Canadians face multiple barriers related to accessing mental health services, including a lack of engagement with health care professionals and a broadly-held negative stigma associated with seeking mental health support. While social work has sought to address these systemic issues by engaging in more traditional interventions (for example, clinical psychotherapy), the field has neglected the study of community-based service models that adopt a market-based approach, such as social enterprise. Related efforts are defined as “activities and processes undertaken to discover, define, and exploit opportunities in order to enhance social wealth by creating new ventures or managing existing organizations in an innovative manner” (Zahra & Wright, 2011, p.68), and represent localized responses to equitable service delivery.
Though social work science has only recently acknowledged the role of social enterprise in advancing social work values, professionals working in the field already have a rich history of promoting socially just and anti-oppressive services within these spaces. Identifying this area as largely understudied, this research aims to better understand how social enterprise might affect barriers to mental health services, and the role of social work within these service models.
Researchers applied a mixed-methods case-study approach, analyzing data from three groups engaging with a nascent nonprofit social enterprise named “Hard Feelings” in Toronto, Canada. Hard Feelings aims to address barriers to mental health services by serving two main functions: As the support to a community of practice of social work counsellors who offer services for a broad range of needs, and as a retail space that offers different curated resources that promote well-being. Data collection included qualitative interviews with service users, counsellors, and local community members, as well as collecting survey data from storefront customers using the stigma-related factor of the Mental Health Knowledge Schedule (MAKS). Qualitative data was triangulated to learn how Hard Feelings impacted access to mental health services while addressing stigma in the community. Concurrently, service engagement data were tested as predictors of the MAKS.
Qualitative data revealed salient aspects of the Hard Feelings service model that addressed barriers to service, including affordability, diversity of services and counsellors, resource provision, and service navigation. Factors reducing mental health stigma included the non-clinical and welcoming dual-use (storefront and office) space, altruistic community support, and awareness raising. Additionally, some discrepancies between sample groups were found in terms of how each theme was discussed and/or emphasized. No significant relationships were found in the multivariate analysis predicting mental health stigma.
Conclusions and Implications
Results highlight opportunities and challenges associated with implementing a novel approach that utilizes a for-profit retail business to provide reduced-cost mental health counselling services for economically disadvantaged groups. Findings from this study will be used to discuss how similar approaches may be utilized to strengthen mental health interventions that adopt a social work lens. Further, opportunities and challenges arising from the advent of social work science in this service context will be identified.
Zahra, S., & Wright, M. (2011). Entrepreneurship's next act. Academy of Management Perspectives, 25(4), 67-83.