We draw out lessons from a multi-level governance system implemented to create more consumer oversight and involvement in the governance of behavioural health services. Through two rounds of interviews, we identified key areas of design that were difficult to implement, resulting in the system continuing to operate as a top-down environment rather than a flatter arrangement. Although new governance structures can be implemented, the underlying culture of government has to shift to allow real buy-in. Until this happens, multi-level governance systems will remain single-layered and command and control systems. The patina of change will cause frustration and animosity among participants.
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