Quality Mental Health Framework shows employers a new path

As mental health continues to dominate workplace safety conversations, a national framework originally designed for health-care settings is emerging as a practical reference point for employers across sectors.

The Quality Mental Health Care Framework, revised in 2025 by the Mental Health Commission of Canada and HealthCareCAN, is based on nearly 100 interviews with people with lived and living experience, health-care organizations and partner groups, as well as national and international frameworks. Key experts such as family members, caregivers, care providers, policy makers and senior leaders also helped shape it.

Quality framework links clinical mental health care and psychologically safer workplaces

Annie Barrette, vice-president external affairs at HealthCareCAN, calls it “a practical guide to what good mental health care should look and feel like for patients, so that the experience is more consistent, respectful, and effective no matter where you seek help.” The framework is overseen by the Quality Mental Health Care Network, co-led by HealthCareCAN and the Mental Health Commission of Canada.

Barrette says the goal is “really straightforward: improve access to high‑quality, stigma‑reducing, recovery‑oriented mental health care, while also supporting the psychological health and safety of the people who actually deliver the care within our clinical environments, whether that's clinics, hospitals or doctors’ offices.”

The revised framework is built around eight dimensions of quality: equitable, integrated, appropriate, stigma‑free and inclusive, recovery‑oriented, trauma‑informed, evidence‑based and a positive work‑life environment. Equitable care, for example, is defined as service that recognizes systemic inequities and barriers and ensures needs are met regardless of factors such as age, location, financial status, racial or cultural background, disability, gender identity or sexual orientation. A positive work‑life environment is described as care delivered by providers and staff who feel psychologically safe and supported in their workplace.

Doorways as a test case

To illustrate how the framework can be applied, the Quality Mental Health Care Network has highlighted several case studies, including Newfoundland and Labrador’s Doorways program. The initiative offers rapid access, single‑session counselling for mental health and substance use issues across the province.

“Newfoundland Health Services Doorways Program is a rapid access single session counseling service for mental health and substance use,” Barrette explains. “One of the biggest challenges in providing quality mental health care is the rising demand and worsening outcomes since the pandemic. We’re seeing persistent access barriers, including long waits, stigma, racism and discrimination, as well as gaps in service, especially in rural and underserved regions.”

Doorways is designed as a “low barrier by design program” that removes common bottlenecks and allows people to access help the same day through walk‑in visits, on‑site appointments or virtual sessions. “It’s this one stop…shop essentially for people to come in…and they get to see someone that day,” Barrette says. Where more sustained support is needed, “the team will then be able to put them in touch with other services or programs for longer‑term support.”

By 2024, Doorways had expanded to more than 87 sites, including 53 outpatient clinics and 30 school‑based services, reaching nearly 18,000 people across the province. For the Quality Mental Health Care Network, this type of scalable, province‑wide program demonstrates how the framework’s dimensions—particularly accessibility, integration and low‑barrier design—can be translated into practice.

From health systems to workplaces

To support practical implementation of the framework, the Mental Health Commission of Canada has developed a Quality Mental Health Care Framework Implementation Toolkit. The resource is intended for health‑care providers, people with lived and living experience, administrators, policy advisors and decision makers, helping them embed the framework’s dimensions into their own settings.

The toolkit is structured around implementation science, outlining phased steps such as engaging stakeholders, planning changes, implementing practices and then sustaining and scaling them over time. It offers examples, reflection questions and case studies for each of the eight dimensions, with a strong emphasis on meaningful engagement of people with lived and living experience throughout program design and evaluation.

While it was built for health-care organizations, Barrette says the underlying values are relevant to workplace health and safety programs in other sectors. “I think the tools are available to them,” she says of employers and safety professionals. “Visit the Mental Health Commission’s website, access those tools and resources. And consider some of the values that are within those programs and how they can be incorporated in a workplace health and safety [program].”

For health and safety leaders, those values translate into several practical questions: Are supports equitable across job types and locations? Are services coordinated, or do workers get bounced between providers? Are programs explicitly trauma‑informed and stigma‑free? And are providers of support—such as supervisors, peer champions or internal clinicians—working in a psychologically safe environment themselves?

The framework’s emphasis on evidence‑based practice and ongoing evaluation may also resonate with organizations already tracking leading and lagging mental health indicators. The toolkit encourages users to identify barriers and enablers, monitor outcomes and adapt initiatives over time, rather than treating mental health campaigns as one‑off efforts.

Barrette notes that the network behind the framework includes nurses, physicians and clinicians who see firsthand where systems fall short and can inform policy and practice improvements. “Their own lived experience on providing care allows us to put them in touch as subject matter experts to different levels of government to make recommendations on improving the system,” she says.

For employers, the Quality Mental Health Care Framework and its implementation toolkit do not offer a ready‑made workplace program. Instead, they provide a structured lens to examine existing policies, benefits and supports—and to align them more closely with a person‑centred, equitable and psychologically safe approach to mental health.

This article is part of our Monthly Spotlight series, which in February focuses on Psychological Safety & Mental Health.