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This article reports on the findings of a 10-month study designed to collaboratively explore the impact of the arrival of Syrian refugee newcomers in 2015-2016 on the way local communities support newcomers. Waterloo Region, a mid-size urban centre in Ontario, Canada, was the focus of study. The study used a mixed-method design involving four methods (document review, key informant interviews, organisational survey focus groups). Findings are presented following a systems change analytical framework that included (1) an emerging vision for local refugee support in the Waterloo Region, (2) the adaptation of local structures, (3) the emergence of collaborative processes and (4) an overall assessment of impact. Three main lessons are discussed. The first lesson demonstrates how local systems change is negotiated within a broader migration landscape (contextualizing local systems change). The second lesson acknowledges that a community's historical migration response can be a springboard for local change (initiating local systems change). The third lesson suggests that expanding and coordinating community engagement in the refugee support system is integral for lasting change (sustaining local systems change). Combined, these lessons provide a comprehensive analysis into how local communities can be adaptive in supporting refugee newcomers.
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Research studies are increasingly complex: They draw on multiple methods to gather data, generate both qualitative and quantitative data, and frequently represent the perspectives of more than one stakeholder. The teams that generate them are increasingly multidisciplinary. A commitment to engaging community members in the research process often adds a further layer of complexity. How to approach a synthesizing analysis of these multiple and varied data sources with a large research team requires considerable reflection and dialogue. In this article, we outline the strategies used by one multidisciplinary team committed to a participatory action research (PAR) approach and engaged in a mixed method program of research to synthesize the findings from four subprojects into a conceptual framework that could guide practice in community mental health organizations. We also summarize factors that hold promise for increasing productivity when managing complex research projects.
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Participación de la Comunidad/métodos , Comunicación Interdisciplinaria , Proyectos de Investigación , Recolección de Datos/métodos , Humanos , Investigación CualitativaRESUMEN
In this article we argue for a community-based approach as a means of promoting a culture of evaluation. We do this by linking two bodies of knowledge - the 70-year theoretical tradition of community-based research and the trans-discipline of program evaluation - that are seldom intersected within the evaluation capacity building literature. We use the three hallmarks of a community-based research approach (community-determined; equitable participation; action and change) as a conceptual lens to reflect on a case example of an evaluation capacity building program led by the Ontario Brian Institute. This program involved two community-based groups (Epilepsy Southwestern Ontarioand the South West Alzheimer Society Alliance) who were supported by evaluators from the Centre for Community Based Research to conduct their own internal evaluation. The article provides an overview of a community-based research approach and its link to evaluation. It then describes the featured evaluation capacity building initiative, including reflections by the participating organizations themselves. We end by discussing lessons learned and their implications for future evaluation capacity building. Our main argument is that organizations that strive towards a community-based approach to evaluation are well placed to build and sustain a culture of evaluation.
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Creación de Capacidad/organización & administración , Redes Comunitarias , Cultura Organizacional , Evaluación de Programas y Proyectos de Salud , Investigación Participativa Basada en la ComunidadRESUMEN
This article presents a framework for understanding the concept of recovery from serious mental illnesses and other life struggles. The framework is based on findings from a longitudinal, qualitative study that involved in-depth interviews with 28 people who experienced serious mental health challenges. The purpose of this article is to clarify the concept of recovery by presenting a grounded theory analysis of the components of recovery. The framework recognizes the experiences of struggle constructed through the words of study participants and captures four main components of recovery: a) a drive to move forward, b) a spiral of positive and negative changes, c) the context of recovery, and d) a dialectical process of ongoing negotiation between self and external circumstances.
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Trastornos Mentales/psicología , Trastornos Mentales/rehabilitación , Recuperación de la Función , Autoimagen , Conducta Social , Humanos , Motivación , Aceptación de la Atención de SaludRESUMEN
In this article we document and reflect on the process and outcomes of consumer/survivor researchers' involvement in a community mental health research project. The study used a participatory action research approach that challenges traditional assumptions of how to conduct research. Research roles and relationships were reexamined by both professional and consumer/survivor researchers. Four values were central to the research process: consumer/survivor empowerment, supportive relationships, learning as an ongoing process, and social justice. The benefits of this value-driven approach were seen in terms of positive impacts on the lives of individual researchers and also in the quality of the research itself. Our reflections on the research process have led us to see the importance of building relationships as a means to share power and knowledge among professional and consumer/survivor researchers.
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Servicios Comunitarios de Salud Mental , Participación de la Comunidad/psicología , Conocimiento , Trastornos Mentales/psicología , Trastornos Mentales/rehabilitación , Poder Psicológico , Adulto , Personal de Salud , Humanos , Sujetos de InvestigaciónRESUMEN
People who have experienced the mental health system were hired and trained as researchers in a community mental health research project. Throughout the course of the project, these consumer researchers reflected on what they learned about their research experience. This article is a window into this learning process and offers an opportunity to see research through the eyes of consumer researchers. We begin by giving an overview of the research project and introducing the research team. Then the consumer researchers in our project share their experiences and insights about involving mental health consumers in research projects. We hope that ourproject's experiences will help other projects that involve consumers in ways that are empowering for the consumer and beneficial to the research.
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Servicios Comunitarios de Salud Mental , Participación de la Comunidad/psicología , Trastornos Mentales/rehabilitación , Percepción/fisiología , Sujetos de Investigación/psicología , Adulto , Femenino , Humanos , MasculinoRESUMEN
The purpose of the paper is to reflect on value dilemmas in mental health consumer-run organizations and to discuss implications for research, policy, and practice. We review the roots of consumer-run organizations in the self-help movement and the psychiatric survivor liberation movement, focusing on the distinctive values espoused by consumer-run organizations. We also discuss evidence-based and value-based approaches to mental health policy formulation and mental health reform, noting the particular importance of value-based approaches and the role that consumer-run organizations can play in mental health reform. Based on our experiences conducting a participatory action research study of four mental health consumer-run organizations, we identify and examine several value dilemmas, discuss the lessons that we learned about these value dilemmas, and note their implications for future directions in research, policy, and practice.
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Organizaciones del Consumidor/organización & administración , Trastornos Mentales/rehabilitación , Política Pública , Grupos de Autoayuda/organización & administración , Valores Sociales , Medicina Basada en la Evidencia , Reforma de la Atención de Salud , Investigación sobre Servicios de Salud , Humanos , Estudios Longitudinales , Modelos Organizacionales , Ontario , Formulación de PolíticasRESUMEN
Taking Culture Seriously in Community Mental Health is a community-based participatory action research project in Ontario devoted to developing, pilot testing, and evaluating mental health service models grounded in the concept of "cultural empowerment." To ensure that the knowledge generated in the project is shared and used, the research collaborative places a heavy emphasis on communicating with stakeholder groups. This paper provides an overview of a communications policy designed to facilitate such sharing and use. It describes the development and key features of the policy, focusing on the broad issues of principles, authorship and acknowledgment, and planning and procedures.
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Servicios Comunitarios de Salud Mental , Investigación Participativa Basada en la Comunidad , Comunicación Interdisciplinaria , Relaciones Comunidad-Institución , Competencia Cultural , Humanos , OntarioRESUMEN
Since the 1970s mental health consumer-run organizations have come to offer not only mutual support, but they have also adopted agendas for broader social change. Despite an awareness of the need for system level efforts that create supportive environments for their members, there has been limited research demonstrating how their system level activities can be documented or their impacts evaluated. The purpose of this paper is to feature a method of evaluating systems change activities and impacts. The paper is based on a longitudinal study evaluating four mental health consumer-run organizations in Ontario, Canada. The study tracked system level activities and impacts using both qualitative and quantitative methodologies. The article begins by describing the development and implementation of these methods. Next it offers a critical analysis of the methods used. It concludes by reflecting on three lessons learned about capturing system level activities and impacts of mental health consumer-run organizations.