What Transformation? A Qualitative Study of Empowering Settings and Community Mental Health Organizations

Abstract

This article is based on empowering settings research and has a twofold objective: to propose an adaptation of the empowering community settings framework to community mental health organizations practice to foster recovery and community integration; and to discuss how the adapted framework is a relevant tool to challenge community mental health transformation at multiple levels of analysis. The current study was anchored in a larger qualitative research project. It used a case study approach, with 8 in-depth interviews with diverse participants from one community mental health organization. The adapted model proved useful to guide transformational practice in community mental health programs and for evaluation of organizational empowerment and multilevel community-oriented interventions. Suggestions and implications for future research are also presented.

Adaptation of Nussbaum's Capabilities Framework to Community Mental Health: A Consumer‐Based Capabilities Measure

“…The principal component analysis of Study 2 also emphasized the dimension of consumers’ activism and political control, with content about specific opportunities for influence within both organizations and the mental health system. The importance of an opportunity role structure was identified as a crucial organizational feature of empowering settings in recent national studies; individuals need to access and participate at diverse capacity‐building opportunities (Jorge‐Monteiro et al., ). Therefore, promoting consumer involvement in valued formal roles for policy and governance, such as membership on an organization's board of directors, is strongly recommended.…”

“…As in the capabilities approach, the empowerment account stresses the role of context: Relational environments are an opportunity to grow and learn via mutual influences and community alliances (Christens, ); the setting itself may be a resource for empowerment. Both empowerment and capability theories help community psychologists to identify setting features that promote individual potential (Shinn, ) and foster empowerment (Jorge‐Monteiro, Aguiar, Sacchetto, Vargas‐Moniz & Ornelas, ; Maton, ).…”

“…However, recent national studies affirm that part of the community mental health programs still follow institutional approaches and standard interventions, maintaining the segregation and social exclusion of people with mental health problems, and hindering valued social roles (Jorge‐Monteiro et al., ). Some organizations were recently categorized as having a low‐recovery orientation, focusing on group services (such as group homes and a common daily program), while others were identified as having a high‐recovery orientation, providing effective programs for social integration (as independent housing and supported employment; Jorge‐Monteiro & Ornelas, ).…”

Empowering Features and Outcomes of Homeless Interventions: A Systematic Review and Narrative Synthesis

“…Indeed, Zimmerman (1990b) and Rappaport (1987) have called for community psychologists to extend their study of empowerment past that of natural community settings to settings that are reliant on professional expertise, and where empowering processes may be constrained. An alternative theory from the field of mental health, developed by Fitzsimons and Fuller (2002), is suitable for extending existing evidence (e.g., Gaboardi et al, 2019;Jorge-Monteiro et al, 2014) to include a wider variety of settings, such as those not founded on empowerment principles, and to include the perspectives of nonmembers of organizations, such as homeless services recipients. Fitzsimons and Fuller (2002) described empowering mental health settings as: (a) competency-building, (b) collaborative, (c) flexible, individualized, and strengths-based, and as (d) promoting and developing support.…”

Properties of the Portuguese version of the empowerment scale with mental health organization users

“…The empowerment concept is a relevant principle to respond to transformative changes in the mental health system [ 26 , 27 ] with implications for both individual and community quality of life [ 17 ]. Based on empirical evidence, community mental health organizations (CMHO) may operate as mediating resources to foster individuals’ empowerment [ 28 – 30 ]. Therefore, the adaptation of the ES to the Portuguese context and language is of relevance in the context of current reform and policy change towards an empowerment and recovery-oriented mental health system.…”