With them, not for them: Putting lived expertise centre stage

By Dr. Joanne Bezzubetz

At The Royal, we’re re-imagining our role and how we deliver care … a future where the clients and families who have lived expertise can move in lock-step with us to co-create the future of care, research and education.

By working shoulder to shoulder with clients and families, we know we are carving a path towards a brighter and meaningful future. And, new research into this shift in mentality, philosophy and approach, where we build partnerships with clients and families, shows that when we meaningfully engage clients and families in the provision of care, we see higher engagement, better outcomes and high-quality care experiences at all levels.


At The Royal’s Research Institute, lived expertise already drives research. Clients, families and peers work alongside scientists in a collaborative process that is opening up new possibilities when it comes to understanding the brain and paving the way for cutting-edge research into novel treatments for people with mental health and addiction issues.

Like every other health care institution, The Royal undertakes a strategic plan every five years. This plan acts as a roadmap: where do we want to go and how do we get there?

As The Royal’s new CEO, I wanted to reimagine The Royal of the future. But I knew that we couldn’t, and shouldn’t, design our future alone. We need the insights of clients, families, staff, partners and the wider community in order to build the organization that we need to be. We need their lessons and insights if we are to aspire to a recovery model of care.

The lessons and insights that come from their journey of recovery is vital to the delivery of modern mental health care. This change from traditional top-down care models to having clients as active members of their own care teams and families as crucial partners in the care of their loved ones is turning the tide in mental health.

And so, what began as a typical strategic planning exercise quickly evolved into a mission to transform and co-create mental health care with clients and families as partners. Their voices have helped to shape our new strategic plan, entitled Co-creating Access, Hope and New Possibilities. This new plan embodies the principle and value of lived expertise. In so doing, it highlights The Royal’s position of the need to elevate the voices of clients and families; to give them credence as integral and valuable members of the care team.

The Royal is a leading academic health science centre in Ontario. As such, we embrace the opportunity to co-create the design, planning, delivery and evaluation of care with clients and families. Doing so goes far beyond the necessity of measuring and tracking our clinical performance and outcomes using quality indicators, which are standardized, evidence-based measures of health care quality. Working in partnership and collaboratively with clients and families will help us provide evidenced-based treatments that enable the very clients we serve to live their best lives.

As we look to improve our organization and the mental health and addictions system, the expertise of clients and families is what will help drive innovation and success … to co-create the future of care, research and education at The Royal.

At the launch of our strategy, Glenda O’Hara, chair of The Royal’s Client Advisory Council, shared that “as a client with lived expertise, my experience in the development of the strategy with staff, the senior leadership team, Board members and community partners made me feel heard and hopeful for the future of mental health and addictions services in our community. I can already see a culture change that is happening from the top down in the codesign of initiatives and inclusion of clients in everything that is [being] undertaken.”

Ms. O’Hara also opened our minds to the value and importance in embracing lived expertise in our new strategy. Her quote from Maya Angelou best captures the essence of The Royal’s visionary new strategic plan: “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

Working shoulder to shoulder with clients and families, we know we are on the path towards a brighter and meaningful future. By putting lived expertise centre stage, The Royal is becoming a hospital without walls — a hospital where mental health care is delivered where people need them the most, close to home.

Dr. Joanne Bezzubetz is the President & CEO, The Royal.