The objective of this study was to explore the meaning of recovery from the perspectives of consumers receiving mental health services in Canada. Methods: Sixty semi-structured interviews were conducted with 54 mental health consumers in Montreal, Québec City and Waterloo-Guelph, Ontario. Results: Two contrasting meanings of recovery emerged. The first definition strongly attached recovery to illness while the second definition linked recovery to self-determination and taking responsibility for life. Conclusions: The prominence of biomedical definitions of recovery suggests the need to find common ground between these two perspectives, if conceptualizations of recovery are to include the views of consumers who routinely experience the mental health system.
Background-Recovery is emerging as a worldwide paradigm in mental health. There is increasing recognition that the transformation of mental health systems to a recovery perspective requires collaboration among all stakeholders. Research to date has focused on the perspectives of service users and providers. The role and influence of organizational decision makers in the transformation process has been less studied.
Purpose The purpose of the present study was to advance a theoretical understanding of the mechanisms by which WISEs can influence the stigma associated with mental illness. Many people with serious mental illnesses want to work, but despite much attention to work entry strategies, unemployment rates remain exceptionally high among this population. Stigma has been identified as a particularly pernicious barrier to the full community participation of people with mental illnesses. If work integration social enterprises (WISE) are to positively impact the full community participation of people with mental illnesses, then addressing stigma will be integral to their operation. Design/methodology/approach A comparative case study approach was used to address the following research questions: “How is the stigma of mental illness experienced in the everyday operations of WISE?” and “What influence do WISEs have on the stigma of mental illness within the workplace and beyond?” Five established WISEs that pay workers at minimum wage or better were selected for inclusion. The maximum variation sample included WISEs that varied in terms of geographical location, form of commerce, business size, revenues and degree of connection with mental health systems and local communities. Data analysis was conducted in four stages using qualitative methods. Findings The study findings suggest processes by which WISEs can positively impact the stigma of mental illness. Three social processes are associated with the potential of WISE to contribute to stigma reduction: perception of legitimacy, perception of value and perception of competence. Each of these social processes is fueled by underlying tensions in practice that arise in the context of negotiating the dual goals of the business. Research limitations/implications This study advances theoretical understanding of the ways in which stigma may be perpetuated or reduced in WISE by revealing the social processes and practice tensions that may be associated with operation choices made by WISEs and their partners. Further research would be required to determine if the processes described actually lead to reduced stigma. Although efforts were made to select WISEs that demonstrate a variety of features, it is likely that some important features were absent. Additional research could further explore the findings identified here with WISEs from other sectors, including youth and workers with transient or less severe forms of illness. This work should be replicated internationally to explore how contextual factors may influence individual and public perceptions. Practical implications The findings provide guidance for WISE developers in the mental health sector concerning strategies that may help mitigate the development of stigmatizing features within a social enterprise and by extension improve the work experience and workforce integration of employees. The identification of these processes and tensions can be used to advance the development of consensus principles and standards in the WISE field and contribute to ongoing evaluation and research. Social implications WISEs have the potential to reduce stigma, an important goal to support their efforts to improve employment and integration outcomes for people with mental illnesses. Through their business structures and operations they may be able to impact stigma by positively influencing perceptions of legitimacy, value and competence – all issues that have been associated with public assumptions about mental illness that sustain stigma. Originality/value To the best of the authors’ knowledge, this study is one of the first to specifically focus on stigma in the WISE sector, particularly as it relates to the work integration of persons with mental illnesses. The findings provide a range of theoretical and practical implications for future development in the field and highlight factors that merit consideration more broadly in the sector.
This study used photo-elicitation methodology to explore how the move from supervised to supported housing affects recovery and community connections for individuals living with serious mental illness (SMI) in four Canadian cities. Qualitative interviews conducted in 2015 revealed five themes: (1) the characteristics distinguishing home from housing; (2) the importance of amenities offered by supported housing; (3) the connections between accessibility, mobility, and wellbeing; (4) the role of certain places in facilitating aspects of recovery such as offering hope or facilitating social connectedness; and (5) the concrete and metaphorical impact of changing vantage points on identity (re)construction. Utilizing therapeutic landscapes as an analytical framework, and combining insights from the health geography, and mental health (MH) housing and recovery literatures, this study deepens current understanding of how everyday places-conceptualized as therapeutic landscapes-directly and indirectly support MH recovery for individuals with SMI. Implications for research on housing, and on the spatial aspects of recovery processes are discussed.
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