previous next
9.3.1

Community development and partnerships

Video: The importance of establishing partnerships

With Axelle Janczur, Executive Director, Access Alliance

One of our key objectives is to achieve systemic change. The barriers faced by immigrants and refugees and other vulnerable communities are such that we need to be looking at the bigger picture and what are those barriers to access that they encounter. For that reason, one of our core values and strategies is working in partnership. We can't do it alone, and nor should we. The system change that we're looking at includes working with other organizations to increase their capacity to respond to needs and issues faced by vulnerable communities, immigrants and refugees. As we think about how to respond to community needs, we think about who else has to be at the table and we reach out. It's as straightforward as that. We sit at a lot of tables already: networks, membership associations, and that's often where we start, but sometimes we reach out to other partners that we know are or should be also working on specific issues. I can give you some examples of partnerships that we have initiated. For example, the non-insured walk-in clinic at our West site was in response to the fact that many vulnerable populations don't have access to health care services. And we reached out to other community health centres who we also knew were struggling with responding to needs of non-insured patients and we created a clinic. It's a seven community health centre partnership, and we have services twice a week and we see hundreds of clients a year and the partners all play different roles either by supporting with resources or by accepting clients, making referrals, being available for consulting. So that's one example of an Access Alliance directed partnership.

It is important to remember and emphasize that while mental health care 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).

Promotion and prevention should consider individuals within the context of multiple levels of nested systems—an ecological framework—that affect an individual's life (Brofenbrenner, 1977) (Centers for Disease Control and Prevention, 2022). The individual is at the centre, with the other systems and agents working around them to help determine and model behaviour, understanding and development (Brofenbrenner, 1977; Strader et al., 2000) (Centers for Disease Control and Prevention, 2022).

These patterns can operate directly or indirectly to influence mental health development, understanding and outcomes (Brofenbrenner, 1977). As a result, working with the individual alone to promote well-being and prevent mental health problems and illnesses may be insufficient.

Health care systems and leaders emphasize early intervention as a means to reduce health care costs and improve treatment maintenance and recovery. Therefore, it is important to factor in the macro, meso and micro systems that affect individuals' lives. One potential way to support early intervention at a level beyond that of the individual is by developing communities and establishing community partnerships. Partnerships can help by increasing 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;).

Establishing strong partnerships can promote mental health wellness and prevent illness among immigrant and refugee groups in Canada. A number of factors need to be considered when deciding whether to contribute expertise to an already-established community partnership or to develop new partnerships.

icon

Promising practice

The social entrepreneurship model at the Canadian Centre for Victims of Torture has been serving refugees and victims of torture and war for the past 40 years. It sees itself “as a community which can provide a bridge for an individual to move from isolation to contact with others, a place in which network relationships can develop and in which families can find support in re-establishing themselves. It is also a community which is connected with other communities, both exile communities and the host community"(Kidd et al., 2014, pp 160-161).

By providing a safe place for newcomers in the community, “CCVT tries to establish opportunities for clients to establish a common ground with others in which they can experience a common personhood and humanity, and recover and build upon their sense of history and continuity. In this way the traumatic experience is not only approached slowly, but is also set within a larger story of an individual in a family, a network, and a community. The violence and torture are then events within a story, terrible events to be sure, and events which threaten to fracture the story completely, but they are not the whole story or the only story” (Kidd et al., 2014, p 161).