The Canadian health care system has been frequently discussed but firmly rejected as a model for guiding the transformation of American medicine. In mental health care, however, one can find a growing convergence between the two systems. This convergence is largely coming about as a result of Canadian borrowing from American programs and strategies. In this paper we provide examples of planning service, and policy elements in U.S. mental health care that Canadians have drawn upon. We analyze this phenomenon in terms of cross-national policy learning, identifying the factors and forces that facilitate this trend for Canada while impeding it for the United States.