Equity is a high priority for communities
Stakeholders and other community groups are more focused on ensuring that services are equitable.
This is true for both the business community that has a significant stake in improving health equity to stabilize and improve the economy, and educational and health institutions that have significant impacts in their surrounding communities (National Academies of Sciences, Engineering, and Medicine, 2017).
Communities are becoming more vocal in asking for equity and thinking about legal action and multilevel collaborations (National Academies of Sciences, Engineering, and Medicine, 2017). Giving priority to community involvement can foster trust and improve individual capacity to have a positive effect on health equity outcomes. It can also improve the effectiveness of proposed strategies and their sustainability (Centers for Disease Control and Prevention, n.d).
Practice from the field: Global Gathering Place, Saskatoon, Saskatchewan
This community based organization is making services more equitable for immigrants and refugees.
Text by Belma Podrug, Executive Director, Global Gathering Place
Global Gathering Place (GGP) is a drop-in, non-profit, organization that started in Saskatoon twenty-five years ago. Our founders recognized that there were refugees and immigrants who were falling through the cracks and they wanted to organize to provide much needed support and spur the kinds of changes that would result in greater equity for all newcomers. To achieve our vision of a society where newcomers are fully engaged and valued, we have remained true to our roots and continue to take community-based approaches to address problems. Our PATH – Providing Access to Healthcare Program is a perfect example of this method in action to achieve greater equity for our clients.
We needed to bridge the gap between a healthcare system that lacks culturally sensitive approaches to care, and newcomers who neither understand the Western approach to healthcare nor speak enough English to navigate the system on their own. At the same time, we needed to collaborate with these large and complex systems to remove barriers that prevent newcomers from being full participants in their own healthcare. Through our work in PATH, we have made great strides toward equity, and we have achieved this by approaching each problem from two directions. We work directly with the client, providing support as needed to ensure they receive the care and support they need and at the same time, we engage with the system, collaborating at the highest levels to try to dismantle barriers so that eventually, our clients won’t need our one-on-one support.
For example, our REACH – Refugee Engagement and Community Health Clinic exists through a collaborative partnership with the Saskatoon Community Clinic, University of Saskatchewan College of Medicine (Family Medicine, Paediatrics, Community Health and Epidemiology), Global Gathering Place, Saskatoon Open Door Society, Saskatoon Health Region (Population and Public Health; Primary Health; Mental Health and Addictions) and TB Prevention and Control Saskatchewan. Refugees who land in Saskatoon receive primary health services from REACH clinic where they are paired with a physician – something that is miraculous given today’s shortage of doctors taking on new patients, can access diagnostic services and pharmacy, and receive follow-up for at least one year.
Clients accessing services in Saskatoon’s hospitals also face barriers, especially if they do not speak English and often face situations where departments insist the client bring their own interpreter to appointments. GGP have collaborated with the Health Authority to ensure our clients can access interpretation services while they are at hospital. We are even able to book these ourselves, paid by the Health Authority, if we face resistance from hospital staff members. We have also participated in developing curriculum that is now used to train maternity nursing staff. The curriculum includes interviews with clients and describes difficulties they faced giving birth in Saskatoon.
We have collaborated with Saskatoon Adult Community Mental Health to establish a simplified referral process for our clients. This means that language barriers and unfamiliarity with the system are no longer barriers to accessing service. Many of our clients are survivors of trauma and need support to work through their feelings of guilt and loss. Further, group sessions tailored to their unique needs and delivered on-site by mental health counsellors create safe spaces where clients can access services.
We start from the point of view of the client, and walk with them, understanding, through their eyes, where the barriers are, and then connecting with people at all levels of the organizations who serve and support our clients. Establishing a strong connection with the receptionist is equally as important as connecting with the CEOs and managers who direct policy change. Together, we are the change makers. We recognize that we cannot empower people; instead, we must work collaboratively to create empowering environments where newcomers can live empowered lives.
Learn more
Consider the following benefits to community engagement and partnerships and how to develop these partnerships:
(Government of Canada, 2022)
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Benefits of community engagement and partnerships
By engaging with communities and developing partnerships and pathways, you can help change systems of inequity and improve service delivery.
It is important to emphasize that while mental health services often focus on the individual, the individual is not separate from larger structures of influence and support. Social determinants of health affect individuals at and across different levels of society, often above and beyond the individual’s control (Bharmal et al., 2015; Dahlgren & Whitehead, 1991). Similarly, programs for promoting mental health and preventing mental health problems and illnesses that intervene at multiple levels (i.e., individual, community and larger society) have a greater chance for success (Castillo et al., 2019; Strader et al., 2000).
Partnerships can help by facilitating early recognition of mental health problems and illnesses, adopting a variety of treatment modalities (e.g., drug treatment, talk therapy, art therapy) and improving the retention of clients in treatment (Castillo et al., 2019; Wallcraft et al., 2011; Rogers & Robinson, 2004). In addition, establishing strong partnerships can promote mental health wellness and prevent illness among immigrant and refugee groups in Canada.
Video: How collaboration between boards of directors could improve health systems
With Axelle Janczur (Executive Director, Access Alliance Multicultural Health and Community Services)
Boards of directors should be talking to each other, especially “like” organizations, settlement organizations, health organizations, to identify key priorities that they can work together on, and this can include: meeting with elected officials around specific issues, advocating with funders to get resources for underfunded priority areas. Those stakeholders listen to boards of directors. Boards of directors are members of the community who have a vested interest and who are respected within our system and sectors. The board of directors at Access Alliance in its strategic planning and priorities identification processes committed to working at a governor to governor level,so essentially that's with other boards of directors at that systems level with these critical stakeholders from other organizations to address systems level issues. A good example in the light of all the anti-black racism incidents that happened was to come together as boards of directors in the community health sector, we decided to do training together and to then talk about what would be next steps for our organizations to develop our anti-black racism perspective, what were position statements, what is the education and professional development we want to do, what are policies that we want to have in place to ensure that our organizations are anti-oppressive, anti-racist, and having the systems level approach to what are critical societal issues..
Featured resource
A detailed study of how an individual's wellness is affected by community engagement and partnerships is discussed in the link below.
Factors affecting individual wellness
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The importance of partnerships
Mental health problems and illnesses are complex, and they require complex interventions that cut across sectors to include the broader social, cultural, economic, political and physical environments (Blair, 2021). A number of guidelines outline how best to develop partnerships, what good community engagement looks like, how to effectively engage community partners and what partnerships should involve.
Engaging in a partnership with communities is done locally. Therefore, the process for determining the best method or best guideline to follow should also consider the local context, especially institutional expectations.
Video: Strategies for building effective partnerships
With Axelle Janczur (Executive Director, Access Alliance Multicultural Health and Community Services)
Organizations work in partnership, sometimes they're one-off,but I would say most impact-fully these partnerships should be ongoing, an opportunity to share and leverage resources for longer term outcomes. Access Alliance has a partnership with a large settlement organization called COSTI. They run the Refugee Reception Centre. Access Alliance goes into the Refugee Reception Centre weekly. We run a medical clinic there. We work together. Their staff refer people and support the Pathway into the services on a weekly basis. This partnership agreement addresses what services are delivered, what facilities COSTI has to provide, how we collect data, share data, how we do follow-up and it's very important to provide the support to staff on the ground who don't need to figure this out on a day-to-day basis and also demonstrates that commitment between the organizations to work collaboratively together. Our shared voices then at systems level tables are stronger because of that relationship that is supported by a memorandum of agreement or a partnership agreement.