1. What is a "system"? What do you mean by "improving systems"?

Systems are often defined in many ways. PSSP thinks about systems as interconnected groups of stakeholders that all have a role to play in supporting the best health outcomes for individuals with mental health and/or addiction issues.

By “improving systems” we mean working with a variety of stakeholders and partners to identify where the system is not meeting the needs of clients and families, and using a collaborative approach to fixing it. Fixing the system is often complex and challenging; it can mean using evidence, experiences, scientific models, and multi-disciplinary expertise to try and find the best way to address a problem or need, or to improve current practices. 

2. What is Implementation Science and what does it mean to create changes in the system?

Research shows that there's an estimated 17-year gap between the creation of health evidence and its use. Only 14 percent of all research evidence is actually incorporated into day-to-day practice.

Implementation Science supports the integration of research findings into healthcare policy and practice, with the goal of producing optimal health outcomes.

Implementation Science is a structured approach to putting in place a new practice or behaviour. It’s a non-linear process that involves: identifying a change that needs to happen, figuring out how to make the change happen, trying out the new change and improving the change so it works within the context it is being applied in.

Implementation bridges the gap between what is a known service gap and what is done to remedy or improve it. Implementing something means working collaboratively with many stakeholders and partners to create a change in the way we currently work, in a way that is purposeful, well-defined, and sustained. 

Learn more about the Implementation Science framework that we use in our work.

3. Is Implementation Science different from knowledge exchange or quality improvement? 

Implementation Science, knowledge exchange, and quality improvement are all tools and models that help us to systematically  apply needed changes to a system. While they can work together to help guide the process,  each approach brings a unique lens and can operate independently of the others.

• Implementation Science is a structured approach to putting in place a new practice or behaviour. It’s a non-linear process that involves: identifying a change that needs to happen, figuring out how to make the change happen, trying out the new change and improving the change so it works within the context it is being applied in.
• Knowledge exchange is a dynamic process that connects knowledge creators (like researchers, but also persons with lived experience, service providers, and others) with those who need knowledge (like policymakers, system planners and many others). Knowledge exchange helps ensure that those implementing changes get the evidence they need, in an accessible form, to inform their decisions.   
• Quality Improvement is a structured approach that allows us to determine how a process has been working and make specific steps to improve it.

4. You use the work "evidence" a lot. What do you mean by that?

Evidence is more than just traditional research found in academic journals. Our definition of evidence includes other forms of knowledge, like practice-based knowledge, the knowledge of persons with lived experience (including personal experience of individuals, their family members, and those with cultural and traditional knowledge).

5. You also talk about "interventions." What are interventions and what types do you implement?

PSSP aims to support the system through evidence-based implementation frameworks and models. We draw from a variety of implementation tools and approaches to best support the community in their needs to move through a large-scale system change. To learn more about our implementation approach please visit the How we work section of our website.

6. Wait, didn’t this website used to focus on Systems Improvement through Service Collaboratives? What happened to that initiative?

The System Improvement through Service Collaboratives initiative is still ongoing in communities across the province. Through the implementation of the initial 18 Service Collaboratives, we learned a lot about large-scale system change. To continue responding to system needs in communities, we have evolved our focus on Service Collaboratives to include other implementation approaches and projects. To ensure that we are continuously innovative and apply our most informed implementation approaches, we have created a website that more accurately describes all of our work.

Learn more about what Service Collaboratives do.

7. I thought CAMH was only in Toronto. You have offices in other regions? 

The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital, as well as one of the world's leading research centres in its field.

CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues.

The Provincial System Support Program (PSSP) has a provincial office in Toronto with nine regional offices throughout Ontario to provide support to the mental health system and addictions system.

See all of our locations across Ontario.

8. My community wants to improve the way mental health and addiction systems and services work. Can PSSP help us?

PSSP provides a variety of system supports and much of the implementation work we do with communities aligns with guiding provincial strategies outlined in the Open Minds, Healthy Minds – Ontario’s Comprehensive Mental Health and Addictions Strategy.

We would like to hear about important areas of focus for stakeholders across the province and in your community. Please connect with us!

9. How do you involve persons with lived experience and families in this work?

We have many different avenues for valuing lived experience as a source of evidence and expertise in our mandate to improve the mental health and addiction system.

Our work engages persons with lived experience and families in advisory structures, consultations and co-design interventions.

We also have a “Persons with Lived Experience and Family Members Advisory Panel” co-chaired by expert family member, Betty-Lou Kristy. This advisory panel translates mental health and addiction information into accessible and user-friendly public knowledge. Everything is shared through the Evidence Exchange Network (EENET), an online participatory network for interdisciplinary experts (persons with lived experience, family members, scholars, and service providers).

“Strengthening Your Voice” prepares people with personal of family lived experience of opioid misuse to share their stories publicly. It also encourages people with problems related to opioid prescriptions to get help, and reinforces the hope for everyone.

To make lived experience a part of our organizational culture, we are currently undergoing a consultation process to explore the most effective structures and mechanisms for integrating lived experience as evidence and expertise.  

10. You talk a lot about “health equity.” What does that mean?

Did you know that low income Canadians report significantly poorer mental health? This is just one example among many health inequities. Factors such as income, racialization (a visible minority), migration, gender, sexual orientation, and physical challenges influence our access to health care, the quality of services received, and our overall health.

Taking a health equity approach means striving to attain the highest level of health for all people. PSSP takes health inequities into account and works to minimize their impact on groups who experience marginalization.

11. I have a question or a thought to share. How can I connect with PSSP?

Check out our Contact Us page to connect with us by email or phone and to see our locations across the province.