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Reading: Mental health network governance and coordination: comparative analysis across Canadian regions


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Research & theory

Mental health network governance and coordination: comparative analysis across Canadian regions


Mary E. Wiktorowicz ,

York Univeristy, CA
About Mary

Mary Wiktorowicz is Chair and Associate Professor in the School of Health Policy and Management at York University.  Professor Wiktorowicz adopts a comparative lens to study models of health system governance, focusing on mental health policy and pharmaceutical policy. A recent study assessed the governance models used by ten local health networks to coordinate mental health care.  In her comparative policy research she also analyses international  pharmaceutical regulatory policy and develops frameworks to enhance our understanding of them. Her recent work compares international postmarketing pharmaco-surveillance strategies, and the decision frameworks that guide them.

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Marie-Josée Fleury,

About Marie-Josée

Professeur Adjoint, Département de Psychiatrie, Université McGill, 845 Sherbrooke St. W. Montreal, Quebec H3A 2T5, Canada

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Carol E. Adair,

About Carol

Adjunct Associate Professor, Department of Psychiatry and Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada

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Alain Lesage,

About Alain

Professor, Department of Psychiatry, Université de Montréal, Associate scientific director, Fernand-Seguin Research Center, L-H Lafontaine Hospital, Montréal, Québec H1N 3M5, Canada

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Elliot Goldner,

About Elliot

Professor, Faculty of Health Sciences, Simon Fraser University, Vancouver campus, HC 2400 515 West Hastings Street, Vancouver, BC V6B 5K3, Canada

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Suzanne Peters

About Suzanne

Doctoral Candidate, Department of Sociology, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3, Canada

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Objective: Modes of governance were compared in ten local mental health networks in diverse contexts (rural/urban and regionalized/non-regionalized) to clarify the governance processes that foster inter-organizational collaboration and the conditions that support them.

Methods: Case studies of ten local mental health networks were developed using qualitative methods of document review, semi-structured interviews and focus groups that incorporated provincial policy, network and organizational levels of analysis.

Results: Mental health networks adopted either a corporate structure, mutual adjustment or an alliance governance model. A corporate structure supported by regionalization offered the most direct means for local governance to attain inter-organizational collaboration. The likelihood that networks with an alliance model developed coordination processes depended on the presence of the following conditions: a moderate number of organizations, goal consensus and trust among the organizations, and network-level competencies. In the small and mid-sized urban networks where these conditions were met their alliance realized the inter-organizational collaboration sought. In the large urban and rural networks where these conditions were not met, externally brokered forms of network governance were required to support alliance based models.

Discussion: In metropolitan and rural networks with such shared forms of network governance as an alliance or voluntary mutual adjustment, external mediation by a regional or provincial authority was an important lever to foster inter-organizational collaboration.

How to Cite: Wiktorowicz ME, Fleury M-J, Adair CE, Lesage A, Goldner E, Peters S. Mental health network governance and coordination: comparative analysis across Canadian regions. International Journal of Integrated Care. 2010;10(4):None. DOI:
Published on 25 Oct 2010.
Peer Reviewed


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