Global Journal of Community Psychology Practice

Volume 5, No. 1

Published June 15, 2014

Articles

  1. Cover Image

    Greg Townley, John Sylvestre

    Special Issue on Transformative Change in Community Mental Health

    This special issue of the Global Journal of Community Psychology Practice (GJCPP) aims to articulate a vision and provide suggestions for transformative change in community mental health. Certainly, in the contributions we have assembled here we can claim no clear or simple solutions. What we can offer are examples of the range of ideas, actions, and levels of actions that can be considered in the quest for transformed community mental health systems.

  2. Cover Image

    Heather L. Bullock, Fredrik Lindencrona, Gary S. Belkin, Jane Vanderpyl, Nicholas Watters, Kevin Hennessy

    Improving Global Knowledge Exchange for Mental Health Systems Improvement

    Policymakers globally are paying increasing attention to the challenges of providing more accessible and integrated mental health care. For transformative change to take place, thought needs to be given to the structure and form of evidence-informed change strategies at all levels: individual, organizational, community and complex, large systems. Yet few frameworks specifically consider the transfer of evidence-based programs across jurisdictions at regional and national levels; most are focused on local service implementation. This paper examines how a specific analytical model developed to assess and develop Knowledge Exchange (KE) can be applied to regional and national KE initiatives.  It specifically examines the efforts of the International Knowledge Exchange Network for Mental Health (IKEN-MH), and the associated community of interest on change and improvement, to support mental health systems change at these levels. Using a theoretical model, the Promoting Action on Research Implementation in Health Services framework (Kitson, Harvey, & McCormack, 1998, Rycroft-Malone, et al., 2002), we explore systems change efforts according to the constructs of evidence, context and facilitation. By matching some exemplars in the use of KE for mental health best practice against this model, the potential strategies of the IKEN-MH to assist transformational change emerge.

  3. Cover Image

    Allison Pinto

    Integrating Complexity and Infant Mental Health for Comprehensive Community Change

    Efforts emerging throughout the United States and at the federal scale suggest that there is a readiness for new perspectives on mental health and community change. Complexity and infant mental health have been developing as fresh orientations within the fields of systems theory and mental health, respectively. Through Sarasota Community Studio, residents of the Central-Cocoanut neighborhood in Florida are now combining the key principles of complexity and infant mental health and applying them to place-based efforts to develop a new model for transformative change and well-being. This paper highlights features of the current U.S. policy landscape that signal a readiness to address community transformation, identifies key principles of complexity and infant mental health that make these orientations especially relevant to transformation, presents Central-Cocoanut as a community case example of efforts to apply complexity and infant mental health, and begins to explore the implications of a new model for transformation that is emerging at the neighborhood scale.

  4. Cover Image

    Jessica Nalani Lee

    Moving Beyond “Better Safe Than Sorry”: Realizing Community Potential to Transform Approaches to Psychiatric Hospitalization

    This essay is composed of three parts to analyze how the field of community psychology can help transform aspects of psychiatric hospitalization that may inadvertently reify oppressive social constructs. I begin by describing approaches to treatment in psychiatric hospitalization that can unintentionally objectify the consumer/survivor and reinforce a standardized approach to treatment that disallows the empathy needed for an efficacious relationship between a healthcare professional and a consumer/survivor. In the next section, I examine how community psychology commitments are achieved through recovery-oriented care that challenges oppressive social constructs. In the final section, I consider the ways in which the rhetorical concept of agency might be enacted in the context of psychiatric hospitalization to create an environment that advances recovery-oriented care.

  5. Cover Image

    Timothy MacLeod

    The Capabilities Approach, Transformative Measurement, and Housing First

    Transformative change to mental health systems involves transformation in how practices, policies, and research respond to the needs of individuals with psychiatric disabilities. This paper presents Amartya Sen’s capabilities approach as a promising framework for outcome measurement congruent with the aims of transformative change in mental health systems. In this paper, Sen’s capabilities approach is contrasted with therapeutic and citizenship values as well as the Housing First approach to housing. The capabilities approach is examined in detail with regard to outcome measurement. Finally, this paper shows the value added of the capabilities approach to transformative mental health.

  6. Cover Image

    Chante’ D. DeLoach, Sujata Regina Swaroop

    Community Transformation and Collective Healing: Lessons from Pakistan, Brazil, and Zambia

    Community psychology has long sought to be global in its scope and focus, particularly having liberation as a primary and overarching goal of the field. Despite seeking to stand in solidarity with marginalized and disadvantaged persons, the field has been criticized as remaining largely western-centric in its worldview and epistemology. The historic disconnect between systems of mental health –as traditionally defined within a western context – and the experiences of marginalized and indigenous peoples around the world necessitates greater consideration of local methods of healing with greater accessibility, cultural credibility, and sustainability within local communities. In this article, the authors utilize traditional mechanisms of healing in Pakistan, Brazil, and Zambia as case studies to advocate for a community based mental health promotion model that weds: 1) prevention and health promotion; 2) professional allopathic service providers partnering with paraprofessional and traditional health practitioners; and 3) community engagement and political literacy as a transformative and empowering mental health system of care that targets the individual and the community as source and location of intervention and healing. Results are aligned with community psychology goals and intended outcomes and suggest an action-oriented model in which the community serves as actors in and agents of their own collective health and healing.

  7. Cover Image

    Benjamin F. Henwood, Kelly Melekis, Ana Stefancic

    Introducing Housing First in a Rural Service System: A Multistakeholder Perspective

    Housing First (HF) represents a fundamental shift in thinking about how to address chronic homelessness that has taken place during the past two decades. Whether and how the logic of HF fits in rural systems of care has not been previously explored in the research literature. Using a case study approach and thematic analysis of accounts from 20 key stakeholders, this study investigated whether and how the introduction of HF into a small, rural state in the Northeastearn United States affected the dominant institutional logic. The overall account by multiple stakeholders remained largely consistent: The introduction of an outside HF program brought new resources and expertise, which resulted in a previously underserved population being effectively engaged in services. The extent to which the introduction of an outside provider with a specific, well-defined HF philosophy fit within the existing social services system was complicated by existing providers’ limited knowledge about or input during the grant submission that provided funding for the HF program. Numerous social forces and concerns regarding limited resources also influenced stakeholder perceptions. The impact of HF on existing institutional logics was not always clearly identified by stakeholders, yet HF’s emphasis on providing service options and allowing for client choice, as well as the demonstrated effectiveness of the approach, emerged as influential. Features of local environments (including systems of care but also funding, political, and cultural contexts) and their potential for triggering transformative change may influence the relative merits of implementing HF services by an outside provider with known expertise or supporting an existing provider to develop the infrastructure and foster a service philosophy based on an HF logic.

  8. Cover Image

    Stephanie A. Farquhar, Marianne Ryder, Derek Henderlong, Robert A. Lowe, Ted Amann

    Listening to Consumer Perspectives to Inform Addictions and Housing-Related Practice and Research

    The study, funded by the Northwest Health Foundation of Portland, Oregon and the National Institute on Drug Abuse (NIDA), was conducted as part of the HEARTH collaborative (Housing, Employment and Recovery Together for Health). HEARTH, established in 2010, is a community-academic partnership involving partners from Portland State University (PSU), Oregon Health and Science University (OHSU), and Central City Concern (CCC). Using the approaches of community-based participatory research (CBPR), these diverse stakeholders collaborated to co-develop research of direct relevance to the local community and to national academic and policy communities.

    This study employed qualitative methods and community-based participatory research principles to solicit personal experiences with housing, employment, and recovery programs. We recruited interview participants via CCC-operated housing programs, including Alcohol and Drug Free Community Housing (ADFC), family housing, transitional housing, and non-ADFC (low barrier) housing units. The manuscript presents interview themes based on the five broad categories of interview questions: housing, employment programs, recovery programs, definitions of recovery, and definitions of success. Co-authors describe recommendations for practice and research protocol based on our findings. Our results highlight the importance of involving consumers in the development, data collection, and analysis of research, and present the unique perspectives of those who experience homelessness, recovery, and the programs designed to assist them.

  9. Cover Image

    Thomas M. LaPorte, Mason G. Haber, Damie Jackson-Diop, Brittany Holt

    Mental Health Systems Transformation through Participatory Evaluation and Action: The Transition-age Youth Appreciative Inquiry/Photovoice (“YAP”) Project

    Participatory action research and evaluation methods (PAR) have been used to help individuals to address a variety of challenges and improve the responsiveness of service systems to these challenges. To the present, however, few studies have examined applications of PAR in systems change advocacy for youth with mental health needs in the transition to adulthood (transition-age youth [TAY]). PAR may be especially beneficial in systems transformation efforts for this population, which lacks resources of other mental health system consumers for advocacy such as formal settings, specialized professional attention, and well established consumer organizations. The present paper describes how specific strategies for PAR, including Appreciative Inquiry and Photovoice, were employed in the Youth Appreciative Inquiry and Photovoice (YAP) project to: 1) gather perspectives of TAY in two statewide youth and family operated programs on needs and aspirations, current responsiveness of their programs and systems, and possible targets for program and system improvement; and 2) share these perspectives with stakeholders to effect change through a video. Findings on these perspectives as well as the impact of video showings are presented, and implications for systems change benefitting TAY and other populations facing systems-level challenges are discussed.

  10. Cover Image

    Maria F. Jorge-Monteiro, Rita Aguiar, Beatrice Sacchetto, Maria J. Vargas-Moniz, José H. Ornelas

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

    This article is based on empowering settings research and has a two-fold 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.

  11. Cover Image

    Vicky Lynn Collins

    Leadership, Empowerment, Advocacy Project (LEAP): College Education for Recovery and Transformative Change in Community Mental Health

    The Leadership, Empowerment, Advocacy Project (LEAP) students represented a heterogeneous groups of individuals commonly referred to as consumers/ peers who deal daily with severe and persistent mental health disorders and/or substance use disorders. They are often ostracized and marginalized and lack the same opportunities and supportive resources for advanced educational attainment as others. Over three semesters, LEAP prepared students with knowledge and tools to develop leadership skills as future leaders and volunteers within the mental health community and the consumer movement. This radical strategy created recovery and empowerment by producing an optimistic future for students that reflects personal goals of improved quality of life, a reduction in mental health symptoms, and the achievement of valued social roles.

  12. Cover Image

    Jonathan Delman, Deborah R. Delman, Brenda R. Vezina, John Piselli

    Peer led Recovery Learning Communities: Expanding Social Integration Opportunities for People with the Lived Experience of Psychiatric Disability and Emotional Distress

    Social integration is the development of mutually supportive relationships with other community members. For people with psychiatric disabilities (PD) social integration is a critical aspect of mental wellness and recovery. While people with PD generally want supportive friends, their social networks tend to be weak, often limited to treatment staff and close family. The barriers to social integration of people with PD are often high, and include public discrimination, lack of confidence, and insufficient financial resources. In the United States, community mental health providers have focused primarily on illness management and have not successfully helped clients integrate socially.  To fill that gap, people with lived experience of psychiatric disability have for many years established networks of peer support, including peer-facilitated groups.

    With the aim of enhancing that approach, peers in Massachusetts developed the “Recovery Learning Community” model, a regional network of peer support and education operated and staffed by people with lived experience, are distinct from most other peer run programs in that they provide meetings and workshops in various community locations, not only in a single location. In this article, we describe conceptually and with examples the significant impact RLCs have on both the social integration of people with PD and the delivery of mental health services in United States and internationally.

  13. Cover Image

    Meghan Caughey

    Creating Deep Democracy through Peer Wellness Services

    As healthcare reform transforms systems of care, there is a compelling necessity for systems to value the contributions of persons with lived experience of psychiatric diagnosis. The concept of deep democracy, of non-violence in action, is consistent with persons who have lived experience leading healthcare reform and helping transform coercion and oppression into health and well-being. Consistent with deep democracy and the creation of a “culture of wellness” for persons with mental challenges, a Portland, Oregon community behavioral healthcare program utilizes Peer Wellness Specialists and initiates a new model of integrated care that values whole health. The Cascadia Peer Wellness Program utilizes the unique and powerful resource of persons with lived experience of psychiatric diagnosis by training and employing Peer Wellness Specialists to partner with clinicians and other healthcare team members in order to help those they serve find their way to recovery.