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- FREE ACCESSThis study explored the experiences of persons experiencing chronic homelessness with and without rent assistance. Qualitative interviews were conducted with 12 participants in order to determine if and how rent assistance impacted participants’ narratives of recovery. These narrative interviews, along with a focus group conducted with 10 support workers, explored implementation factors impacting recovery narratives. The findings suggest that access to rent assistance helps to promote recovery outcomes, conceptualized as life transitions (streets to home, home to community, and past to future), among individuals experiencing chronic homelessness. These transitions were enhanced by various participant, program, and community factors.
- OPEN ACCESSIn this paper, we outline three genealogies of housing policy in Canada—affordable housing, mental health housing, and housing for homeless persons—and present the focus, research, and strengths/critiques of these genealogies. The increased visibility and adoption of Housing First (HF) in Canadian policy has created tension between groups working on housing and homelessness. Critics rightly point out that HF does little to increase the availability and accessibility of affordable housing. We discuss the homelessness sector as a bridge between the affordable housing sector and the mental health sector and outline how collaboration might take shape in addressing homelessness and affordable housing in Canada.
- OPEN ACCESSThis study documented the perspectives of landlords and clinical and housing service teams for head lease (agency holds the lease) versus rent subsidy (tenant holds the lease) in housing programs for adults with psychiatric disabilities. Sixteen landlords and 24 housing and clinical team members participated in individual or focus-group interviews. It was found that there was less contact between landlords and tenants in the head lease program, where housing teams tended to negotiate trouble spots. Also, head lease programs were marked by intensive oversight and partial (as opposed to full) separation of housing and clinical service teams.
- OPEN ACCESSThis study examined the long-term impacts of the Better Beginnings, Better Futures project, a universal, community-based prevention program. Generativity was studied as an indicator of positive mental health, using a narrative analysis of youths’ stories about turning points in their lives. A quasi-experimental design was used to compare youths aged 18–19 who participated in Better Beginnings when they were 4–8 (n = 62) and with youths from comparison communities who did not participate in Better Beginnings (n = 34). Significant differences between the 2 groups were found on 2 measures of generativity. The findings suggest the utility of adopting a narrative approach to evaluate the long-term outcomes of prevention programs for children and youth.
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- Michael McCubbin,
- Bernadette Dallaire,
- Véronique Lagrange,
- Hubert Wallot,
- Christiane Bergeron-Leclerc,
- Cécile Cormier, and
- Geoffrey Nelson
Le paradigme du rétablissement en santé mentale remet la question de l'inclusion sociale, de l'appropriation du pouvoir d'agir et de l'espoir d'un mieux-être au cœur des approches d'intervention et des services. Dans le présent article, nous présentons les résultats du volet qualitatif (n = 15 participants et participantes) d'une recherche exploratoire réalisée à Québec auprès de personnes aux prises avec la schizophrénie ou des psychoses apparentées, vivant dans la communauté et suivies dans le cadre d'un programme de traitement et de réadaptation fondé sur une approche de rétablissement. Nos résultats fournissent un éclairage particulier sur les dynamiques de reconstruction et de rééquilibrage des liens sociaux dans les cheminements de rétablissement de ces personnes. Ils suggèrent ainsi que la relation entre l'inclusion sociale et l'appropriation du pouvoir d'agir est dialectique: l'inclusion sociale est facilitée par, et contribue à, l'appropriation du pouvoir. De plus, cette dialectique se vit aussi dans un changement du regard porté sur soi et sur son devenir, incluant l'espoir d'être « mieux », d'être « plus » et, surtout, d'être avec. - OPEN ACCESSAs part of a participatory action research project, we surveyed 300 psychiatric consumers/survivors from southwestern Ontario regarding their housing preferences and housing satisfaction. We found that, while 79% of the sample preferred independent living, 76% were living in some other type of setting (e.g., temporary shelter, supportive housing, sheltered care). Those living in temporary shelters reported the lowest levels of housing satisfaction, and those who were living in the type of housing that they preferred had the highest levels of housing satisfaction. This information is being used by stakeholder groups involved in the project to help build the capacity of the community to provide the types of housing that are preferred by consumers/survivors.
- OPEN ACCESSTo evaluate the processes and outcomes of a short-term shelter, both quantitative and qualitative data were gathered via participant observation, focus group interviews with shelter staff and residents, and individual interviews with a sample of 40 young women who had been homeless prior to using the shelter. The process evaluation showed that the shelter staff strived to utilize an empowerment philosophy in their relationships with residents, but that there were many challenges to implementing this philosophy. The outcome evaluation showed that, at a 3-month follow-up, the participants reported significant improvements in housing, income, independence, and life satisfaction, but most continued to experience poverty and a number of other difficulties. The results were discussed in terms of the implications for future research and the value and limitations of shelters for dealing with homeless youth. The need for more sustained and comprehensive program interventions and supportive social policies was underscored.
- OPEN ACCESSUsing qualitative methods, we studied current and desired relationships between members of mental health consumer/survivor and family self-help groups and mental health professionals. Two major themes, professional ideology and practices and power and control, captured both the positive and negative aspects of the relationships the participants had experienced. To move toward more desired relationships, participant suggested education and ongoing interaction between self-helpers and professionals are needed to change professional ideology and practices, while consumer/survivor and family participation and involvement in decision making are required to reduce the power imbalance between self-helpers and professionals. We discuss the implications of the findings for changes in training, practice, and research.
- OPEN ACCESSWe describe a qualitative study of four neighbourhood centres jointly created by a sponsoring agency and community members to prevent problems in the lives of children and adults in these neighbourhoods. Individual and focus group interviews with staff, community members, and other agency workers were used to develop an understanding of issues involved at various stages across the lifespan of these settings. Two tensions noted in this process were between community members and professionals from the sponsoring organization and between lower-class and middle-class community members. We discuss the implications of these findings for practice in community development.
- OPEN ACCESSIn this paper, we review the literature on housing for psychiatric consumer/survivors since the publication of the Nelson and Smith Fowler (1987) review more than a decade ago. First, we review research and propose a definition to contrast key features of three approaches to housing: (a) custodial, (b) supportive, and (c) supported. Second, we examine studies of the relationships between the characteristics of housing and adaptational outcomes for residents (e.g., personal empowerment). Third, we review studies which have examined out-comes for residents for these three different housing approaches. We conclude by critically reflecting on the values and research of the different approaches to housing, to make recommendations for future policy and planning, practice, and research.
- OPEN ACCESSAs a part of a larger study of change towards the values of an empowerment-community integration paradigm in community mental health, we examined changes in 3 mental health organizations in 1 community. Using qualitative methods, we focused on: (a) change pathways, (b) organizational change outcomes, and (c) the factors which helped and hindered change outcomes. We found evidence of a paradigm shift in the values and related practices within the organizations. Our results and themes are discussed and aimed at understanding and integrating knowledge about organizational change and the empowerment-community integration paradigm in community mental health.
- OPEN ACCESSThis paper reports the findings of an evaluation of supportive housing for people who have been hospitalized in psychiatric facilities. Both qualitative and quantitative methods were used to inquire into two key processes, social support and control in the residence, and two key outcomes, quality of life and personal growth. Interviews were conducted with 34 residents of small supportive housing programs, and staff of these settings also provided information. While residents were generally pleased with the amount of support and control they had in their residences, there were some areas in which staff exerted unilateral control (i.e., they made decisions without involving residents in the process). With respect to quality of life, residents were satisfied with their housing, but voiced some concerns over a lack of privacy, stigma, and limited opportunities for participation in the community. Residents reported showing personal growth since entering supportive housing in terms of greater independence, more instrumental role involvement, and improved self-esteem and social skills. Staff confirmed these changes. Residents indicated their increased feelings of competence were due to the social support of staff and friends, acceptance by members of their networks and the community at large, and participation in the residence and community activities. The findings expand our understanding of supportive housing in showing that such programs have beneficial effects besides reduced recidivism rates and increased work productivity for residents and in identifying program processes which contribute to residents' increased competence. Moreover, the findings illustrate the value of using qualitative data in program evaluation.
- OPEN ACCESSThis paper describes the context and process, as well as the content, of an assessment of the housing and social support needs of long-term psychiatric clients in a community. The principles of the ecological perspective were used as a framework for conceptualizing and analyzing the data. Using key informant interviews, community forums, and a survey of the clients, it was found that a visible minority of the population has significant housing problems and lacks adequate aftercare and supervision. The ways in which the data have been utilized are described, along with directions for further action.
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- OPEN ACCESSThis paper reviews research concerned with community housing programs for the chronically mentally disabled (CMD). In the first section, the ecological perspective is presented as a conceptual framework for the study of housing for the CMD. Several key concepts, such as the least restrictive environment, normalization, and integration, are tied into the ecological perspective. In the second section, literature on three dimensions of the social context of housing for the CMD is reviewed: (a) the geo-social environment: (b) responses from informal social systems; and (c) the planning, policy, and service delivery system. This literature is summarized within the framework of the ecological perspective, and the paper concludes with directions for further research and action.
- OPEN ACCESSThis paper reviews process and outcome research on community housing programs for the chronically mentally disabled. Several methods for conceptualizing and assessing housing environments are presented, and pertinent literature on each method is then reviewed. Next, research on the impact of various types of housing programs on clients' adaptation is reviewed. Methodological problems in both the process and outcome research are highlighted, and directions for future research are suggested. It is concluded that future research requires an integration of the process and outcome findings and methods to ascertain how different program characteristics are related to different facets of adaptation for different client groups.
- OPEN ACCESSA national survey was conducted to determine current opportunities for graduate education in community psychology in Canada. The results show expanded offerings for academic and field work education in community psychology in the past decade. Also, faculty perceptions of the goals, activities, and adequacy of training in community psychology were obtained. Finally, similarities and differences between graduate education in community psychology in Canada and the U.S. are noted. Issues related to the development of community psychology in Canada are discussed.
- OPEN ACCESSThis paper describes a resource exchange program between two human service organizations: a public school board and a university. This case study illustrates the utility of the concept of resource exchange as a response to pressures for the effective management of limited human resources. With an emphasis on mutual goals, needs, and strengths, the resource exchange program expanded resources available to both organizations. For the public school board, new services in the form of primary, secondary, and tertiary prevention programs were developed. For the university, research and training opportunities were created. Finally, the fragmentation between and within the organizations was reduced in correspondence with their increased mutual interdependence.
- OPEN ACCESSThis paper is a response to the British Columbia mental health planning report's position on primary prevention. The report adopts the position of Lamb and Zusman (1979) that research and service aimed at primary prevention should not be funded with money allocated for mental health, and arguments are presented to support this viewpoint. This paper critically reviews the ideological underpinnings, the research base, and the action implications of these arguments, and provides another paradigm for mental health policy in Canada. It is proposed that a spirit of open inquiry is needed so that alternative paradigms can be explored and innovations in both rehabilitation and primary prevention can be allowed to develop.
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