Ingrid McKhool, Early Childhood Studies (MA) ‘11.

FCS Dean’s Graduate Essay Award Recipient, 2010-11:
“Implementation of Ontario’s Policy Framework for Child and
Youth Mental Health: Leadership and System Change Themes
in Cross-Ministry and Cross-Sector Collaboration.”

Summary of Paper:
It is estimated that 15-21% of children and youth have a mental health issue (Waddell, McEwan, Peters, Hua & Garland, 2007). Ontario’s current children’s mental health service system reflects 30 years of growth largely driven by community decision-making, with little provincial direction. Despite the prevalence of problems, services are not mandatory under the Child and Family Services Act, and are provided to the level of available provincial resources.

In 2006, the Ministry of Children and Youth Services (MCYS) released A Shared Responsibility: Ontario’s Policy Framework for Child and Youth Mental Health (Framework). The Framework calls for all child-serving groups and sectors to work together to support a “sector that is coordinated, collaborative and integrated at all community and government levels, creating a culture of shared responsibility” (MCYS, 2006, p.i). While this priority may seem obvious, there are systemic challenges for ministries and their funded organizations (community-based agencies, school boards, hospitals) to work jointly on issues that cross ministry mandates.

This qualitative study investigated leadership perspectives on the transformational change process over the last decade involving the provincial development, implementation and sustainability of the Framework. The author conducted a semi-structured interview with Dr. Bruce Ferguson, Director, Community Health Systems Group (CHSRG), Hospital for Sick Children (Dr. Ferguson has given permission to use his name) to better understand the change process from the perspective of a key sector champion and learn about his perceptions of leadership, his sense of personal and professional accomplishment, and the challenges still to come.

Five key themes emerged:

1. The change process is complex, time-consuming and dynamic;

2. Change requires a combination of top-down and bottom-up pressure;

3. Relationships are key at all levels;

4. Building capacity is at the heart of sustainable change; and

5. Educational change will not be sustainable without a transformational societal change.

Through a thematic analysis approach, these themes were related to current literature on educational leadership and system transformation (e.g. Fullan, 2007; Hall & Hord, 2006; Hargreaves, 2003; Heifetz, Grashow & Linsky, 2009).

While this study was limited to the perceptions of one key informant, there are valuable insights to be derived from a first-hand account of the change process by a community leader who has experienced and influenced its evolution over several years. Clearly, the implementation of system reform is a complex undertaking that requires a deep understanding of research and evidence, a planned and disciplined approach, consideration of perspectives across levels of government and stakeholders, and respectful attention to mechanisms that can help to create the conditions – systemic, cross-sectoral, and at the societal/personal level for all child-serving professionals - to effect fundamental changes in practice and build shared moral purpose over time.