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Understanding perceptions of community participation in persons with severe mental illness: A mixed-methods approach

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Abstract

OBJECTIVES: This study aims to measure community participation in persons with severe mental illness (SMI) in Toronto, Ontario and outlines a methodological approach for understanding the dimensions of community participation.

METHODS: A mixed methods approach was used to define activity spaces through participatory mapping and a qualitative survey interview for participants (N = 31), selected through a stratified purposeful sampling strategy. Five neighbourhoods in Toronto were sampled in an attempt to obtain an ethnically diverse sample. Participants were interviewed over the study period and asked to draw maps indicating places that constituted their community. A qualitative interview was also administered to understand participants’ perceptions of their communities. Point locations from the mapping exercise were used to measure and construct activity spaces using a mean circle approach; outlying locations were simultaneously recorded. Observed spatial patterns were then analyzed alongside the findings of the qualitative interviews.

RESULTS: There were no observed relationships between the number of locations reported by participants and the resultant activity space or outlier count. There were no quantitative relationships between activity space size and perceptions of community by participants. However, qualitative data revealed that a number of underlying factors (mental health status and associated stigma; relationships with friends and family; cultural background; income; and neighbourhood safety) influenced participants’ activity spaces.

CONCLUSIONS: These results highlight the ways that community participation is influenced by an interplay of determinants, all of which have implications for service delivery and population-level interventions. They also point to the importance of mixed methods approaches in spatial analysis.

Résumé

OBJECTIFS: Notre étude vise à mesurer la participation communautaire de personnes atteintes d’une grave maladie mentale à Toronto (Ontario) et décrit une démarche méthodologique qui permet de comprendre les dimensions de la participation communautaire.

MÉTHODE: Nous avons utilisé une approche à méthodes mixtes pour définir des espaces d’activité, au moyen de la cartographie participative et d’un sondage par entretien qualitatif auprès des participants (N = 31), sélectionnés selon une stratégie d’échantillonnage intentionnel stratifié. Cinq quartiers de Toronto ont été échantillonnés afin d’obtenir un échantillon diversifié sur le plan ethnique. Les participants ont été interviewés au cours de la période de l’étude, et nous leur avons demandé de dessiner des cartes indiquant les endroits qui constituaient leur communauté. Nous avons aussi mené des entretiens qualitatifs pour connaître leurs perceptions de leurs communautés. Les emplacements des points obtenus par l’exercice de cartographie ont servi à mesurer et à construire des espaces d’activité selon l’approche du cercle moyen; les emplacements périphériques ont été enregistrés simultanément. Les structures spatiales observées ont ensuite été analysées côte à côte avec les constatations des entretiens qualitatifs.

RÉSULTATS: Nous n’avons observé aucun lien entre le nombre d’emplacements indiqués par les participants et le nombre résultant d’espaces d’activités ou d’emplacements périphériques. Il n’y avait pas de liens quantitatifs entre la taille des espaces d’activité et les perceptions de la communauté par les participants. Cependant, les données qualitatives ont révélé que des facteurs sous-jacents (l’état de santé mentale et la stigmatisation associée; les relations avec les amis et la famille; le contexte culturel; le revenu; et la sécurité du quartier) influençaient les espaces d’activité des participants.

CONCLUSIONS: Les résultats obtenus montrent que la participation communautaire est influencée par l’action réciproque de déterminants, lesquels ont tous des conséquences sur la prestation de services et les interventions en population. Ces résultats montrent aussi l’importance des approches à méthodes mixtes pour l’analyse spatiale.

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Authors and Affiliations

  1. Department of Geography and Planning, University of Toronto, Toronto, ON, Canada

    Angela K. Day MA

  2. Centre for Addiction and Mental Health, 1001 Queen Street West, Unit 2-1, #161, Toronto, ON, M6J 1H1, Canada

    Angela K. Day MA, Rajiv Lalla MSA, Lesley A. Tarasoff MA, Gursharan Virdee DPsych, William Zahn BS & Sean A. Kidd PhD

  3. University of Ontario Institute of Technology, Oshawa, ON, Canada

    Tyler Frederick PhD

  4. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Lesley A. Tarasoff MA

  5. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Kwame McKenzie MD, MRCPsych & Sean A. Kidd PhD

Authors
  1. Angela K. Day MA
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  2. Rajiv Lalla MSA
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  3. Tyler Frederick PhD
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  4. Lesley A. Tarasoff MA
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  5. Gursharan Virdee DPsych
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  6. Kwame McKenzie MD, MRCPsych
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  8. Sean A. Kidd PhD
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Corresponding author

Correspondence to Sean A. Kidd PhD.

Additional information

Acknowledgements: This study was funded by a grant from the Ontario Mental Health Foundation.

Conflict of Interest: None to declare.

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Day, A.K., Lalla, R., Frederick, T. et al. Understanding perceptions of community participation in persons with severe mental illness: A mixed-methods approach. Can J Public Health 107, e568–e574 (2016). https://doi.org/10.17269/CJPH.107.5519

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  • DOI: https://doi.org/10.17269/CJPH.107.5519

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