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Social entrepreneurship tackles mental health equity head on

February 9, 2012

Originally posted on the MaRS blog, cross-posted to Social Innovation Generation and SEE Change Magazine.

Bill Young emceeing the SEMH Awards Ceremony with characteristic verve

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.

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.

It struck him that while there are a number of wonderful organizations doing great work in mental health, it’s 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.

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. As Charles Leadbeater memorably described it in his innovations matrix, reinvention consists of disrupting the system from the inside. 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.

Centre for Addiction and Mental Health

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. This project was supported by a number of organizations, including Ashoka Canada, Social Innovation Generation (SiG) @MaRS, and was funded by the Population Health Improvement Research Network and the Ontario Ministry for Health and Long Term Care.

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

  1. The right group of people working to address the right problem, brought together by an initial, all-important catalyst
  2. A clearly articulated mission, careful needs assessment, finding partners and establishing a structure
  3. Adopting unique approaches on multiple levels
  4. Staying focused, remaining current and consistently exceeding expectations
  5. 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:

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

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

ThirdRise 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:

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.”

The event certainly succeeded in attracting attention – it was standing-room only at the Gladstone on Wednesday. “We got better turnout than we had imagined – more people showed up than had RSVPed,” enthused Dr. Kidd. “This is a very new dialogue for the health sector, and there’s great energy around it.”

SiG@MaRS played a strong role in supporting the success of this initiative, as a mentor for not only the organizers, Drs. Kidd and McKenzie, but also 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.”

McNeil also testified to the support of her advisor, Leslie Wright: “She’s helped me navigate the nonprofit sector and acted like a mentor all through this process. Being at CSI [the Centre for Social Innovation] has also been wonderful, helping immerse us in the social business movement and crucially, giving couriers social interaction.”

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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