Taking stock of the 2017–2027 federal mental health transfer

Key points •The 2017-2027 federal mental health transfer of $5 billion and associated investments in system infrastructure achieved mixed success in several domains.• Transparency and accountability improved through the publication of detailed bilateral agreements with provinces and territories and shared indicators.• However, expenditure tracking and outcome measurement remain limited.• Nevertheless, the transfer appears to have spurred investments and innovations that would otherwise have been unlikely to occur on the same scale.• A renewed dedicated transfer, supported by expanded investments in system infrastructure, is warranted to build on the momentum of the past decade and bring mental health and substance use health care closer to parity with other parts of the health sector.