The British Columbia Mental Health and Substance Use Services (BCMHSUS) Patient and Family Engagement Framework is a practical decision tool designed to assist health care staff, physicians and researchers in the process of engagement with patients and families. Based on decades of evidence and international best practices, the framework outlines: How patient and family engagement is defined at BCMHSUS, and the importance of meaningful engagement; The Spectrum of Engagement; Practical steps for meaningful engagement; and, Practical steps for meaningful engagement.