In the summer of 2018, Mayor Naheed Nenshi of Calgary, Canada, decided to make mental health and addiction the cornerstone of his third term. Like many cities in North America, Calgary was experiencing a mental health crisis. The stigmas surrounding mental illness made people reluctant to access help, and addiction was a serious and growing problem. Opioids were wreaking havoc, and the city was averaging three to five overdose deaths per week.

Mayor Nenshi did not have formal authority over the health-care system, but he did have the power to convene public, for-profit, and nonprofit actors. Coordinating these entities, however, to work together across boundaries—spanning departments, organizations, and even sectors—to produce a lasting solution would take a lot of time and effort. He had to find a way to initiate and accelerate a complex collaboration to save lives.

The mayor appointed his community relations coordinator, Nancy Close, to head a team to create a comprehensive, person-centered strategy on mental health and addictions in Calgary. To ensure a range of perspectives, the mayor and Close invited representatives from United Way of Calgary and Area, Calgary Homeless Foundation, the provincial Alberta Health Services, the police department, and Calgary Neighborhoods—the city’s business unit tasked with addressing social needs. They also invited a community advocate who had shared the story of her late husband’s struggles with mental illness and addiction in an effort to raise awareness and improve outcomes for people in similar situations.

Because efforts were fragmented, members struggled to determine whether the patchwork of organizations and their combined portfolio of services had the appropriate scale and scope to reduce opioid deaths and address the systemic issues related to mental health and addiction. They also faced difficulty in determining what types of interventions were most helpful to the individuals most at risk. Furthermore, the team suspected that the services were not sufficiently integrated, so the interventions were not as effective as they could be. The Calgary team wondered how they could begin to solve the problems of addiction and mental illness in their community if they weren’t able to solve their own problems in working together. To successfully design an action plan for Calgary that would rise to the challenge Mayor Nenshi had set, they needed to become a more productive team and overcome the barriers to engaging in constructive collaboration.

Building collaborative capacity requires repeated practice, constant care, and iterative evaluation of progress and goals. Like fitness, it requires dedicated time to warm up and cool down, and equipment that helps stretch the right muscle groups. The Calgary team established biweekly meetings, beginning in February 2019, to work on the barriers they had identified. The team also decided to open the conversation to include more stakeholders. They created a forum to share their definition of the problem, vet their proposed course of action, and gather feedback from public officials and community leaders. This approach helped them to sharpen their public value proposition, identify barriers, and build support at the same time. In the months that followed, they decided to focus on continuing to build the best coalition that could develop a community-wide strategy. In May 2019, the coalition launched a community listening project to understand and identify gaps in social services, and they convened more than 80 philanthropists to identify ways to work together.

Having strengthened the coalition and articulated their collaborative solution, they secured support and resources to turn ideas into action. In 2019, the city council approved CA$3 million (US$2.4 million) for projects designed to promote mental health and prevent addiction through early and/or targeted interventions. In addition, the council approved CA$1 million (US$787,000) for fast-pilot projects to find new solutions to mental health and addiction challenges. Different community organizations added CA$275,000 (US$217,000) to this effort, which allowed funding for 31 projects in two rounds during 2020. These ventures included mental health tool kits for youth, interpreters for immigrant families to support emotional wellness, stigma-reduction campaigns through peer workers, and a community-wellness desk at the Calgary Public Library.

Through this process, the team grew stronger and their understanding of the problem and of what worked (and what didn’t) deepened. The lessons from the pilots became the foundation for the Community Action on Mental Health and Addiction strategy, a comprehensive policy agenda with deep integration of social services, which comprises the city of Calgary, together with the community organizations. The team will present to the city council in 2021.

Read the full article about cross-organizational collaboration by Jorrit De Jong, Amy Edmondson, Mark Moore, Hannah Riley Bowles, Jan Rivkin, Eva Flavia Martínez Orbegozo, and Santiago Pulido-Gomez at Stanford Social Innovation Review.