagement with community, service providers and people with lived experience, and perceived internal department silos that limit cross fertilization;

· High expectations and hopes for the MHCC to have a pan-Canadian scope when the provinces/territories have the responsibility for the operation of most components of the mental health system; and,

· Systemic issues such as advocacy, multiplicity/complexity of stakeholders both within and outside of health and the need for a comprehensive approach to attain systemic change.

The Mental Health First Aid program is generally unknown; the transition of this program to the MHCC and its effectiveness are undetermined.

How has the MHCC affected the work and lives of partners and collaborators in the mental health system?

The MHCC succeeds as a catalyst in :

· Mobilizing resources and people, especially engaging people with lived experience;

· Building awareness and extending the profile of mental health;

· Establishing pan-Canadian communication and collaboration; and,

· Emerging as a provider of valid and useful information and research.

The three values seen as reflected in the work of the MHCC were:

· Inclusiveness – people with lived experience, the pan-Canadian scope, place created for families and caregivers, level of public consultation and respect for the issues;

· Value of systemic change – the vision to transform the mental health system, to improve lives, to design and implement a pan-Canadian strategy, to facilitate individuals and organizations that work in the sector and build their capacity to impact systems; and,

· Collaboration – the value of team work, the collaborative processes and building of partnerships that are embedded in programs and approaches, the hard work and dedication evident in the MHCC “family”.

The MHCC is innovative in:

· Raising awareness of mental health;

· Linking health and mental health;

· At Home/Chez-Soi and focused research attention on the Canadian experience of mental illness/mental health;

· Supporting others to do their work; and,

· Being a learning organization, taking knowledge from other jurisdictions and adapting it to the Canadian context.

Respondents rely on (and mentioned a growing expectation that the MHCC will be relied on the


In conclusion, the staff, leadership and partners of the MHCC have had a successful first three years of

implementation. Despite this relatively short time frame the MHCC has created allies across Canada and

produced results that are attracting attention.

Stakeholders perceive that the MHCC is achieving the mandate but are concerned that this will prove to

be a challenge over time, given the Commission’s restricted and time-limited resources. In general the

organizational structure, processes and mechanisms that have developed over the first three years are

functioning and stakeholders are positive about what the MHCC has accomplished to date.

The Commission is encouraged to build on the achievements and to work collaboratively with the range

of enthusiastic partners and stakeholders that are committed to the transformation of the mental

health system. In this way, the MHCC is well positioned to make a difference in the lives of people with

lived experience, families and caregivers.

future):

· Valid and usable resources and tools (such as documents, website, policy and best practice knowledge);

· Taking the lead in garnering pan-Canadian attention to the issues, moving agendas and facilitating policy shifts; and,

· Collaborations that provide support and direction.

The MHCC is making a difference for people with lived experience, families and caregivers in three ways:

· Building awareness about anti-stigma, to produce systemic change, in the workplace, schools and homes,

· Engagement and renewed interest in mental health issues and policy among all levels of government; and,

· Program impacts in the lives of homelessness individuals derived from At Home/Chez-Soi and Opening Minds reducing stigma for people with lived experience, in general.

What can be learned from implementation to date?

Respondents were a diverse group that provided valuable insight and expertise to the evaluation. They were positive about the MHCC’s capacity to catalyze effective change in the mental health system in Canada. Two main themes emerged related to areas for improvement:

· A desire for more communication, knowledge and resource dissemination; and,

· A need to increase inclusion and partnership with groups heavily invested or actively involved in the mental health systems in Canada.

The most important contributions for the future were considered to be:

· Anti-stigma and public awareness campaigns;

· Mental Health Strategy;

· At Home/Chez-Soi Homelessness Research Demonstration Projects;

· Partnerships with others; and,

· The Advisory Committees’ work and projects.


5.2 Recommendations

Observations have been offered in this section and the entire document about the initiatives and efforts

of the MHCC that are seen to be going well by the respondents to this evaluation. While it is early to tell

what longer term impact the MHCC will have, respondents have indicated what they perceive to be the

successes. In order to ground the data results and in consonance with the success factors as outlined in

the MHCC’s business plans, Charis summarized the data and made observations that the Commission

may want to consider (see Appendix E). Our assessment of the lines of evidence indicates that if the

following recommendations are implemented, the MHCC will move closer to fully actualizing the

mandate.

With the question will this MHCC activity/product make a difference to people who experience mental

illness? kept central to their work, the evaluators recommend the MHCC:

Fulfill the pan-Canadian mandate by ensuring focused engagement with all regions, including those currently less actively involved.

Proceed with full implementation of the Knowledge Exchange Centre and Partners for Mental Health initiatives to fulfill the mandate and make certain they develop to the same standard as the other key initiatives.

Continue to build collaborations and stakeholder engagement with the groups most perceived as poorly represented:

Individuals: people with lived experience; families and caregivers; First Nations, Inuit and

Métis; and, Francophone populations, particularly from Québec.

Grassroots/front line service providers creating meaningful networks with them to validate

their work and catalyze their capacity to impact policy.

National First Nations, Inuit and Métis organizations that work in the health and mental

health sector, for the purposes of forming partnerships and building alliances.

Develop a clear communication plan to inform stakeholders of the MHCC’s approach to actively include people with lived experience and other diverse groups within their staff.

Increase communication and promotion about Mental Health First Aid, to build awareness and mitigate concerns about its transfer to the Commission.

Review evidence based models of governance and structure to inform decisions to be made regarding Advisory Committees’ structure and reporting mechanisms.

Focus on building a model workplace:

Fully assess staff skill sets in order to fully utilize their skills in their work with the

Commission;

Provide opportunities for collaboration and encourage cross-cutting discussions to mitigate

the perception that staff work in “silos;” and,

Continue to build the capacity of the Committee of Champions to positively influence

workplace culture.


LDER I

Appendix A: Logic Models, Evaluation Questions, Data Matrix


Logic Model for the Evaluation of the MHCC – Level 2: Mental Health Strategy for Canada (as of December 2010) Vision: A society that values and promotes mental health and helps people living with mental health problems and mental illness to lead meaningful and productive lives

KEY ACTIVITIES IMPACT/ INITIAL

OUTCOMES (2-4 YRS) INTERMEDIATE OUTCOMES

(5-8 YRS)

OUTPUTS INPUTS/RESOURCES AUDIENCES

MHCC has contributed to:

System outcomes

A transformed mental

health system and

transformed Canadian

society as outlined by

the 7 goals of the Mental

Health Strategy for

Canada and evidenced

by effective and efficient

delivery of services

PWLE outcomes

Active engagement for

improved health

outcomes/ quality of life

and able to live

meaningful, productive

lives

Phase 1 – WHAT

12 invitational regional

dialogues

Online bilingual public and

stakeholder consultation

3 focused consultations with

other key stakeholders

Ongoing consultation with the

FPT table

Consultation with the 8 advisory

committees

Production of final document

Phase 2 – HOW

Consultation with 8 Advisory

Committees

7 roundtables

Review of international and

national strategies -Assessment of

international strategies to inform

Phase 2

Research and analysis to propose

strategic directions, criteria and

priorities for action as well as

promising practices.

Priority setting against criteria

Consultations with provincial and

territorial government mental

health managers

Consultations with federal

agencies

Consultations with mental health

consumer, family, non-

governmental and professional

stakeholders

Writing and production of final

documents

Increased awareness of the

Mental Health Strategy for

Canada among stakeholders

Increased national focus on

mental health issues among

stakeholders.

Increase collaboration with

stakeholders in the

consultation process

Utilization of the MHCC

Vision and goals in

stakeholders’ documents and

programming

Action plan have begun to be

funded and implemented by

stakeholders

Increased use of the Mental

Health Strategy to inform

stakeholder policy and

decision making

Goals

Focus national attention on

mental health issues

Set clear targets for

transforming the mental health

system

Promote recovery & well-being

Establish priorities for action

Funding

HC - $4.0 (per year as per the

2010/2011 Business Plan)

Accountability

Governance Board

GOC/HC

Human resources

MHCC Executive Team and

Staff

Contracted staff and agencies




People with lived experience of

mental illness


Policy makers and government

Stakeholders

NGO Stakeholders

Service Provider Stakeholders

Researchers


Phase 1: Framework for Mental health

strategy

Developed a broad consensus on the

vision and goals for a mental health

strategy, resulting in identification of 7

goals

Released and disseminated Toward

Recovery and Well-Being: Framework

for a Mental Health Strategy for Canada

that sets out the vision and goals

(3400 English and 600 French copies

distributed) (2009)

Presentations at conferences about the

framework

ULTIMATE

OUTCOMES (9-10YRS)

PWLE /

Families/Caregivers

Mental Health

Professionals/Service

providers/

NGOs

All

People living in

Canada

Federal, Provincial

and Territorial

Ministries and

Authorities

Minister of Health/

Health Canada

Federal, Provincial

and Territorial Decision

and Policy Makers

The MHCC is responsible to people with

lived experience of mental illness and

their families, service providers,

researchers and governments in

Canada.


system have a responsibility related to

the mental well being, mental health

promotion and mental illness prevention

for all people living in Canada, including

children, youth, adults and seniors.

The implementation of a mental health

strategy for Canada relies not just on the

development of the strategy by the

MHCC but the combined support and

collaboration of all stakeholders to make

this a reality.

People living in Canada support the work

of the MHCC.

Communities and service providers are

responsive to and working

collaboratively to support the work of the

MHCC.

People in the mental health community

(including PWLE, families, caregivers,

mental health service providers and

other stakeholders) who are aware of the

MHCC, have high expectations including

an expectation of real and concrete

deliverables.

Increased progress on

each of the 7 goals;

Increased utilization by of

the MHCC Strategy Action

plan in government mental

health funding, plans and

strategies

Phase 2: Development Products

Roundtables held on key topic areas

7 background papers and roundtable

reports

Report on international and national

review

Revised work plan for Phase 2

Draft strategy document for

consultations and consultation

materials

Phase 2 final products:

Business Case for Investing in Mental

Health

Mental Health Strategy for Canada

(Action plan) 2012

ASSUMPTIONS

GOC – Government of Canada

HC – Health Canada

MHCC – Mental Health Commission of Canada

KEC – Knowledge Exchange Centre

PWLE – People with lived experience

NGOs – Non-Governmental Organizations

(Red text indicates future)

Note: outcomes not all

directly attributable to the

MHCC

105


OUTCOMES (2 – 4 YRS) INTERMEDIATE OUTCOMES

(5 – 8 YRS) OUTPUTS INPUTS/RESOURCES AUDIENCES

Contribute to: System outcomes A transformed mental health system and transformed Canadian society as outlined by the 7 goals of the Mental Health Strategy for Canada and evidenced by effective and efficient delivery of services PWLE outcomes Active engagement for improved health outcomes/ quality of life and able to live meaningful, productive lives

Undertake environmental scan to identify English and French mental health knowledge exchange activities across Canada

Undertake scoping review of French and English literature to better understand the mental health knowledge exchange field

Develop a comprehensive knowledge management system to organize information and data

Develop and support networks, communities of practices and communities of interest across the country to catalyze knowledge exchange among stakeholders

Engage with people and organizations across Canada and link and leverage their work

Develop a portal that will increase access to information and highlight best practices

Develop cross cutting Knowledge to Action group that will work together in a coordinated and organized way to mobilize MHCC knowledge

Identify and invest in Knowledge Activation Initiatives focused at transforming the system

Evaluate knowledge exchange activities and contribute to the field of knowledge exchange

Consult 8 advisory committees and other external key stakeholders

Increased awareness of MHCC products and resources

Increased access to information among MHCC partners and collaborators

Increased utilization of MHCC resources among partners and collaborators

Enhanced communication and networks among MHCC partners and collaborators

Improved communication and collaboration between stakeholders

Improved process and mechanisms to mobilize knowledge to action

Linking and connecting stakeholders together

Promotion of best practices

Goals

To facilitate the development, uptake, adoption and integration of different types of knowledge and to close the gap between knowledge and practice.

Funding

HC - $3.1 M (per year as per the 2010/2011 Business Plan)

Accountability

Governance Board

GOC/HC

Infrastructure

Vision, mission and goals


Human resources MHCC Executive and Staff Contracted staff and agencies Volunteers (Advisory





Government and FPT stakeholders

NGO stakeholders

Service provider stakeholders

Researchers

Educators


Content Management system developed

Knowledge Activation Framework developed to guide development of the KEC and provide lens for its activities

Communities of practice/interest and networks supported, developed and linked to foster collaboration and communication among diverse groups/individuals across the country

Knowledge to Action team developed and process in place to mobilize knowledge in a coordinate and integrated way

Online activities and web components created

Contribute to the field of knowledge exchange and transfer

Program linkages developed

KE capacity development (Scheduled for implementation in summer

2011)

ULTIMATE

OUTCOMES (9 – 10 YRS)



MHCC

PWLE/ Families/ Caregivers

Health Canada and other Policy

and Decision Makers

Researchers

Health Care Providers/

Professional/

NGOs

Logic Model for the Evaluation of the MHCC – Level 2: Knowledge Exchange Centre (KEC) (as of December 2010)

Vision: A society that values and promotes mental health and helps people living with mental health problems and mental illness to lead meaningful and productive lives

The MHCC is responsible to people with lived experience of mental illness and their families, service providers, researchers and governments in Canada.

The MHCC and the mental health system have a responsibility related to the mental well being, mental health promotion and mental illness prevention for all people living in Canada, including children, youth, adults and seniors. The implementation of a mental health strategy for Canada relies not just on the development of the strategy by the MHCC but the combined support and collaboration of all stakeholders to make this a reality. People living in Canada support the work of the MHCC.

Communities and service providers are responsive to and working collaboratively to support the work of the MHCC. People in the mental health community (including PWLE, families, caregivers, mental health service providers and other stakeholders) who are aware of the MHCC, have high expectations including an expectation of real and concrete deliverables.

Contribute to: Increased percent

evidence-informed knowledge available on KEC

Increased number of

users report evidence-informed knowledge applied to programs as services

Enhanced knowledge of/ understanding of mental health issues shown by: Increased number of

“communities of interest” operating through KEC

Increased number of

users report information provided by KEC created greater knowledge/ understanding of mental health issues

GOC – Government of Canada HC – Health Canada MHCC – Mental Health Commission of Canada KEC – Knowledge Exchange Centre PWLE – People with lived experience NGOs – Non-Governmental Organizations


ASSUMPTIONS

Educators

106



(5-8 YRS) OUTPUTS INPUTS/RESOURCES

AUDIENCES

Contribute to: System outcomes

A transformed mental health

system and transformed

Canadian society as outlined

by the 7 goals of the Mental

Health Strategy for Canada

and evidenced by effective

and efficient delivery of

services

PWLE outcomes

Active engagement for

improved health outcomes/

quality of life and able to live

meaningful, productive lives

Strategy Development

Undertake research of organizations that have engaged Canadians at a large scale as well as research successful social movements

Development of the Partners for Mental Health team, concept and strategic objectives

Development of project management tools, protocols

and processes

Partner Outreach and Coalition

Building

Extend the reach of the MHCC through partnerships with existing mental health and mental wellbeing organizations and other organizations (from labour unions, to banks, to large employers) to support the MHCC’s immediate and long term goals

Leverage partner organizations’ resources to increase the resource pool available to achieve the aims of the MHCC

Increased engagement of partner organizations, both in number and variety of partners

Increased involvement of people living in Canada in discussing the issues of mental health and mental well being

Increased awareness of mental health and mental wellbeing across a broad spectrum of organizations and stakeholders

Increased resources available to achieve the goals of the MHCC

Goal

Engage Canadians, raise

awareness of mental health and

mental illness and build support

for mental health system reform

Concept

A national engagement and

partnership of people and

organizations across Canada

dedicated to advancing the

priorities of the mental health

community with the MHCC.

Galvanize the partners with

various events either tangible or

virtual – designed to raise

awareness of mental health

issues and attract people and

organizations across Canada to

the mental health cause.

Funding

HC - $2.4M (per year as per


Accountability

Governance Board

GOC/HC

Infrastructure



Human resources

MHCC Executive and Staff







NGO stakeholders


Other organizations


Social Media & Marketing

Development of bilingual on-line technology platform to invite and engage people living in Canada to join a discussion on mental health and wellbeing

Development of on the ground mechanisms and concepts

Development of access to large scale mailing lists and plan to access these

Marketing and communication strategy developed

List of organizations who have engaged Canadians

Understanding of other organizations that have successfully accomplished large scale engagements and mobilization

Partners for Mental Health Strategy developed

Project management tools, protocols and processes developed

ULTIMATE

OUTCOMES (9-10 YRS)


directly attributable to

the MHCC

PWLE/ Families/

Caregivers

Mental Health

Professionals/ Service

providers

All

People living in

Canada

Non-governmental

Organizations

Governments/ Health

Canada

Other

Organizations

Figure 4. Logic Model for the Evaluation of the MHCC – Level 2: Partners for Mental Health (as of December 2010)

Vision: A society that values and promotes mental health and helps people living with mental health problems and mental illness to lead meaningful and productive lives

The MHCC is responsible to

people with lived experience of

mental illness and their families,

service providers, researchers

and governments in Canada.


system have a responsibility

related to the mental well being,

mental health promotion and

mental illness prevention for all

people living in Canada, including

children, youth, adults and

seniors.

The implementation of a mental

health strategy for Canada relies

not just on the development of the

strategy by the MHCC but the

combined support and



People living in Canada support

the work of the MHCC.

Communities and service

providers are responsive to and

working collaboratively to support


People in the mental health

community (including PWLE,

families, caregivers, mental health

service providers and other

stakeholders) who are aware of

the MHCC, have high

expectations including an

expectation of real and concrete

deliverables.

Increased recognition of a broad base of public support t for the MHCC goals

Improved awareness of issues related to mental health and mental illness and the evidence-informed best practices to address those issues

Increased support from people living in Canada for change to the mental health services and systems that exist for mental health and mental illness

Partnerships built with multiple organizations (within the mental health/mental wellbeing field as well as more broadly)

Building and expanding existing successful awareness programs

Resources leveraged to support the work of the MHCC

Online platform developed to engage and galvanize Canadians

Marketing and communication strategy developed

Mailing lists established and widespread contact made with potential

participants






ASSUMPTIONS

107



(5-8 YRS)


Contribute to:

System outcomes



Canadian society as outlined

by the 7 goals of the Mental

Health Strategy for Canada

and evidenced by effective

and efficient delivery of

services

Pilot Projects

Consultation with 8 Advisory Committees

Pilot Symposium for journalism students at Mount Royal University

RFI calling for existing anti-stigma programs

Establishment of a national consumer panel “the Hallway Group”, a Mental Health Table (national health care professional associations)

Public Awareness

Integrated Media Campaign Opening Minds website Statistics Canada Survey Tool Canadian Community Health

Survey Mental Health First Aid program

delivery

Increased contact with people living with mental illness

Increased engagement of the media

Increased positive reporting and reduced negative reporting on mental health and mental illness

Increased awareness of mental health and mental illness

Increased understanding of best practice aimed at reducing -stigma and-discrimination

Establish baseline of Canadians’ attitudes about mental health and mental illness

Improved collaboration across stakeholders to address stigma and discrimination

Increased engagement with diverse partners on stigma reduction

Identification and replication of effective anti-stigma programs

Goals

To change the view of people

living in Canada so they treat

people with mental illness as

full citizens

To encourage organizations to

eliminate stigma &

discrimination

To ensure individuals living with

mental illness experience equal

opportunities in society & daily

life

Target Groups

Children and Youth

Health Care Providers

Workforce

Seniors (future)

First Nations/Inuit/Métis (future)

Other cultural groups (future)

Funding

HC - $4.8 M (per year as per


Accountability

Governance Board

GOC/HC

Infrastructure



Human resources






PWLE


Government stakeholders

NGO stakeholders


Researchers

Educators


Media & Professional Education

Media Guidelines

Media Council

Media Monitoring

Ongoing Symposia (Journalism

Schools)

Mount Royal Project

Justice Symposia with Alberta

Criminal Justice Assoc. in

Calgary and Edmonton;

Manitoba Criminal Justice

Assoc. in Winnipeg

Release of symposium evaluation at “Into the Light” conference

Partnered with 49 Pilot projects targeting Youth and Health Care Providers and the Workforce

Evaluation teams established

Survey instruments developed; evaluation underway

ULTIMATE

OUTCOMES (9 – 10 YRS)



MHCC

PWLE/ Families/

Caregivers

Federal, Provincial

and Territorial

Decision and Policy

Makers

Minister of

Health/ Health

Canada

Federal, Provincial and

Territorial Ministries

and Authorities

People living in

Canada/ Workplaces

Mental Health


providers/

NGOs

Logic Model for the Evaluation of the MHCC – Level 2: Opening Minds (Anti-Stigma/Anti-Discrimination Initiative) (as of December 2010)

The MHCC is responsible to

people living with mental illness

and their families, service

providers, researchers and

governments in Canada.


system have a responsibility

related to the mental well being,

mental health promotion and

mental illness prevention for all

people living in Canada, including

children, youth, adults and

seniors.


health strategy for Canada relies

not just on the development of the


combined support and



People living in Canada support


Communities and service

providers are responsive to and

working collaboratively to support






stakeholders) who are aware of

the MHCC, have high

expectations including an

expectation of real and concrete

deliverables.

Reduced stigma and discrimination related to mental illness

Earlier access to treatment

Improved participation in education and the workplace

Validation of best practice to reduce stigma and discrimination

Opening Minds Launch

(October 2, 2009) Integrated media

campaign Open Minds intranet site Survey instrument

developed for Statistics Canada

Stigma measurement survey commissioned

Canadian Community Health Survey

Mental Health First Aid trainings provided

Media monitoring study initiated

Symposia held Evaluation of Mount Royal

Media/professional education program

3 Justice Conferences

Scholarships established




NGOs – Non-Governmental Organizations PWLE – People with lived experience


ASSUMPTIONS

108


OUTCOMES (2 – 4 YRS) INTERMEDIATE OUTCOMES (5 –

8 YRS)


Contribute to:

System outcomes



Canadian society as outlined by

the 7 goals of the Mental Health

Strategy for Canada and

evidenced by effective and

efficient delivery of services

Project Development &

Management

Establish project infrastructure (selection and funding of service and research partners, contracts, grants, service and research staff, data plan and support contracts)

Establish National Working Group, National Consumer Panel and local governance structures

Service Stream

Developed service contracts

and model

Training on “Housing First” and

technical support to site teams

Provision of housing and

recovery-oriented services

Fidelity scales developed and

implemented

Improved housing stability for some project participants

Improved functioning and quality of life for some project participants

Improved health outcomes for some project participants

Reduced involvement with justice system

Reduced use of the health care system

Increased knowledge about the impact of interventions on participants

Increased knowledge about

on better meeting the unique needs and outcomes for special groups (e.g. ethnocultural, rural, youth)

Improved knowledge about the implementation of Housing First programs in Canada

Mandate

To launch 5 research

demonstration projects on

housing and complementary

supports as they relate to mental

health and homelessness in order

to identify best practices that

could be applicable on a national

scale.

Objectives

Multi-site, field research trial, two

program variations of the Housing

First model are being compared to

care-as-usual in the following five

cities: Moncton, Montreal,

Toronto, Winnipeg & Vancouver

Funding

HC - $110 M (as per 2010/11

Business Plan)

Leveraged “in kind”

contributions - $20 M+

Accountability

Governance Board

GOC/HC

Human resources


3rd party service providers


Researchers

Consumer consultants




Government (FPT)

stakeholders

NGO stakeholders


Researchers

Educators

Universities

International partners


Local communities

Research Stream

National research teams

established

Qualitative & quantitative data

protocols

designed/implemented

Qualitative & quantitative data

management support

Site visits to ensure fidelity

Support research governance

committees

ULTIMATE

OUTCOMES (9-10 YRS)



MHCC

PWLE/ Families/

Caregivers

FPT Decision and

Policy Makers,

Ministries and

Authorities

Minister of

Health/ Health

Canada

People living in

Canada/ Local

Communities

Mental Health


Providers/ NGOs

Logic Model for the Evaluation of the MHCC – Level 2: At Home/Chez Soi Research Demonstration Sites

The MHCC is responsible to people

with lived experience of mental

illness and their families, service

providers, researchers and

governments in Canada.


system have a responsibility related

to the mental well being, mental

health promotion and mental illness

prevention for all people living in

Canada, including children, youth,

adults and seniors.


health strategy for Canada relies not

just on the development of the


combined support and collaboration

of all stakeholders to make this a

reality.

People living in Canada support the

work of the MHCC.

Communities and service providers

are responsive to and working

collaboratively to support the work of

the MHCC.





stakeholders) who are aware of the

MHCC, have high expectations

including an expectation of real and

concrete deliverables.

Project legacy including:

Improved support systems, including IT solutions

Improved & enduring service & evaluation capacity

Communities, service providers &

governments:

Improved delivery of services and supports for individuals who are homeless and mentally ill across Canada

Improved, safer and healthier communities

Improved creative collaboration among service providers to provide integrated services

Improved ability to invest in recovery oriented services and supports based on evidence

Knowledge on Homelessness &

Mental Illness:

Improved effective approaches to integrating housing & other supports

Improved knowledge of best practices & lessons learned

Improved solutions for diverse

ethno-cultural groups

CIHR Complementary Funding

Selection of 3 complementary

research projects, 2 focused on

youth who are homeless and

mentally ill and 1 on the service

context

Co-funding with CIHR of 3

complementary projects

Initiate and evaluate

complementary research

projects

Project staff hired/ contracted

Research project implemented in all 5 communities (Moncton, Montreal, Toronto, Winnipeg and Vancouver)

Established national and

local committees

Two national training events held

Intake of participants Provision of Housing First

with supports Recovery-oriented

treatment and intervention 1300 participants 600 individuals have new

homes

Recruitment of participants Screening and

randomization Data gathering including

fidelity visits Data analysis and reporting Knowledge transfer

exchange plan implemented

Findings shared nationally and internationally

Selection of complementary research projects

Establishment of collaboration/ communication linkages between At Home/ Chez Soi and complementary projects




PWLE – People with lived experience


FPT – Federal, Provincial, Territorial

ASSUMPTIONS


KII Staff and Partners KII PWLE FG

Mandate

To focus national attention on mental health issues and to work to improve the health and social outcomes of people living with mental illness— Generally speaking, is the MHCC doing this?

Is the MHCC meeting the mandate that has been set out in their funding agreements with Health Canada?

B1 Are the MHCC 5 initiatives consistent with the assigned

mandate as per the funding agreements with Health

Canada?

From your experience, do you think the MHCC’s 5

initiatives will improve the mental health of

Canadians?

Are the 5 initiatives the right ones? Are they consistent with the MHCC’s

mandate?

B2 Are the 5 initiatives the right ones? Are there any gaps? Are the 5 initiatives the right ones? Are there any

gaps?

Is the mandate sill relevant? Are there gaps? Have the priorities changed

Are there activities that should no longer be implemented?

B3 Is the allocated funding sufficient to implement the

mandate? Is the funding used to leverage additional

funding supports?

Is the funding sufficient to implement the mandate?

Structure Are the current organizational structure, processes and support mechanisms functioning as expected?

C1 Are the MHCC’s governance structure, processes and

support mechanisms contributing to the achievement of

the MHCC mandate and goals?

Are the current organizational structure, processes and support

mechanisms functioning as expected?

C2 In your opinion, are the current organizational structure,

processes and support mechanisms functioning as

expected? Are they congruent with the (implied)

organizational values of the MHCC?

How are decisions being made? Are the

governance and management structures

congruent with the MHCC’s implied organizational

values?

Are there the right mix of staff and the right functions for staff? Is the

staffing model adequate to support the work of the Commission, for

instance the AC’s?

C3 Are the current advisory committees the right ones? Are

the advisory committees focused on the right content

areas? Are the right people involved?

Are there the right number and mix of AC’s members and other

volunteers, including PWLE?

C4 Is the role of the people who have experienced mental

health problems either directly or as family members or

caregivers, authentically involved with the MHCC?

From your perspective, do you see that the MHCC

includes you or others who have experience with

mental health in their lives within MHCC activities

or structures? What is working well? What are the

challenges?

Is the role of the people with lived experience authentically a key

component of the MHCC? Please describe.

MHCC Formative Evaluation

Qualitative Questions - Key Informant Interviews, Focus Groups, and Open Ended Survey Questions



C5 Has the MHCC been able to establish effective and

collaborative partnerships?

Do you see the MHCC achieving collaboration with

the groups that mean the most to you?

Has the MHCC established effective and collaborative partnerships with all

stakeholders? What contributes to these partnerships? What are the

barriers?

C6 Has the MHCC established itself as a model workplace? From your experience, do you think the MHCC’s 5


Canadians?

Achievements What has been achieved by the MHCC to date in terms of implementation of the assigned mandate?

D1 How effective was the transition of the Mental Health

First Aid (MHFA) program to the MHCC? Is the MHFA

program being implemented effectively?

D2 Concerning all aspects of the MHCC’s activities, products

and services: what early examples of success are evident?

What has been the MHCC’s most important achievement

to date?

What early examples of success are evident, in

terms of the MHCC’s work? What has been the

MHCC’s most important achievement to date?

What aspects of the implementation of the MHCC are working well? What

early examples of success are evident? What has been the MHCC’s most

important achievement to date?

D3 What have been the key challenges and/or barriers to

the work of the MHCC?

What aspects are problematic? What are the challenges/barriers? Why?

D4 How effective are the MHCC’s communication strategies?

D5 How effective is the MHCC in:

*Catalyzing the reform of mental health policies?

*Communication

*Facilitating a national/Pan-Canadian approach to mental health issues?

*Diminishing stigma/discrimination faced by Canadians living with mental

illness?

*Disseminating evidenced informed information on mental health/illness

to government?

*Providing a workplace congruent with the MHCC (implied) organizational

value



Early Impacts

How has the MHCC affected the work and lives of partners and collaborators in the mental health system?

E1 Is the MHCC a catalyst for the mental health sector in

Canada? In what ways?

Is the MHCC making a difference? How does the MHCC act as a catalyst for the work that is done by partners

and collaborators?

E2 What principles and values do you see reflected in the

work of the MHCC?

What would you identify as the principles and values of the MHCC

workplace?

E3 Is the MHCC innovative? What is innovative in the work of the MHCC? What do you think is innovative about the work of the MHCC?

E4 To what extent do stakeholders rely on the MHCC? To what extent do you rely on the MHCC? To what extent do governments rely on the work of the MHCC?

E5 Is the MHCC going to make a difference for people with

lived experience of mental illness or mental health

problems and their families or caregivers?

If you wanted to have influence on changing the

mental health system, with whom would you talk

about this?

Is the MHCC well positioned for success?

Recommendations What can be learned from implementation to date? Are there any recommendations for improvement?

F1 What can be learned from implementation to date? What can be learned from implementation to

date?

What can be learned from implementation to date?

F2 Are there any recommendations for improvement? Are there any recommendations for

improvement?

Are there any recommendations for improvement?

F3 What could be the MHCC’s most important contribution

In the future?

What could be the MHCC’s most important

contribution In the future?

What could be the MHCC’s most important contribution in the future?

F4 Do you have any final comments? Do you have any final comments?



Mandate To focus national attention on mental health issues and to work to improve the health and social outcomes of people living with mental illness— Generally speaking, is the MHCC doing this?

Is the MHCC meeting the mandate that has been set out in their funding agreements with Health Canada?

B1 Are the MHCC 5 initiatives consistent with the assigned

mandate as per the funding agreements with Health

Canada?

From your experience, do you think the MHCC’s 5


Canadians?

Are the 5 initiatives the right ones? Are they consistent with the MHCC’s

mandate?

B2 Are the 5 initiatives the right ones? Are there any gaps? Are the 5 initiatives the right ones? Are there any

gaps?

Is the mandate sill relevant? Are there gaps? Have the priorities changed

Are there activities that should no longer be implemented?

B3 Is the allocated funding sufficient to implement the

mandate? Is the funding used to leverage additional

funding supports?

Is the funding sufficient to implement the mandate?

Structure Are the current organizational structure, processes and support mechanisms functioning as expected?

C1 Are the MHCC’s governance structure, processes and

support mechanisms contributing to the achievement of

the MHCC mandate and goals?

From your perspective, do you see that the MHCC

includes you or others who have experience with

mental health in their lives within MHCC activities

or structures? What is working well? What are the

challenges?

Are there the right mix of staff and the right functions for staff?

C2 In your opinion, are the current organizational structure,

processes and support mechanisms functioning as

expected? Are they congruent with the (implied)

organizational values of the MHCC?

How are decisions being made? Are the

governance and management structures

congruent with the MHCC’s implied organizational

values?

Is the staffing model adequate to support the work of the Commission, for

instance the AC’s?

C3 Are the current advisory committees the right ones? Are

the advisory committees focused on the right content

areas? Are the right people involved?

Are there the right number and mix of AC’s members and other

volunteers, including PWLE?

C4 Is the role of the people who have experienced mental

health problems either directly or as family members or

caregivers, authentically involved with the MHCC?

Is the role of the people with lived experience authentically a key

component of the MHCC? Please describe.

Qualitative Data

Blended Detailed Results


Appendix B: Program Utilization Table


Mental Health Commission of Canada Speaking Engagements Chart

Who Speaking engagement Location Type

2010

Michael Kirby Homeward Trust Edmonton Conference AB Conference

Louise Bradley Café Scientifique (CIHR), Calgary Alberta AB Other

Louise Bradley Café Scientifique AB Symposium

Louise Bradley Northern ADM’s AB Meeting

Jayne Barker Conference Board of Canada, Chronic Disease Prevention and Management – presentation – Co-morbidity between mental illnesses and other chronic diseases, Calgary

AB Presentation

Louise Bradley East Kootenay Conference, Cranbrook, BC BC Conference

Dr. Gillian Mulvale MHCC Strategist: Into the Light conference, Vancouver BC Conference

Michael Kirby A Mental Health Strategy for Canada and British Columbia, UBC Dept. Psychiatry, CHEOS, BC Alliance on Mental Health / Illness & Addiction, Vancouver.

BC General

Louise Bradley Grand Opening of the Bosman Hotel Community Vancouver, British Columbia BC Launch

Louise Bradley BC Provincial Mental Health and Substance Use Services Planning Council Meeting, Vancouver BC BC Meeting

Catharine Hume & Cameron Keller

Presentation to the “Mental Health Systems and Services” class, Vancouver, BC BC Presentation

Louise Bradley East Kootenay Conference BC Conference

Louise Bradley CCSA Conference BC Conference

Louise Bradley PSR –Convention – per Vicky Heuhn, Keynote BC Conference

Jayne Barker presentation – BC Provincial Community Safety Steering Committee – Mental Illness and Homelessness and the relation to justice issues.

BC Presentation

Jayne Barker Wosk Center for Dialogue, Vancouver – Forum on Mental Health and Homelessness – speaker BC Forum

Jayne Barker Killarney, Ireland – C&Y Mental Health Forum – speaker – Mental Health and Homelessness Ireland Forum

Jayne Barker Killarney, Ireland – IIMHL Conference – workshop presentation – At Home/Chez Soi Project Ireland Workshop

Louise Bradley Jt. presentation with Ian Arnold – Ministers MB Presentation

Geoff Couldrey National Health Care Leadership Conference – Transforming Health – From Silos to Systems, “Knowledge to Action: Advancing healthcare reform through knowledge exchange and social marketing”.

MB Conference

Louise Bradley & Michael Kirby

Canadian Rural Health Conference, Beyond City Limits: Creating a Mental Health Strategy That Works For Rural Canadians, Fredericton, New Brunswick

NB Conference

Louise Bradley Canadian Rural Health Research Society - “Rural Life: Connecting Research and Policy” Fredericton, NB NB General

Louise Bradley AARAO Conference - Atlantic Association of Registrars and Admissions Officers NB Conference

Louise Bradley Cdn. Rural Health Conference NB Other

Jayne Barker Moncton, NB – At Home/Chez Soi National Training event – keynote speaker NB Keynote Speech

Louise Bradley Canadian Association of Statutory Human Rights 2010 Conference, St. John’s, Newfoundland and Labrador NL Conference



Louise Bradley Newfoundland Public Health Forum, panel discussion on Peer Support and Recovery, St. John’s , NL NL Forum

Louise Bradley Rotary Club, St. John’s Newfoundland NL Other

Michael Kirby Newfoundland and Labrador Public Service, St.John’s Newfoundland NL Other

Louise Bradley Canadian Association of Statutory Human Rights 2010 Conference NL Conference

MHCC St. John’s Conference NL Presentation

Louise Bradley CASHRA Newfoundland and Labrador Human Rights Commission NL Other

Louise Bradley NL Public Health Forum NL Other

Louise Bradley Rotary Club NL Other

Louise Bradley AARAO Conference - Atlantic Association of Registrars and Admissions Officers, Sackville, NS NS Conference

Andy Cox Schizophrenia Society, Nova Scotia NS General

Louise Bradley Mental Health Summit of Nova Scotia, Halifax, NS NS Summit

Louise Bradley Mental Health Summit @ Health Assoc. of NS NS General

Louise Bradley Prov. MH Strategy Adv. Group NS Other

Louise Bradley Ministers MH and Addiction Adv. Council NS Meeting

Dr. David Goldbloom The Mental Health Commission of Canada. Knowledge Transfer Conference on Re-Thinking Borderline Personality Disorder, funded by the Canadian Institutes for Health Research, Toronto, Ontario.

ON Conference

Dr. David Goldbloom The Mental Health Commission of Canada: Working to Catalyze Change. Schizophrenia Update Conference, Centre for Addiction and Mental Health/University of Toronto

ON Conference

Louise Bradley CMHA - Thriving Conference, London, ON ON Conference

Dr. Tim Aubrey 16th

Annual First Nations, Metis and Inuit Urban Housing Conference, Ottawa ON Conference

Dr. David Goldbloom Anti-Stigma First Annual McMaster University Mental Health and Wellness Fair- McMaster University, Hamilton, Ontario

ON Fair

Fern Stockdale Windsor Health Canada - Mental Health Table, Access to Mental Health Services and Supports Forum, Greetings on behalf of MHCC, Ottawa

ON Forum

Phil Upshall Health Canada - Mental Health Table, Access to Mental Health Services and Supports Forum - Greetings on behalf of MHCC, Ottawa

ON Forum

Dr. David Goldbloom Breaking the Barriers of Mental Illness, Bell Canada Enterprises, Mississauga, Ontario ON General

Dr. David Goldbloom Summary comments, Child and Youth Mental Health, The Walrus RBC Conversation Series, Toronto, Ontario ON General

Dr. David Goldbloom Mental Health and Stigma, Taking Action for Workplace Mental Health, Ministry of Education, Government of Ontario

ON General

Dr. David Goldbloom The Stigma of Mental Health “Issues” in the Workplace, 5th

Annual Mental Health Forum, Rotman School of Management, University of Toronto

ON General

Faye More At Home/Chez Soi Multi-Site Homelessness Research Demonstration Project, Community Connections, Toronto, Ontario

ON General

Shalini Lal & Carol Adair Canadian Association for Health Services and Policy Research, Toronto ON General

Dr. David Goldbloom The Future of Psychiatry. Massey College Grand Rounds Seminar, Massey College, University of Toronto ON Grand Rounds



Dr. David Goldbloom The Future of Psychiatry - Grand Rounds, Department of Psychiatry, University Health Network. Toronto, Ontario ON Grand Rounds

Dr. David Goldbloom Responsible Use of Advanced Technologies in Medicine: Summary Perspective, Massey Grand Rounds Symposium - Massey College, University of Toronto

ON Grand Rounds

Dr. David Goldbloom The Mental Health Commission of Canada Grand Rounds, Department of Psychiatry, Credit Valley Hospital, Oakville, Ontario

ON Grand Rounds

Dr. David Goldbloom Mental Illness, Stigma and Mental Health Keynote Address - Annual General Meeting, Brockville General Hospital. Brockville, Ontario

ON Keynote Speech

Dr. David Goldbloom Mental Illness, Stigma and Discrimination Keynote Address - Royal Ottawa Hospital Centennial Open House ON Keynote Speech

Dr. David Goldbloom The Mental Health Commission of Canada. Keynote Address, Annual General Meeting, The Eating Disorders Association of Canada, Toronto, Ontario

ON Keynote Speech

Louise Bradley Building Healthier Workplaces, Addressing the Growing Impact of Mental Health in the Workplace, Ottawa, Ontario ON Keynote Speech

Dr. David Goldbloom Healing and Recovery: The Hope for the Future Special 25th

Anniversary Keynote Address for the Mood Disorders Association of Ontario Annual General Meeting

ON Keynote Speech

Dr. David Goldbloom Stigma and Mental Illness in the 21st

Century - CAMH in the Community Lecture Series, Kingston, Ontario. ON Lecture

Dr. David Goldbloom The Mental Health Commission of Canada Is Two Years Old: Walking, Talking and Running. Massey College Senior Fellows’ Luncheon - Massey College, University of Toronto

ON Luncheon

Michael Kirby Royal Ottawa Health Care Group, Board of Trustees Meeting, Ottawa ON Meeting

Dr. David Goldbloom The Mental Health Commission of Canada. Annual General Meeting, Medical Staff Association. Penetanguishene Mental Health Centre. Midland, Ontario

ON Meeting

Dr. David Goldbloom Understanding Mental Illness in the Workplace: Stigma, Reality & Hope. Municipal employees, Region of Peel. Brampton, Ontario

ON Presentation

Dr. David Goldbloom Embracing New Approaches: Reducing Stigma in Substance Use and Mental Health Services, CAMH in the Community, Orillia, Ontario

ON Presentation

Louise Bradley Ontario Health Workplace Coalition Symposium, Toronto, Ontario ON Symposium

Patrick Dion First Nations and Inuit Mental Wellness Team (MWT) Workshop, Ottawa, Ontario ON Workshop

Patrick Dion CSLS-ICP Conference on the Implications of Happiness Research for Public Policy in Canada ON Conference

Michael Kirby Canadian Auto Workers National Workers' Compensation Conference, "Challenging the Impact of Workplace Stress"

ON Conference

Dr. Tim Aubrey PSR Canada 2010 Conference ON Conference

Paula Goering & Carol Adair

Canadian Association for Health Services and Policy Research (CAHSPR) 2010 Annual Conference ON Conference

Patrick Dion Official Ribbon Cutting Ceremony for the new North Bay Regional Health Centre ON Launch

Sonia Cote and Cecile Leclercq

The Canada Mortgage and Housing Corporation’s national research committee about housing ON Other

Louise Bradley Ontario Health Workplace Coalition Symposium ON Symposium

Louise Bradley Building Healthier Workplaces ON Other



Louise Bradley CPA – Can Psychological Assoc. – Board meeting (15 ppl) ON Meeting

Geoff Couldrey Mobilizing Research Knowledge. Pannelist “As Knowledge Mobilizes, Paradigms Shift”. ON Other

Jayne Barker Youth Housing Forum – speaker – CHEO, Ottawa ON Keynote Speech

Jayne Barker Toronto – speaker at Institute for clinical Evaluative Sciences (ICES): Mental Health and Addictions Research Initiative "Strategy Symposium"

ON Keynote Speech

Stephanie Lassonde Anti-stigma conference Québec QC Conference

Dr. David Goldbloom Breaking the Barriers of Mental Illness, Bell Canada Enterprises, Montreal, Québec QC General

Louise Bradley Clubhouse, Montréal: Communities Creating Opportunities for People with Mental Illness QC General

Eric Latimer & Sonia Cote

Congrès de l'ACHRU, Congrès annuel de lʼAssociation canadienne dʼhabitation et de rénovation urbaine Montreal, Québec

QC General

Jijian Voronka & Sonia Cote

Living homeless: My learnings from street life, Dept. of Psychology, Concordia University and Ami Québec QC Keynote Speech

Jijian Voronka Collectif de Recherche sur L’Itinerance, University of Québec at Montreal QC Other

Louise Bradley Women’s Canadian Club of Montreal QC Other

Eric Latimer l'ACFAS, a French-speaking scientific congress, Université de Montreal QC Other

Louise Bradley Women’s Cdn. Club QC Other

MHCC Health Canada - Mental Health Table, Access to Mental Health Services and Supports Unknown General

Col. Stephanie Granier Symposium – Department of National Defense Unknown Symposium

MHCC VAC-DND-RCMP Mental Health Committee Unknown Presentation

MHCC National Association for the Dually Diagnosed conference Unknown Keynote Speech

MHCC Institute for Mental Health Research Board Retreat Unknown Presentation

MHCC Thriving Conference Unknown Keynote Speech

MHCC Access Forum Unknown Presentation

MHCC CAMH-PAHO Symposium Unknown Keynote Speech

Louise Bradley Sixth World Conference on the Promotion of Mental Health and Prevention of Mental and Behavioral Disorders http://wmhconf2010.hhd.org

USA Conference

Geoff Couldrey Sixth World Conference on the Promotion of Mental Health and Prevention of Mental and Behavioral Disorders: “Transforming Mental Healthcare through Knowledge Exchange and Grassroots Mobilization”.

USA Conference

Jayne Barker Washington DC – workshop presentation on At Home/Chez Soi, Mental Health Promotion and Prevention Conference

USA Workshop

Louise Bradley Opening Remarks, 6th

World Conference on the Promotion of Mental Health and Behavioural Disorders, Washington DC

USA Conference

Michael Kirby Expert Panellist, 6th

World Conference on the Promotion of Mental Health and Behavioural Disorders, Washington DC

USA Conference


Who Speaking Engagement Location Type

2009

Michael Kirby Key note address at the Calgary Chamber of Commerce AB Keynote Speech

Michael Kirby Focussing upstream: The role of medical education in encouraging diversity in the organization and delivery of health services

AB Presentation

Louise Bradley Schizophrenia Conference Sutton Place

AB Conference

Louise Bradley Organization of Bipolar Affective Disorders (OBAD) AB General

Louise Bradley Wild Rose Room, Lister Conf. Centre, University of Alberta AB Forum

MHCC Mental Health Leadership issues in Canada: what led to the creation of the Mental Health Commission of Canada? The Mental Health Services Conference - Sydney, Australia

Australia Conference

MHCC CAMH: An Overview, Cohos Evemy Architects Toronto, Ontario. The Mental Health Commission of Canada Seminar for Residents in Psychiatry, Department of Psychiatry, University of British Columbia

BC Seminar

Geoff Couldrey Into the Light: Transforming Mental Health in Canada. Panellist “From Silos to Systems: Brining Knowledge to Action through the Development of the Mental Health Commision of Canada’s “Knowledge Exchange Centre”.

BC General

Jayne Barker Vancouver – presentation at Forum: Serving More People More of the Time: Advancing High Capacity Mental Health Programs through Partnerships with Primary Health Care, sponsored by the BC Government

BC Presentation

Jayne Barker presentation at Symposium on Workforce Standards for Psychological Safety in the workplace, Vancouver BC Presentation

Louise Bradley Youth and Mental Health and the Justice System Conference MB Conference

MHCC The Homelessness Initiative of the Mental Health Commission of Canada Project Launch - Moncton, New Brunswick. NB Launch

MHCC The Mental Health Commission of Canada is Two Years Old: Talking, Walking and Running. Distinguished Member Lecture, Canadian Psychiatric Association Annual Meeting - Saint John’s, Newfoundland

NL Lecture

MHCC Adolescent Mental Health, Special Lecture for Parents, Halifax Grammar School. Halifax, Nova Scotia. NS Lecture

MHCC Reflections on the Halifax Grammar School, Distinguished Alumni Lecture, Halifax Grammar School - Halifax, Nova Scotia

NS Lecture

Louise Bradley Queen’s International Institute on Social Policy 2009 Conference, Kingston, Ontario ON Conference

MHCC Be it Resolved: The Short Man is the Better Man (arguing in the negative), Leacock Debate - Toronto, Ontario ON Debate

MHCC Creativity, Mental Illness and Mental Health. 17th

Annual Rendezvous With Madness Film Festival, Workman Arts, Toronto, Ontario.

ON Festival

MHCC The Mental Health Commission of Canada. Ontario Agency for Health Protection and Promotion - Toronto, Ontario ON General

MHCC The Mental Health Commission of Canada, Ontario Agency for Health Protection and Promotion - Toronto, Ontario. ON General

MHCC Mental Health Awareness and the Jewish Response, Beth Tzedec Synagogue - Toronto, Ontario. ON General

MHCC Mental Health and the Workplace, Rotman School of Management, University of Toronto ON General

MHCC Mental Health and Stigma Hats On For Awareness - Toronto, Ontario. ON General

MHCC The Canadian Health System and Mental Health Care, Toronto, Ontario ON General

MHCC Mental Health in Canada: Imagining the Future, Canadian Club of Halton-Peel - Oakville, Ontario. ON General

MHCC Mental Health Issues, Elementary Teachers Federation of Ontario, Waterloo Region - Waterloo, Ontario ON General



Dr. David Goldbloom The Mental Health Commission of Canada Grand Rounds, Ontario Shores Centre for Mental Health Science - Whitby, Ontario.

ON Grand Rounds

MHCC The Mental Health Commission of Canada Grand Rounds Department of Psychiatry, University Health Network, Toronto, Ontario.

ON Grand Rounds

MHCC The Mental Health Commission of Canada Grand Rounds, Department of Psychiatry, Mount Sinai Hospital - Toronto, Ontario

ON Grand Rounds

MHCC Social Responsibility and Social Entrepreneurship: A Public Health Perspective, Summary Remarks, Massey College Grand Rounds Symposium, Massey College, University of Toronto

ON Grand Rounds

MHCC The Mental Health Commission of Canada: Child and Youth Mental Health is Everybody’s business, Grand Rounds, Department of Psychiatry, Hospital for Sick Children - Toronto, Ontario

ON Grand Rounds

Patrick Dion Key note address by Patrick Dion, Director of the Board of MHCC, to the Ottawa Symposium on Mental Health ON Keynote Speech

MHCC The Future of Stigma Keynote Address - Weaving the System Together, Public Symposium - University of Ottawa Mental Health Research Institute

ON Keynote Speech

MHCC Stigma Keynote Address, Parents for Children’s Mental Health - Mississauga, Ontario. ON Keynote Speech

MHCC A Journey into Advocacy Keynote Address, Residents’ Day on Advocacy, Department of Psychiatry, University of Toronto

ON Keynote Speech

Michael Kirby Launch of the York University Psychology Clinic, Toronto, Ontario ON Launch

MHCC Creativity, Mental Health and Mental Illness, The Harry Somers Lecture, Stratford Summer Music Festival - Stratford, Ontario

ON Lecture

MHCC Stigma and Mental Illness in the 21st

Century, CAMH in the Community Lecture Series - Waterloo, Ontario ON Lecture

MHCC Stigma and Mental Illness in the 21st

Century, CAMH in the Community Lecture Series -Hamilton, Ontario. ON Lecture

MHCC Stigma and Mental Illness, Mini-Med School Public Lecture, Faculty of Medicine, University of Toronto, Mississauga, Ontario.

ON Lecture

MHCC Stigma and Mental Illness. Mini-Med School Public Lecture, Faculty of Medicine, University of Toronto, ON Lecture

MHCC Mental Health and the Workplace, Women’s Executive Network Diversity Luncheon -Toronto, Ontario ON Luncheon

MHCC Interactions with Industry: A Perspective. Canadian Association of Chairs of Surgery Annual Meeting - Toronto, Ontario.

ON Meeting

MHCC Mental Health: 15-24 Joint meeting, Ministry of Training, Colleges and Universities/Council of Ontario Universities/Ontario Committee on Student Affairs/Inter-University Disabilities Issues Association - Toronto, Ontario

ON Meeting

MHCC The Mental Health Commission of Canada Ontario District Branch, American Psychiatric Association - Toronto, Ontario.

ON General

Michael Kirby Presentation to the House of Commons Standing Committee ON Presentation

Michael Kirby Presentation to the House of Commons ON Presentation

MHCC The Mental Health Commission of Canada at 18 months of age – running, walking and talking, Association of Canadian Chairs in Psychiatry, Toronto, Ontario

ON Presentation

MHCC The CAMH Redevelopment: Adventures of a psychiatrist in architecture and fundraising , Residents’ Seminar, Centre ON Seminar



for Addiction and Mental Health - Toronto, Ontario.

MHCC Advocacy, Psychiatry Residents’ Seminar, Department of Psychiatry, Saint Michael’s Hospital - Toronto, Ontario ON Seminar

MHCC The Mental Health Commission of Canada, Special Symposium, Department of Psychiatry, McMaster University - Hamilton, Ontario

ON Symposium

Kathryn Power Key note speech at MHCC May Board meeting ON Meeting

MHCC Royal Ottawa Health Care Group brainstorming session ON Presentation

MHCC Ottawa Symposium on Mental Health ON Presentation

Louise Bradley Frontenac Community Mental Health Strategies AGM ON Meeting

Louise Bradley Queen’s International Institute on Social Policy ON Other

Louise Bradley OHA / CPSI ON Conference

Louise Bradley National PSR Conference ON Conference

Louise Bradley CSTD Conference ON Conference

Louise Bradley Symposium in Ottawa with Patrick Dion ON Symposium

Louise Bradley Speaking in place of Mike K. Info to come – Nancy Lawand ON Other

Michael Howlett The Dominion Insurance company ON Keynote Speech

Michael Howlett Medavie Blue Cross - Meeting of the Board of Directors ON Conference

Michael Howlett Mental Health in the Workplace – CEO Forum ON Keynote Speech

Michael Howlett 2nd

National Symposium on Child and Youth Mental Health ON Keynote Speech

Jayne Barker Presentation on At Home/Chez Soi Project – Researcher’s Symposium on Mental Health and Homelessness – City of Toronto

ON Presentation

Jayne Barker presentation on Mental Health and Homelessness – House of Commons Human Resources Parliamentary Committee

ON Presentation

Jayne Barker Presentation at Wellsley Institute, Toronto – Mental Health and Homelessness ON Presentation

Jayne Barker Toronto – Keynote speaker, National Training event, At Home/Chez Soi ON Keynote Speech

Jayne Barker Keynote speaker – 2nd

National Child and Youth Mental Health Forum, Ottawa – sponsored by the Child Welfare League

ON Keynote Speech

Jayne Barker speaker – National launch of At Home/Chez Soi, Toronto – also did 10 radio shows and 3 TV shows ON Keynote Speech

MHCC Mental Health and the Mental Health Commission of Canada. Premier and Members of the Legislature of the Province of Prince Edward Island. Charlottetown, Prince Edward Island

PEI General

Michael Howlett Keynote address to Board of Directors, Canadian Association of Chiefs of Police, Charlottetown, PEI PEI Keynote Speech

MHCC The Mental Health Commission of Canada Keynote Address, Canadian Mental Health Association Prince Edward Island Annual General Meeting - Charlottetown, Prince Edward Island.

PEI Meeting

Michael Howlett The Canadian Association of Chiefs of Police Board meeting PEI Keynote Speech

MHCC Assoc. Québécoise pour la réadaptation psycosociale QB Webinar

Louise Bradley Federal / Provincial / Territorial Heads of Corrections Working Group on Health QB Meeting

Jayne Barker Keynote speaker – Symposium on Mental Health and Homelessness – Montreal, CSSS Jeanne-Mance QB Keynote Speech



Jayne Barker Keynote at National training event, At Home/Chez Soi Project, Montreal QB Keynote Speech

Jayne Barker presentation – National Roundtable on Ethics and Cultural Safety – Saskatoon SK Presentation

MHCC Mental health table for regulated health professions Unknown Presentation

MHCC Public Health Agency Knowledge Exchange Forum Unknown Conference

MHCC Clifford Beers Mental Health Promotion Conf Unknown Keynote Speech

MHCC Canadian Medical Association Board working group Unknown Presentation

MHCC CAMIMH Unknown Presentation

MHCC International Psychogeriatric Association Unknown Workshop

MHCC OPDI Annual General Meeting Unknown Keynote Speech

MHCC Canadian Psychiatric Assoc Board meeting Unknown Keynote Speech

MHCC Canadian Assoc. for Suicide prevention Unknown Keynote Speech

MHCC Making Gains Conference Unknown Keynote Speech

MHCC Stand in the Light Unknown Keynote Speech

MHCC Connections Canada Unknown Webinar

MHCC “Is there hope for recovery” symposium Unknown Keynote Speech


2008

MHCC Overview of the Mental Health Commission of Canada. Alberta Mental Health Board 4th

annual Research Showcase - Banff, Alberta

AB Showcase

Michael Howlett Homelessness and Mental Illness: We Can’t Address One without the Other AB General

Jayne Barker presentation at Mental Health Think Tank AB Presentation

MHCC The Mental Health Commission of Canada: A One-Year Update. Canadian Psychiatric Association 58th

Annual Meeting - Vancouver, British Columbia

BC Meeting

Michael Kirby Simon Fraser Convocation BC Other

Dr. David Goldbloom The Homeless and Mental Illness: Solving the Challenge BC General

Jayne Barker presentation on “Lessons on What Works: A Housing First Approach” to the Greater Victoria Commission to end Homelessness

BC Presentation

Jayne Barker Keynote speaker - Forum on Mental Health and Homelessness – Simon Fraser University, Vancouver BC Keynote Speech

Jayne Barker keynote speaker at Child and Youth Mental Health Conference put on by the Interior Health Authority “Creating System Change in C&YMH Service Systems”

BC Keynote Speech

MHCC Out of the Shadows: The Mental Health Commission of Canada, Stigma and You, Plenary Lecture. 11th

International Continuing Professional Development Conference, Canadian Psychiatric Association - Montego Bay, Jamaica

Jamaica Lecture

Jayne Barker Presentation on Mental Health and Homelessness at Winnipeg Invitational Symposium put on by Winnipeg Health Authority.

MB Presentation

Michael Howlett Luncheon Address, Mental Health Forum, Moncton, NB NB Luncheon



MHCC One Year Later – the Mental Health Commission of Canada NB General

Michael Howlett Blue Cross Mental Health Symposium NB Symposium

Jayne Barker presentation on “Homelessness and Mental Illness” to Moncton City Council and University of NB NB Presentation

MHCC Stigma in Mental Illness: Past, Present and Future Keynote Address, Canadian Mental Health Association National Annual Meeting - Halifax, Nova Scotia

NS Keynote Speech

MHCC Canadian Mental Health Association National Conference NS Conference

Michael Howlett Keynote Address at Ontario Hospital Association Aboriginal Conference ON Conference

MHCC Mental Health in the Workplace: A Measurable Cost. Employer Forum – Measuring for Success: The Why and How of Measurement in Workplace Health, Connex Health - Niagara-on-the-Lake, Ontario

ON Forum

MHCC The Good, The Bad and the Ugly: Attitudes Toward Mental Illness in the 21st

Century, The Canadian Club - Toronto, Ontario

ON General

MHCC Depression in the Workplace, Ernst and Young Human Resources Professionals -Toronto, Ontario ON General

MHCC Mental Health in the Workplace, Gowlings LLP - Toronto, Ontario, ON General

MHCC Stigma and Mental Illness, Self-Help Resource Centre - Toronto, Ontario. ON General

MHCC Adolescents and substance abuse, Branksome Hall School - Toronto, Ontario ON General

MHCC Mental Health and the Workplace: Stigma, Reality and Hope, Fraser Milner Casgrain LLP - Toronto, Ontario ON General

MHCC The Canadian Health System and Mental Health Care Graduate Program in Health Administration, Pfeiffer University, North Carolina - Toronto, Ontario.

ON General

MHCC Teen Drinking. Bishop Strachan School - Toronto, Ontario. ON General

MHCC Transforming Mental Illness in the 21st

Century: Stigma, Reality and Hope, Kiwanis Club of Don Mills - Don Mills, Ontario.

ON General

MHCC The Mental Health Commission of Canada: A One-Year Update. Grand Rounds, Department of Psychiatry, Sunnybrook Health Sciences Centre

ON Grand Rounds

MHCC The Mental Health Commission of Canada, Suicide Studies Rounds, Department of Psychiatry, Saint Michael’s Hospital - Toronto, Ontario

ON Grand Rounds

MHCC Out of the Shadows: The Mental Health Commission of Canada, Stigma, and You, Grand Rounds, Centre for Addiction and Mental Health - Toronto, Ontario

ON Grand Rounds

MHCC Out of the Shadows: The Mental Health Commission of Canada, Stigma, and You Grand Rounds, Department of Psychiatry, Toronto East General Hospital - Toronto, Ontario.

ON Grand Rounds

MHCC Perspectives on Creativity in Mental Illness and Mental Health Keynote Address, Expressions! Creativity in Mental Health, Family Services Ottawa/Canadian Mental Health Association Ottawa/The National Gallery - Ottawa, Ontario.

ON Keynote Speech

Dr. David Goldbloom The Nature and Impact of Mental Health Issues Keynote Addres, Mental Health Trends: An Emerging Social Trends Forum, Research and Evaluation Unit, Ministry of Community and Social Services, Government of Ontario

ON Keynote Speech

MHCC Mental Health in the Workplace: Stigma, Reality and Hope, Hospital for Sick Children; Mental Health Issues in the Workplace. Keynote Address 23

rd Fasken Forum: Employment, Labour, Human Rights, Pensions and Benefits

ON Keynote Speech



Conference - Toronto, Ontario.

MHCC Mental Illness in the 21st

century Vic One Lecture Series, Victoria College, University of Toronto - Toronto, Ontario ON Lecture

MHCC The Mental Health Commission of Canada: A One-Year Update, Health Science Information Consortium of Toronto Annual General Meeting - Toronto, Ontario

ON Meeting

MHCC Anxiety: An Overview. Rotman School of Management, University of Toronto - Toronto, Ontario ON Meeting

MHCC Thinking About Stigma, Plenary Address, Annual General Meeting, Consent and Capacity Board of Ontario - Toronto, Ontario

ON Meeting

MHCC Adolescent Mental Health Havergal College -Toronto, Ontario ON General

Michael Howlett Speech To The Toronto Board Of Trade "Turning Caring into Action” - Presentation to the RPNC World Congress for Psychiatric Nurses

ON Presentation

MHCC Journeys in Therapeutics, History of Psychiatry Seminar, Department of Psychiatry, University of Toronto ON Seminar

Dr. David Goldbloom Mental Illness in the 21st

Century Special Seminar, Trinity College, University of Toronto - Toronto, Ontario ON Seminar

MHCC Transforming the treatment of mental health and addiction, Open Minds Speakers Series - Toronto, Ontario ON Series

MHCC Summary Remarks and Synthesis. Well-Being in a Competitive World in Students and Beyond, 2nd

Annual Massey College Grand Rounds Symposium, Massey College, University of Toronto - Toronto, Ontario

ON Symposium

MHCC Mental Illness in the Workplace: Stigma, Reality and Hope, Ontario Teachers Insurance Plan Benefits Workshop - Mississauga, Ontario

ON Workshop

Michael Kirby Silver Dinner Remarks ON Keynote Speech

Michael Kirby ‘Children’s Mental Health and the Need for a National Mental Health Movement’ ON General

Jayne Barker Raising the Roof – conference on youth homelessness – workshop presentation on Housing First ON Workshop

MHCC The Mental Health Commission of Canada: A New Model for Change, Plenary Address, Canadian Association for Suicide Prevention Annual Meeting: Suicide et Addictions - Québec City, Québec

QB Meeting

Tony Clement Minister of Health at Canadian Medical Association Annual Conference Unknown Conference

MHCC Throne speech supports the MHCC Unknown Other

MHCC “Group of 7” providers Unknown Presentation

MHCC RAMHPS seminar Unknown Seminar

MHCC Mental Health Promotion Think Tank Unknown Presentation

Jayne Barker presentation to the US Committee to end Homelessness (chaired by Phillip Mangano) USA Presentation

Jayne Barker workshop presentation at Forum on Mental Illness and Homelessness – Columbia University, New York USA Workshop

MHCC Mental Illness in the Workplace: Stigma, Reality and Hope. Plenary Lecture, Institute of Health and Productivity Management International Conference - Scottsdale, Arizona

USA Lecture



2007

MHCC Future Opportunities and Challenges Keynote Address, Inukshuk Conference on The Brain, Mental Health, and Addiction: From Synapse to Society, Alberta Heritage Fund for Medical Research - Banff, Alberta.

AB Keynote Speech

MHCC Mental Health in the Canadian Workplace, Spectra Energy - Medicine Hat, Alberta; Mental Health in the Canadian Workplace, Spectra Energy, Fort St. John’s, British Columbia

BC General

MHCC Mental Health in the Canadian Workplace, Spectra Energy - Halifax, Nova Scotia. NS General

MHCC A Perfect Storm Yielding a Perfect Opportunity 2nd

US/Canada Forum on Mental Health and Productivity - Ottawa, Ontario.

ON Forum

MHCC Mental Health Issues, Challenges and Opportunities, Group Insurance and Pharmaceuticals Committee - Toronto, Ontario

ON General

MHCC Mental Health in the Canadian Workplace, Faskens LLP - Toronto, Ontario ON General

MHCC Mental Health in the Canadian Workplace, Amgen Canada Inc. - Mississauga ON General

MHCC Adolescent Mental Health, The York School, Toronto, Ontario ON General

Dr. David Goldbloom Mental Health and the 21st

Century Massey Grand Rounds, Massey College - Toronto, Ontario ON Grand Rounds

MHCC Mental Illness and the Workplace: Stigma, Reality and Hope, Stephen E. Lett Lecture, Homewood Health Centre - Guelph, Ontario

ON Lecture

MHCC Mental Health in the Canadian Workplace, Spectra Energy, Brantford, Ontario ON General


Appendix C: Survey Instrument and Interview Guides


EVALUATION OF THE MENTAL HEALTH COMMISSION OF CANADA

REVISED KEY INFORMANT GUIDE – PHASE 1

Name:

Date and Time:

Phone:

LDER I Please note that your privacy is protected throughout this process. The information that we, as

consultants, provide to the Mental Health Commission of Canada will not contain names or personal

information.

If you have any questions or concerns please contact the following:

Mental Health Commission of Canada Charis Management Consulting Inc.

Laureen MacNeil

Planning & Risk Management Officer

Suite 800, 10301 Southport Lane S.W.

Calgary, Alberta T2W 1S7

(403) 385-4068

[email protected]

Lynn Damberger

Senior Evaluation Consultant

418, 10123 99 Street

Edmonton, AB T5J 3H1

(780) 496-9067 ext 226

[email protected]

mailto:[email protected]



INTRODUCTION

The Mental Health Commission of Canada (MHCC) was created in 2007 as a result of recommendations

made in the ground breaking report Out of the Shadows at Last – Transforming Mental Health, Mental

Illness and Addiction Services in Canada (May 2006). To fulfill its mission, the MHCC is actively engaged

in five key initiatives, addressing areas of core significance to the sector’s needs:

1) A mental health strategy 2) An anti-stigma initiative 3) Homelessness research demonstration projects 4) Knowledge exchange 5) Partners for mental health

In compliance with the Health Canada funding framework and Treasury Board evaluation guidelines, the

MHCC has initiated a formative evaluation process to garner an assessment of: progress made towards

the five key initiatives; policy or program effectiveness; of impacts (intended and unintended); and, if

located, of alternative ways of achieving results. Charis Management Consulting has been selected as

the Canadian evaluation firm to complete this formative evaluation of the MHCC.

The focus of the Phase 1 Key Informant interviews is to probe on MHCC activities, outputs, and

outcomes; evaluation issues/questions; and potential data sources. The purpose is to understand the

MHCC’s objectives and priorities and the five identified initiatives sufficiently to inform the development

of the logic model and evaluation matrix to be utilized in the next phase of the evaluation. Key

individuals from the MHCC Executive Team and additional key stakeholders, selected by the MHCC, have

been asked to provide their perspective in this phase of the evaluation. You may also be interviewed or

surveyed in the second phase of the evaluation that will occur in early 2011.

The interview should take around 45 to 60 minutes to complete.

Do you consent to do this interview?

Do you consent to our audio-taping the interview to ensure the data collection is complete? The tape

file will be held confidential – to be used by evaluators as backup to their notes. Data will be aggregated

in order to assist in the completion of the logic model and evaluation framework and methodology

which will guide Phase 2 of the evaluation.

Finally, do you have any questions before we start the interview?

How long have you been involved with the MHCC?

What is your role?


SECTION A: PROPOSED LOGIC MODEL FOR THE MHCC EVALUATION

I would like to talk about the proposed level 1 logic model that will be utilized for Phase 2 of the MHCC

evaluation. The attached logic model is the highest level logic model that captures the overall

implementation of the MHCC. Charis Management Consulting will also be developing Level 2 logic

models for each of the 5 initiatives undertaken by the MHCC.

A1. Are the assumptions listed on the right side of the page accurate? Is there anything more to

these assumptions that you would like to add?

A2. Is the identification of inputs/resources a valid description of the resources available? Are there

any gaps?

A3. Are the key activities listed accurate? Are there any gaps?

A4. Are there any other outputs that you believe should be reflected in the logic model?

A5. Do the audiences listed accurately reflect the groups that were intended to be impacted by the

implementation of the MHCC?

A6. This evaluation will focus on the impact/initial outcomes derived from the first 4 years of the

MHCC implementation. In this outcome area, are there any other aspects of the overall

implementation that you believe need to be included?\

A7. While it is too early to do a full impact assessment of the MHCC’s work, we are contemplating

highlighting or profiling examples of early impacts that have been achieved to date. Do you

have any suggestions of particular work that has been completed that we could review and

consider for profiling?

A8. Both of the Intermediate and ultimate outcomes areas will be examined in future evaluations of

the overall implementation of the MHCC. Are there any other outcomes that you believe should

be added for these future evaluations?

SECTION B: LOOKING FORWARD TO THE EVALUATION

In the next phase of the evaluation, Charis Management Consulting will be conducting a systematic

review of all project documentation, completing a targeted literature review and collecting data through

interviews, focus groups and surveys to answer key evaluation questions. This formative evaluation will

focus on assessing aspects of the MHCC’s work from inception until March 31, 2010. Later in

implementation, the MHCC will undertake a separate summative evaluation to assess the impact of

strategies over the entire lifespan of the organization.


B1. As a formative evaluation of the MHCC, what questions do you think will be most critical for

Charis Management Consulting to ask others in surveys, interviews or focus groups?

B2. Do you believe there are any specific issues for the evaluation that Charis needs to be aware of

and if so, please describe these issues?

B3. Key documents being reviewed include funding agreements, strategic and business plans,

implementation plans for each initiative, Advisory Committee projects and other projects

completed/in process, communication plans, media releases, Board reports, organizational

policies and procedures, environmental scans, surveys and frameworks that have been

developed. Are there any other key documents or key people that would you recommend we

review/interview as part of this evaluation?

SECTION C: OTHER QUESTIONS

This next group of questions is more evaluative and seeking your thoughts and opinions on the MHCC

rather than on the evaluation process. Before I ask you this final group of questions, let’s review what

the MHCC vision and mandate are:

MHCC Vision:

A society that values and promotes mental health and helps people living with mental health problems

and mental illness to lead meaningful and productive lives.

MHCC Mandate:

To act as a catalyst to improve the mental health system in Canada, develop a mental health strategy for

Canada, reduce stigma and discrimination faced by people living with mental illness and mental health

problems, and create a knowledge exchange centre (2001- 2017)

C1. Do you believe the MHCC has been formed and organized as intended? Please describe.

C2. How effective are the structures and processes implemented by the MHCC to achieve their

mandate?

C3. What do you believe has been working best in terms of the MHCC?

C4. What do you believe has been most challenging for the MHCC?

C5. Are there any major suggestions or recommendations you would like to make?

C6. Is there anything else that you would like to add or any questions that you have?

We would like to thank you very much for your time.

If you have any questions about the study, please do not hesitate to contact Lynn Damberger at 780 496 9067, ext 226.



KEY INFORMANT GUIDE PHASE TWO

PEOPLE WITH LIVED EXPERIENCE (8-10), FAMILY MEMBERS AND CAREGIVERS (3-5)

Name and Role:

Date and Time:

Phone:

Interviewer:

Please note that your privacy is protected throughout this process. The information that we, as


information. We will not use direct quotes from interviews in the evaluation report without specific

consent from you to do so.


Mental Health Commission of Canada

Laureen MacNeil




(403) 385-4068

[email protected]

OR

Sapna Mahajan

Executive Associate to the President and Chief

Executive Officer


Calgary, Alberta T2W 1 S7

(403) 385-4054

[email protected]

Charis Management Consulting

Lynn Damberger


418, 10123 99 Street


(780) 496-9067 ext 226

[email protected]





The Mental Health Commission of Canada (MHCC) was created in 2007. To fulfill its mission, the MHCC

is actively engaged in five key initiatives:

1. A mental health strategy 2. An anti-stigma initiative 3. Homelessness research demonstration projects 4. Knowledge exchange 5. Partners for mental health

In order to meet the requirements set up by Health Canada, the funder of the MHCC, an evaluation

process has been started to assess the progress made towards achieving the mandate of the MHCC.

Charis Management Consulting Inc. has been selected to complete this work.




file will be held confidential to Charis Management Consulting Inc. and will only be used by evaluators as

backup to their notes. If you choose not to be audio-taped, we can continue with the interview with

only notes being taken. You have the right to not answer any question that you would prefer not to

answer, to conclude the interview at any point, and to withdraw your information at any time during or

after the interview without having to give a reason for this or without fear of retribution. Data will be

aggregated and your privacy is ensured.


SECTION A: DESCRIPTIVE - ROLES

A1. Please describe your involvement with the MHCC. (Describe the length of time, role and

experience you have brought to the work.)

SECTION B: MHCC MANDATE

Before I ask you the following group of questions, let’s review the MHCC’s mandate and 5 initiatives:

MHCC Mandate:



problems, and create a knowledge exchange centre (2001- 2017).


MHCC 5 initiatives:


B1. From your experience, do you think the MHCC’s five key initiatives will improve the mental

health of Canadians?

B2. Are the five key initiatives the right ones? Are there any gaps?

SECTION C: MHCC STRUCTURE

C1. From your perspective, do you see that the MHCC includes you or others who have experience

with mental health in their lives within MHCC activities or structures? (For example, as staff

members, volunteers, committee members, or for consultation). What is working well? What

are the challenges?

SECTION D: MHCC ACHIEVEMENTS

D1. What early examples of success are evident, in terms of the MHCC’s work?

D2. What has been the MHCC’s most important achievement to date?

D3. Do you see the MHCC achieving collaboration with the groups that mean the most to you?

SECTION E: MHCC EARLY IMPACTS

E1. Is the MHCC making a difference?

E2. What is innovative in the work of the MHCC?

E3. To what extent do you rely on the MHCC? For example, their website, documents, newsletters, etc.

E4. If you wanted to have influence on changing the mental health system, with whom would you talk about this?

SECTION F: RECOMMENDATIONS AND FINAL COMMENTS

F1. What can be learned from implementation to date?

F2. Are there any recommendations for improvement?


F3. What could be the MHCC’s most important contribution in the future?

F4. Do you have any final comments?

We would like to thank you very much for your time. If you have any questions about the study, please do not hesitate to contact

Lynn Damberger at 780 496 9067, ext 226.



KEY INFORMANT GUIDE PHASE TWO

MHCC STAFF (6-8) AND PARTNERS (6-10)

Name and Title:

Date and Time:

Phone:

Interviewer:

LDER I Please note that your privacy is protected throughout this process. The information that we, as


information. As well, we will not use direct quotes from interviews in the evaluation report unless

interviewees’ permission is granted for citing directly from their interviews.


Mental Health Commission of Canada

Laureen MacNeil




(403) 385-4068

[email protected]

OR

Sapna Mahajan

Executive Associate to the President and Chief

Executive Officer


Calgary, Alberta T2W 1 S7

(403) 385-4054

[email protected]

Charis Management Consulting

Lynn Damberger


418, 10123 99 Street


(780) 496-9067 ext 226

[email protected]





INTRODUCTION

The Mental Health Commission of Canada (MHCC) was created in 2007 as a result of recommendations

made in the ground breaking report Out of the Shadows at Last – Transforming Mental Health, Mental

Illness and Addiction Services in Canada (May 2006). To fulfill its mission, the MHCC is actively engaged

in five key initiatives, addressing areas of core significance to the sector’s needs:


In compliance with the Health Canada funding framework and Treasury Board evaluation guidelines, the

MHCC has initiated a formative evaluation process to garner an assessment of: progress made towards

the five key initiatives; policy or program effectiveness; of impacts (intended and unintended); and, if

located, of alternative ways of achieving results. Charis Management Consulting has been selected as

the Canadian evaluation firm to complete this formative evaluation of the MHCC.




file will be held confidential to Charis Management Consulting Inc. and will only be used by evaluators as

backup to their notes. If you choose not to be audio-taped, we can continue with the interview with

only notes being taken. As well, you have the right to not answer any question that you would prefer

not to answer, to conclude the interview at any point, and to withdraw your information at any time

during or after the interview without having to give a reason for this or without fear of retribution. Data

will be aggregated and your privacy is ensured.


SECTION A: DESCRIPTIVE - ROLES

A1. Please describe your involvement with the MHCC. (Probe for length of time, role and

experience brought to the work.)


SECTION B: MHCC MANDATE

Before I ask you the following group of questions, let’s review the MHCC’s mandate and 5 initiatives:

MHCC Mandate:



problems, and create a knowledge exchange centre (2007- 2017).

MHCC 5 initiatives:


B1. Are the MHCC five key initiatives consistent with the assigned mandate as per the funding

agreements with Health Canada?

B2. Are the 5 initiatives the right ones? Are there any gaps?

B3. Is the allocated funding sufficient to implement the mandate? Is the funding used to leverage

additional funding supports?

SECTION C: MHCC STRUCTURE

C1. Are the MHCC’s governance structure, processes and support mechanisms contributing to the

achievement of the MHCC mandate and goals?

C2. In your opinion, are the current organizational structure, processes and support mechanisms

functioning as expected? Are they congruent with the (implied) organizational values of the

MHCC?

C3. Are the current Advisory Committees the right ones? (Child & Youth; Family Caregivers; First

Nations, Inuit, & Métis; Mental Health & the Law; Science; Seniors; Service Systems; and,

Workforce). Are the Advisory Committees focused on the right content areas? Are the right

people involved?

C4. Is the role of people who have experienced mental health problems either directly or as family

members or caregivers, authentically involved with the MHCC? (Probe: as staff? Volunteers?

Consultants?)


C5. Has the MHCC been able to establish effective and collaborative partnerships? (Probe: e.g., with

governments? Service providers? Researchers? Media? People with mental health problems,

their families and caregivers?)

C6. Has the MHCC established itself as a model workplace?

SECTION D: MHCC ACHIEVEMENTS

D4. How effective was the transition of the Mental Health First Aid (MHFA) program to the MHCC? Is the MHFA program being implemented effectively?

D5. Concerning all aspects of the MHCC’s activities, products and services: what early examples of success are evident? What has been the MHCC’s most important achievement to date?

D6. What have been the key challenges and/or barriers to the work of the MHCC?

SECTION E: MHCC EARLY IMPACTS

E5. Is the MHCC a catalyst for the mental health sector in Canada? In what ways?

E6. What principles and values do you see reflected in the work of the MHCC?

E7. Is the MHCC innovative?

E8. To what extent do stakeholders rely on the MHCC?

E9. Is the MHCC going to make a difference for people with lived experience of mental illness or mental health problems and their families or caregivers?

SECTION F: RECOMMENDATIONS AND FINAL COMMENTS

F5. What can be learned from implementation to date?

F6. Are there any recommendations for improvement?

F7. What could be the MHCC’s most important contribution in the future?

F8. Do you have any final comments?

We would like to thank you very much for your time. If you have any questions about the evaluation, please do not hesitate to contact

Lynn Damberger at 780 496 9067, ext 226.



FOCUS GROUP GUIDE - ADVISORY COMMITTEE MEMBERS

VANCOUVER (FEBRUARY 03, 2011)

Introductory Remarks:

I am ______________________ from Charis Management Consulting Inc. and will be facilitating today's

focus group discussion.

Description of the evaluation data gathering process:

a. This focus group is one of four that will assist us with answering questions on the early

results and impacts of the MHCC over the first 3 years of implementation of their

mandate.

b. We are also conducting interviews with key individuals and implementing an online

survey.

Before we get started, it would be great to have some introductions from all of you. Please provide your

name, position, where you are working and which Advisory Committee you represent.

(After the round table introductions)

I have a few housekeeping items to make you aware of:

If at all possible, please turn off cell phones or place them on vibrate.

Please help yourself to refreshments.

The washrooms are located. . .

Guidelines for today’s session:

You have received an invitation which provided some information about the purpose of this

focus group.

This will be up to a 2 hour session.

We will be taking notes/recording the discussion with a view to summarizing the feedback into

themes.

Will follow a round table format for initial questions

To facilitate recording, please speak one at a time


consultants, provide to the MHCC will not contain names or personal information, or any means

of identifying you.

Do you have any questions?


Questions

1. Mandate –to focus national attention on mental health issues and to work to improve the

health and social outcomes of people living with mental illness—Generally speaking, is the

MHCC doing this? Is the MHCC meeting the mandate that has been set out in their funding

agreements with Health Canada?

Probes:

a. Are the 5 key initiatives the right ones? Are they consistent with the MHCC’s mandate?

b. Is the mandate still relevant? Are there gaps? Have the priorities changed? Are there

activities that should no longer be implemented?

c. Is the funding sufficient to implement the mandate?

2. Structure –are the current organizational structure, processes and support mechanisms of the

ACs functioning as expected?

Probes:

a. Is your role and the purpose of the AC clear to you?

b. Are there the right number and mix of AC’s members?

c. What kind of support should MHCC staff provide to the ACs? To what extent do you

receive the support you need?

d. Have the ACs established effective and collaborative partnerships with all stakeholders?

What contributes to these partnerships? What are the barriers?

e. Is the role of people with lived experience authentically a key component of the ACs?

Please describe (e.g., roles, types of participation and perceptions of involvement).

3. Achievements – what has been achieved by the ACs to date in terms of contributing to the

MHCC’s implementation of its mandate?

Probes:

a. Do you feel the work of the AC and your role in it has an impact on the functioning of

the MHCC?

b. What aspects of the implementation of the ACs are working well? What early examples

of success are evident? What have been the most important achievements to date?

c. What are the challenges/barriers?

d. How effective are the communication strategies?

e. Are the AC’s products and services consistent with the mandate and vision?

4. Early Impacts – how have the ACs affected the work and lives of partners and collaborators in

the mental health system?

Probes:

a. What difference are the ACs making to the system? Do they inform or influence system

improvements?

b. Do the ACs act as a catalyst for the work that is done by partners and collaborators?

c. What do you think is innovative about the work of the ACs?


d. To what extent do stakeholders rely on the work of the ACs?

e. Is the MHCC well positioned for success?

5. Recommendations – what can be learned from implementation to date? Are there any

recommendations for improvement?

Probe:

a. What should be the MHCC’s most important contribution in the future?



FOCUS GROUP GUIDE – MHCC STAFF

CALGARY (FEBRUARY 8, 2011) AND OTTAWA (FEBRUARY 23, 2011)




Description of the evaluation data gathering process: c. This focus group is one of four that will assist us with answering questions on the early

results and impacts of the MHCC over the first 3 years of implementation of their mandate.

d. We are also conducting interviews with key individuals and implementing an online survey.


name and position with the Commission.



If at all possible, please turn off cell phones or place them on vibrate. Please help yourself to refreshments.


You have been randomly selected and received an invitation letter that provided some information about the purpose of this focus group.

This will be up to a 2 hour session. We will be taking notes/recording the discussion with a view to summarizing the feedback into

themes. Will follow a round table format for initial questions To facilitate recording, please speak one at a time

Please note that your privacy is protected throughout this process. The information that we, as consultants, provide to the MHCC will not contain names or personal information, or any means of identifying you.



History

The Mental Health Commission of Canada was established in the fall of 2007 as an independent, not-for-

profit organization funded by the Government of Canada. The Commission grew out of a

recommendation in the first-ever national report on mental health, Out of the Shadows at Last,

prepared by the Standing Senate Committee on Social Affairs, Science, and Technology. The creation of

the Commission was endorsed by all provincial and territorial governments (with the exception of

Québec, which is involved in a bi-lateral process) at a meeting of Ministers of Health in 2005, and all

governments have since confirmed their support for the Commission. The report and the 10 year Health

Canada funding agreement recommended that the Commission undertake three major initiatives:

Develop a Mental Health Strategy for Canada

Create a national Knowledge Exchange Centre

Implement a national anti-stigma/ anti-discrimination initiative

In addition to the three initiatives stated above, a fourth initiative was added when the Commission

entered into a five year Health Canada funding agreement in 2008, to support five research

demonstration projects on mental health and homelessness. The fifth key initiative, Partners for Mental

Health, was added in 2008/09 to support the other initiatives by engaging Canadians in the work of the

Commission and to bring mental health issues into the public eye.

Vision and Mission

The Commission remains committed to the vision and mission stated below. At the highest level, the

vision describes the future the commission wants to see, and long term aspirations, based on the

fundamental beliefs and values of the Commission, its stakeholders and Canadian society as a whole.

The mission expresses the role the Commission will play in achieving the long term vision.

The Vision of the Commission is:

A society that values and promotes mental health and helps people living with mental health problems

and mental illness to lead meaningful and productive lives.

The Mission of the Commission is:

To promote mental health in Canada change the attitudes of Canadians toward mental health problems

and mental illness, and to work with stakeholders to improve mental health services and supports.


Questions

6. Mandate –to focus national attention on mental health issues and to work to improve the health and social outcomes of people living with mental illness—Generally speaking, is the MHCC doing this? Probes:

a. Are the 5 key initiatives the right ones? b. Are they consistent with the MHCC’s mandate? c. Is the mandate still relevant? Are there gaps? Have priorities changed? Are there

activities that should no longer be implemented? d. Is the funding sufficient to implement the mandate

7. Structure –are the current organizational structure, processes and support mechanisms

functioning as expected? Probes:

a. Does the MHCC have the right mix of staff and the right functions for staff? b. Are there the right number and mix of AC’s members, and other volunteers, including

PWLE? Is the staffing model adequate to support the work of the Commission, for instance, the ACs?

c. How are decisions being made? d. What would facilitate your work to make it more effective? e. Are the governance and management structures congruent with MHCC’s (implied)

organizational values?

8. Achievements – what has been achieved by the MHCC to date in terms of implementation of the mandate? Probes:

a. What aspects of the implementation of the MHCC are working well? What early examples of success are evident? What has been the MHCC’s most important achievement to date?

b. What are the challenges/barriers? c. How effective is the MHCC, in:

i. Communication? ii. Facilitating a pan -Canadian approach to mental health issues?

iii. Diminishing stigma/discrimination faced by Canadians living with mental illness? iv. Disseminating evidenced informed information on mental health/illness to

government? v. Providing a workplace congruent with MHCC (implied) organizational values?


9. Early Impacts – how has the MHCC affected the work and lives of partners and collaborators in the mental health system? Probes:

a. What would you identify as the principles and values of the MHCC workplace? b. What difference is the MHCC making to the system? Does it inform or influence system

improvements? c. Does the MHCC act as a catalyst for the work that is done by partners and

collaborators? d. What do you think is innovative about the work of the MHCC? e. To what extent do stakeholders rely on the work of the MHCC? f. Is the MHCC well positioned for success?

10. Recommendations – what can be learned from implementation to date? Are there any recommendations for improvement? Probe:

a. What should be the MHCC’s most important contribution in the future?



FOCUS GROUP GUIDE – PT REFERENCE GROUP

OTTAWA (FEBRUARY 23, 2011)




Description of the evaluation data gathering process:

a This focus group is one of four that will assist us with answering questions on the

early results and impacts of the MHCC over the first 3 years of implementation of

their mandate.

b We are also conducting interviews with key individuals and implementing an online

survey.


name, expertise, and ministry.



Washrooms located. . .

If at all possible, please turn off cell phones or place them on vibrate.

Please help yourself to refreshments.


You have received an invitation which provided some information about the purpose of this

focus group.

This will be up to a 2 hour session.

We will be taking notes/recording the discussion with a view to summarize the feedback into

themes.

Will follow a round table format for initial questions

To facilitate recording, please speak one at a time


consultants, provide to the MHCC will not contain names or personal information.



The Mental Health Commission of Canada is a non-profit organization created to focus national

attention on mental health issues and to work to improve the health and social outcomes of people

living with mental illness.

The Commission, while funded by the Government of Canada, is a national body, not a federal one. It

has been endorsed by all levels of government, although the Commission operates at arm's length from

them.

The Commission's work currently includes the following key areas:

1. A Mental Health Strategy for Canada 2. Opening Minds - an anti-stigma / anti-discrimination initiative 3. At Home / Chez Soi - Homelessness research demonstration projects 4. Knowledge Exchange Center 5. Partners for Mental Health

The Mental Health Commission of Canada will:

Be a catalyst for the reform of mental health policies and improvements in service delivery; Act as a facilitator, enabler and supporter of a national approach to mental health issues; Work to diminish the stigma and discrimination faced by Canadians living with mental illness; Disseminate evidence based information on all aspects of mental health and mental illness to

governments, stakeholders and the public.

Questions

11. Mandate –to focus national attention on mental health issues and to work to improve the

health and social outcomes of people living with mental illness-- is the MHCC meeting the

mandate that has been set out in their funding agreements with Health Canada?

Probes:

a. Are the 5 key initiatives the right ones? Are the consistent with the MHCC’s mandate?

b. Is the mandate still relevant? Are there gaps?

c. Is the funding sufficient to implement the mandate?

12. Structure –are the current organizational structure, processes and support mechanisms

functioning as expected?

Probes:

a. Has the MHCC established effective and collaborative partnerships with all levels of

government and other stakeholders?

b. Is the role of people with lived experience, their families and caregivers authentically a

key component of the MHCC?

c. How are decisions being made? Are the governance and management structures

congruent with the MHCC’s (implied) organizational values?

http://www.mentalhealthcommission.ca/English/Pages/Strategy.aspx

http://www.mentalhealthcommission.ca/English/Pages/OpeningMinds.aspx

http://www.mentalhealthcommission.ca/English/Pages/homelessness.aspx

http://www.mentalhealthcommission.ca/English/Pages/KnowledgeExchangeCenter.aspx

http://www.mentalhealthcommission.ca/English/Pages/PartnersforMentalHealth.aspx


13. Achievements – what has been achieved by the MHCC to date in terms of implementation of

the assigned mandate?

Probes:

a. What aspects of the implementation of the MHCC are working well? What early

examples of success are evident? What has been the MHCC’s most important

achievement to date?

b. What are the challenges/barriers?

c. How effective is the MHCC, in:

i. Catalyzing the reform of mental health policies?

ii. Facilitating a national approach to mental health issues?

iii. Diminishing stigma/discrimination faced by Canadians living with mental illness?

iv. Disseminating evidenced informed information on mental health/illness to

government?

14. Early Impacts – how has the MHCC affected the work and lives of partners and collaborators in

the mental health system?

Probes:

a. What difference is the MHCC making to the sector? Does it inform or influence sector

improvements?

b. Is the MHCC contributing to meeting the broader mental health goals for people in

Canada?

c. How does the MHCC act as a catalyst for the work that is done by partners and

collaborators?

d. What do you think is innovative about the work of the MHCC?

e. To what extent do governments rely on the outputs of the MHCC, to inform their work?

f. Is the MHCC well positioned for success?

15. Recommendations – what can be learned from implementation to date and are there any

recommendations for improvement?

Probe:

a. What could be the MHCC’s most important contribution in the future?


The Mental Health Commission of Canada (MHCC) was created in 2007 as a result of recommendations made in the ground breaking report Out of the Shadows at Last – Transforming Mental Health, Mental Illness and Addiction Services in Canada (May 2006). To fulfill its mission of promoting mental health in Canada, working with stakeholders to change the attitudes of Canadians toward mental health problems, and to improve services and support, the MHCC is currently engaged in five key initiatives:

1) A Mental Health Strategy for Canada to transform the mental health system.

2) An anti-stigma/anti-discrimination initiative to change people’s attitudes and behaviours toward those who suffer from mental illness.

3) A national research project on homelessness and mental illness to determine which services and systems are best to help those who are living with a mental illness and are homeless.

4) A Knowledge Exchange Centre to help improve the lives of people living with mental illness by creating ways for Canadians to access information, share knowledge, and exchange ideas about mental health.

5) Partners for Mental Health as a national social movement to position mental health on the national agenda.

In compliance with the Health Canada funding framework and Treasury Board evaluation guidelines, the MHCC has initiated a formative evaluation process. Charis Management Consulting Inc. has been selected as the Canadian evaluation firm to complete this formative evaluation of the MHCC. Completion of this questionnaire will take 15 - 20 minutes of your time. As Charis Management Consulting is an external evaluator, all of the information you provide is confidential and will be kept anonymous. Your privacy is protected! Instructions for completion of this online questionnaire:

The survey functions as an online webpage. Use the side bars to scroll up and down, use the mouse to click on the responses you choose, and click inside the textboxes before you begin to type inside.

Return to the previous page by clicking on the ‘Back’ button at the bottom of the page. Navigate to the next page by clicking on the ‘Next’ button. Should you wish to change all


your answers, the ‘Clear’ button will erase all responses on the current page and you may then start at the top of the page and select new responses.

In this survey, we have included a series of statements around the mandate and activities undertaken by the MHCC. Taking each of these statements in turn, please indicate your level of agreement to each of the statements using the following scale:

Strongly Disagree Disagree Agree Strongly Agree Don’t Know

Awareness of the MHCC

Awareness

Strongly Disagree Disagree Agree

Strongly Agree Don't Know

1. I am aware of the MHCC and its work.

2. I understand the mandate of the MHCC.

3. I know as much as I want to know about the MHCC.

4. The MHCC does a good job of sharing information.

5. I believe the MHCC has a positive reputation.

Collaboration



6. I understand how my work contributes to the MHCC.

7. I understand how the MHCC contributes to my work.

8. I have adequate opportunities to provide input to the MHCC.


Five Key Initiatives of the MHCC

1) A Mental Health Strategy for Canada to transform the mental health system.

2) An anti-stigma/anti-discrimination initiative to change people’s attitudes and behaviours toward those who suffer from mental illness.

3) A national research project on homelessness and mental illness to determine which services and systems are best to help those who are living with a mental illness and are homeless.

4) A Knowledge Exchange Centre to help improve the lives of people living with mental illness by creating ways for Canadians to access information, share knowledge, and exchange ideas about mental health.

5) Partners for Mental Health as a national social movement to position mental health on the national agenda.

Listed below are the five key initiatives of the MHCC. Please indicate your level of agreement or disagreement with the following statements.



9. It is important for the MHCC to develop a mental health strategy for Canada.

10. It is important for the MHCC to develop an anti-stigma initiative.

11.

It is important for the MHCC to carry out a national research project on homelessness and mental illness.

12. It is important for the MHCC to develop a Knowledge Exchange Centre.

13. It is important for the MHCC to develop Partners for Mental Health.

Please provide your overall opinion on the five key initiatives.



14. The five key initiatives of the MHCC are the right ones.

15. There are issues that are not being addressed in the five key initiatives.


Promotion of the MHCC



16. The MHCC effectively communicates its activities.

17. The MHCC effectively disseminates its resources and information.

18. How do you receive information about the MHCC, and its products and services?

Please check all that apply.

Newsletter Newspaper Brochures Press releases, media coverage Emails Project reports (including Advisory Committee reports) Annual reports Formal presentations Television MHCC website Social Media (e.g. Facebook) Word of mouth Other ____________________


Impacts of the MHCC

Please indicate your level of agreement or disagreement with the following statements about the MHCC.

19. To this point, the MHCC's activities, products and resources contribute to:



Reducing stigma and discrimination related to mental illness.

Improving collaboration among partners.

Improving collaboration with people with lived experience and their families or caregivers.

Improving awareness of issues and evidence-informed practices to address those issues.

Enhancing integration and collaboration in the mental health system in Canada.

Increasing the use of MHCC research to impact the development of policy and service delivery.

20. Looking to the future, the MHCC is structured and resourced to contribute to:



Reducing stigma and discrimination related to mental illness.

Improving collaboration among partners.

Improving collaboration with people with lived experience and their families or caregivers.

Improving awareness of issues and evidence-informed practices to address those issues.

Enhancing integration and collaboration in the mental health system in Canada.

Increasing the use of MHCC research to impact the development of policy and service delivery.


21.



I rely on the products, information, and activities provided by the MHCC.

22. In my work, I rely on the following products for sources of information:

Please check all that apply.

Newsletters Fact sheets Annual reports Brochures Speeches Interviews News reports Reports and articles (including Advisory Committee reports) MHCC website Other ____________________

23. Based on the progress made to date, the MHCC is having a positive impact on the following groups:





Mental health professionals

Service providers Non-governmental organizations Researchers Educators Government decision and policy makers Health Canada Media Employers Members of the general public

24.



The MHCC is making a difference in the mental health sector.


25. If you wanted to influence changes to the mental health system, with whom would you be most likely to talk?

Mental Health Commission of Canada Canadian Mental Health Association My general practitioner/family physician Mental health professional Elected government official Health Canada Provincial/territorial health department Local health authority Other ____________________

Overall Observations

Please answer the following questions:

26. Overall, what aspects of the MHCC are working well?

__________________________________________________ __________________________________________________ __________________________________________________

27. Overall, what aspects of the MHCC are not working well?

__________________________________________________ __________________________________________________ __________________________________________________

28. Do you have any recommendations to strengthen the MHCC going forward?

__________________________________________________ __________________________________________________ __________________________________________________

29. As per its funding agreement with Health Canada, the mandate of the MHCC ends in 2017. If the MHCCwere

to pursue activities beyond that time, which of the five key initiatives should be sustained? Please check all that apply.

Mental health strategy for Canada Anti-stigma/Anti-discrimination initiative Research on homelessness and mental illness Knowledge Exchange Centre Partners for Mental Health

Please indicate any

comments you have in regards to the question above.

__________________________________________________ __________________________________________________ __________________________________________________


Background Information

Not at All A Little Fairly Very Not

Applicable

30. How knowledgeable do you feel about mental health and mental health improvement?

31. How involved are you with the MHCC?

32.

If you interact with persons with lived experience, family or caregivers, how often do you hear about the MHCC from them?

33. Check the box that describes your role in relation to the MHCC.

If you fulfill more than one role, please check all that apply.

Person with lived experience of mental illness or mental health problem Family member of a person with lived experience Caregiver of a person with lived experience Mental health service provider Health service provider Non-governmental organization Researcher Educator Government official/staff MHCC staff MHCC volunteer Advisory Committee chair or member Media International partner Recipient of At Home/Chez Soi homelessness research demonstration project Other ____________________

Please describe your work, or your organization's work if applicable.

__________________________________________________ __________________________________________________ __________________________________________________


Optional Information

Demographic Information

34. Please indicate your gender.

Male

Female

35. Please indicate your age group. 15-24

25-44 45-64 65-74 75+

Enter a Draw!

If you are interested in entering your name into the draw for one of two $100.00 Amazon gift cards, please provide your first name and email address in the field below. This will be separated from your responses to the survey and your responses will not be identifiable. If your name is drawn as a prize winner, the electronic gift card will be sent to your email address.

First name and email address: __________________________________________________

__________________________________________________ __________________________________________________

Thank you for your participation in this survey!


Appendix D: Organizational Chart

Charis Management Consulting Inc 168

Appendix E: Formative Evaluation Summary and Observations for Consideration

Charis Management Consulting Inc 170

Formative evaluation summary and observations for consideration

MHCC Business plan: 2010/2011 – 2014/2015 Formative evaluation findings

Critical Success

Factor Description Summary and observations for consideration

Providing

leadership

The Commission must provide

leadership on a national level and act

as a catalyst for change in the mental

health field. . . .

Fulfill the national mandate by extending coverage and providing focused engagement with regions that are less actively involved.

Be ground-breaking in leadership by actioning the assessment of the MHCC by people with lived experience. Ask the question: will this MHCC activity/product make a difference to people who experience mental illness? This will increase organizational alignment with the mandate and build relevance with the grassroots service providers.

Promoting shift

in attitudes

and behaviors

The ability of the Commission to shift

attitudes and behaviors about

mental health and mental illness is

one of the cornerstones of success. .

. .

Strong relationships with media and increasing their positive coverage are a sign that awareness is occurring. For instance, Opening Minds has increased awareness about mental health and mental illness, but it is early in the mandate to assess any shifts in attitudes and behaviors. The MHCC will want to track changes in this over the time frame of the mandate.

KEC and Partners are innovative and cutting edge. Move forward with intention and creativity as this will fulfill the mandate and result in a multiplier effect with other MHCC activities (e.g., AC products).

There is increasing government attention on mental health; many opportunities to develop synergy across governments build sector capacity for national evaluation/data collection and move forward with transforming policy.

Engaging

Canadians

The ability of the Commission to put

mental health on the national

agenda depends on its ability to

engage Canadians on the issue. . . .

Build linkages with the groups most perceived by respondents (internal and external) as poorly represented: people with lived experience, families and caregivers, First Nations Inuit and Métis, and, Québec.

Use the map of Canada to track activities and disseminate widely.

Ensuring that

people living

with mental

health

Changes to the mental health system

will only be successful if they meet

the needs of people living with

mental health problems and mental

Continue to integrate people with lived experience into the Commission:

Build on the MHCC’s capacity to integrate people with lived experience, Aboriginals and others into the “MHCC Family” as a core component of creating a model workplace.

Develop a clear communication plan to inform stakeholders of the MHCC’s approach to actively


problems and

mental illness

and their

families are

central to the

Commission

illness and their families. . . . include people with lived experience and other diverse groups, within their staff.

Take the Commission out to where people with lived experience are:

Build strong linkages with grassroots service providers and create meaningful networks with them; validate their work and give it presence. Strengthen their capacity to track and evaluate their results and utilize this information to shift policy; be their national catalyst.

Communicating Excellence in communication

continues to be fundamental to the

Commission’s success. . . .

Continue to increase communication and promotion about the MHFA, to build awareness across the sector and mitigate concerns about its transfer to the Commission.

Create processes that will increase the transparency of the decision-making methods utilized by the Commission and build a sense among staff and other stakeholders that they are able to influence the work of the MHCC.

Building

relationships

and

partnerships

The Commission will fulfill its mission

largely through relationships and

partnerships. . . .

Respondents identified the Provincial/Territorial Reference Group as an important committee that results in real wins for MHCC. It will be important to continue to build on this success and leverage its potential for increasing MHCC sustainability.

Build on the existing strengths of MHCC stakeholder relations with governments and other partners.

Strengthen alliances with grassroots organizations, build partnerships and capitalize on their existing work in the sector. Utilizing the Opening Minds model, address the substantive concerns that have been expressed concerning lack of collaboration with these groups.

Similarly, facilitate connections with national Aboriginal organizations that work in the health and mental health sector, for the purposes of forming partnerships and building alliances.

Managing

expectations

The positive response to the creation

of the Commission has resulted in

high expectations among

stakeholders. . . .

There is, among respondents, a perceived expectation that MHCC is to advocate for the sector. This perception needs to be addressed and brought into alignment with the MHCC mandate and then clearly communicated to stakeholders. Continue to further develop the MHCC role as a trusted advisor to federal, provincial and territorial governments, as well as to other stakeholders.

Use the website to show visually what the MHCC is achieving and what is around the corner, and include easy access to information about fiscal decisions.

Promoting the

creation of

evidence-

informed

The importance of research, science,

and evaluation to build evidence-

informed knowledge has been

identified as a critical success factor.

While all of the five key initiatives have been strongly affirmed by the data as relevant, there has equally been substantive observation that the Knowledge Exchange Centre and the Partners initiatives have not been implemented satisfactorily. It is important that these two initiatives receive focused attention that ensures they develop to the same standard.

An important finding from this evaluation is that there is real interest among stakeholders for


knowledge and

translating this

knowledge into

action

. . . MHCC products/services; capitalize on this energy by nurturing “pull” for MHCC results. This will balance the current emphasis on “push.”

Building an

effective

organization

. . . Ongoing efforts to make the

commission’s structure work

efficiently and effectively continue to

be critical to success.

Concerning the Advisory Committees, it is traditional for these kinds of committees to report directly to the CEO. Suggest that the MHCC review evidence based models for Advisory Committees used by other national organizations. If ACs will not report to the CEO, it is recommended that the ACs’ terms of reference identify the differences. This would assist with mitigating perceived reporting and access to decision-makers issues that emerged in the lines of evidence.

Consider implementing processes that allow for open participation in decision-making at the MHCC and a simplification of internal processes and the organizational structure, to mitigate the perceived increase in both hierarchy and bureaucracy. Additionally, develop processes that will assist staff with understanding how their work contributes to the MHCC.

Address concerns that the boundaries between the board and the staff are too close and that the board is too involved in the day-to-day operations of the Commission.

Concerning the goal of building a model workplace:

Fully assess staff skill sets and fully utilize their skills in their work with the MHCC;

Provide opportunities for collaboration and encourage cross-cutting discussions to mitigate the perception that staff work in “silos;”

Undertake processes that will increase perceived organizational stability;

Build the capacity of the Committee of Champions;

Facilitate the annual staff workplace satisfaction survey; and,

Build organizational capacity to work with people with lived experience who are employed by the MHCC or volunteer for the Commission, in alignment with the values of a “recovery orientation.”