Implantation dans une région québécoise de pratiques centrées sur le rétablissement en milieux résidentiels en santé mentale soutenue par l’évaluation émancipatrice

Abstract

The overall goal of the study was to support managers in the mental health housing sector, in a region of Quebec, in implementing recovery-oriented practices. Fetterman’s emancipatory approach was applied at all stages. First, priorities for improvements were identified in collaboration with residential resource managers, service users, health and social service workers, and managers. Next, the evaluation examined the impacts and challenges of implementing the Action Over Inertia intervention approach with three cohorts. Finally, various means were used to support managers’ ownership of the entire process. The results show a link between recovery principles and the emancipatory approach, particularly inclusive co-construction, a space for ongoing reflection, and the “critical friend” stance. Furthermore, the results could not have been achieved without the presence of a champion from the practice community who was tasked with supporting the intervention’s implementation and the flexibility to adapt it to the individuals involved. Challenges such as manager turnover and ongoing organizational issues disrupting priorities were surprisingly mostly absent from the emancipatory approach literature. The study’s findings seem to indicate that the support structure put forth by Fetterman, sharing commonalities with recovery, has interesting implications for mental health because it centres on the collaborative involvement of all stakeholders, including people with serious mental disorders. Due to current organizational challenges in the health care system, it is suggested that, from the outset, when analyzing evaluative research’s facilitating factors and anticipated barriers, one should explicitly add the identification of strategies to overcome potential organizational barriers and reduce impacts on sustainability to the process.