Engagement in mental health services : stakeholder attitudes towards a local governance initiative

Abstract

Stakeholder participation is an emerging governance approach within health care. Despite a literature on the theoretical potential of participatory, stakeholder-based governance in health care, less is known about the process variables associated with effective implementation and sustainability. The viability of participation is associated with: clarity of mandate; scope of stakeholder decision making; roles and responsibilities of participants; participant skill and attribute mix; and accountability requirements. This exploratory, qualitative study utilized 20 semi-structured interviews with mental health services stakeholders regarding their expectations of a proposed mental health Community Advisory Committee (CAC's) within the Fredericton-area of the Province of New Brunswick. Findings reveal convergence around four process variables; meaningfulness; trust; legitimacy; and effectiveness. Participants diverged on outcome expectations; some preferring instrumental outcomes (i.e. housing); and others viewing establishment of a well-functioning engagement process as a key outcome in itself. Managerial implications and future research directions are discussed.