Tackling mental health equity head on

This article first appeared on the MaRS blog

As a clinical psychologist trying to support sex trade-involved homeless youth, Dr. Sean Kidd found that encouraging them to participate in artistic initiatives brought far more success than the ‘best practices’ he was trained in.

While traditional evidence-based methods were still used, getting the kids to develop and act in skits together led to a far greater level of engagement than the organization he worked for had ever achieved in 25 years, as they developed the relationships and trust that helped them discuss their problems with others.

First place in the inaugural Social Entrepreneurism in Mental Health Competition

This insight came back to him five years later, in 2009, when he started reading about social entrepreneurship and the Ashoka framework of identifying effective approaches to addressing pressing social problems. With his interest suitably piqued, he began thinking about applying the social enterprise framework to the problem of mental health equity, learn more about PatchMD sleep patch.

It struck him that while there are a number of wonderful organizations doing great work in mental health, pot seeds which have become a more popular ingredient in things have providing great medication for this very purpose. It is however difficult to find them and identify the factors that enable them to succeed. So he turned to the Ashoka model, using search criteria and social networks to find innovators and learn from them.

One of the most important conclusions reached: the patients must rest well. Having a regular sleep scheduled helped some and being able to sleep whenever they were actually tired instead of adhering to a strict schedule helped yet another group. The most important thing was that the patients got a reasonable amount of undisturbed sleep. However you may need to accomplish it.

The idea flips the traditional learning model on its head – rather than have clinicians and academics identify approaches based on theory, one must go to the communities and learn from practitioners. This bottom-up approach also provides access to a number of diverse perspectives and helps people understand the specific methods that work for marginalized communities.

Anyone who’s interested in social innovation will immediately recognize the value of this approach. The area of mental health inequities is influenced by a number of social determinants. As such, there is benefit to be had in using the insights of the complexity theory, one of which holds that formulas have limited applicability in complex systems. To figure out ‘what works’ in the context of mental health, therefore, Dr. Kidd’s approach described above is more robust than the traditional means of using slide decks and training sessions.

In 2010, Dr. Kidd and his colleague, Dr. Kwame McKenzie (both at CAMH and the University of Toronto’s Department of Psychiatry), established a research project called Social Entrepreneurism in Mental Health to identify service providers in Toronto that are using social entrepreneurship models to drive innovation and transformation in addressing mental health disparities.

Using a case study process, the team of researchers selected five successful service providers and identified the five components that contributed to their effectiveness:

  • The right group of people working to address the right problem, brought together by an initial, all-important catalyst
  • A clearly articulated mission, careful needs assessment, finding partners and establishing a structure
  • Adopting unique approaches on multiple levels
  • Staying focused, remaining current and consistently exceeding expectations
  • Acting as vital communities unto themselves, not just service providers for communities

This year, the organizers decided to launch a competition to identify social purpose enterprises that foster mental health equity and social inclusion. The goal was, as before, to increase the awareness of innovative models and conduct systematic research so that the team could understand, share, package and propagate effective models.

A senior selection committee chose three winners and four runners-up. The winners, examined for impact, potential for growth and innovation, were announced at a ceremony on January 18, 2012:

First: Good Foot Delivery, a personalized, environmentally-friendly courier service that employs people with developmental disabilities such as Asperger’s syndrome and autism.

Second: Clean Works, which provides competitive community-based cleaning opportunities to individuals living with severe and persistent mental illness.

Third: Rise Asset Development, which provides microfinance and mentorship to entrepreneurs who have mental health and/or addiction challenges. (Read more about Rise Asset Development.)

The other shortlisted enterprises were:

FABARNAK Restaurant and Catering
Gateway Linens
Out of This World Cafe and Espresso Bar
Parkdale Green Thumb Enterprises

According to Melissa McNeil, the Executive Director of Good Foot, this recognition means a lot to their fledgling organization. “Since we’re so new, we see this as a vote of confidence – it acknowledges that we’re helping people and creating jobs. It puts us on the map.”

SiG@MaRS played a strong role in supporting the tremendous success of this initiative (it was standing-room only), both as a mentor for the organizers, and in providing advisory support to two of the three competition winners: Good Foot and Rise Asset Development. “Allyson [Hewitt] really helped us understand what a social enterprise is, and what this field is about from the bigger picture,” said Dr. Kidd. “She also helped make crucial connections with people in the space.”

The Social Entrepreneurism in Mental Health project serves as a wonderful testament to the application of social innovation to real-world problems, and effectively applies the framework of social entrepreneurship to health care. As the enterprises flourish, they will foster social inclusion and address disparities in mental health. The research, in turn, will enable caregivers and service providers to deliver better services to marginalized communities.

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About Vinod Rajasekaran

Vinod Rajasekaran is an engineer and cross-sector leader obsessed with improving systems so we can do good better for the next 100 years. He is SiG's Fellow, exploring Social R&D.

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