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IntroductionAs mental health challenges rise globally, arts engagement offers an evidence-based strategy for promotion and treatment. However, cross-sectoral US policy efforts at this intersection remain limited and largely top-down.MethodsThis study employed constructivist grounded theory to explore conceptions of arts in mental health advocacy among stakeholders actively engaged in cross-sectoral practice - artists, public health practitioners, and municipal leaders. Semi-structured interviews were held with 44 participants that represented each of the three primary sectors and spanned work across national and local initiatives.ResultsThe data yielded five theoretical categories: Knowledge Needs, Skill and Tool Needs, Policy Needs, Considerations for Advocacy Engagement, and Strategies for Advocacy. These categories informed the development of the IMPACT Theory, a grounded theory that outlines pathways for mobilizing equitable and effective advocacy. Findings emphasize the need for increased stakeholder preparedness, public awareness, and policy mechanisms that support funding, access, and cross-sectoral integration.ConclusionTo develop actionable and informed advocacy, efforts should increase advocacy preparedness for invested stakeholders, prioritize the time and energy of advocates, and work to improve public awareness about arts and health. This theory offers a framework for advancing arts in mental health policy and may inform broader interdisciplinary advocacy efforts.