Abstract
Transferring principles and practices to different sociocultural and professional contexts in the field of mental health can be very complex. Previous research on public health policy points to difficulties in different areas such as the understanding the new concepts, their applicability in different health systems, and suitable approaches to its effective implementation. The purpose of this article is to describe and analyze the process of transferring the concept of Citizenship, from its United States origins in mental health outreach work with persons who are homeless to Catalonia, Spain. We define Citizenship as promoting the rights, responsibilities, roles, resources and relationships of persons with mental illnesses, along with a sense of belonging that is validated by other citizens. The process of this transition involves embedding Citizenship in the mental health “first-person” (internationally known as Consumer/Survivor/Peer) movement in Catalonia. The paper includes a discussion of the concept of transference, including a case example of the adoption of the concept of mental health recovery in different countries. Following this, we describe the United States Citizenship model and key elements of its development. We then turn to Spain and the evolution of its mental health system, and then to Catalonia for a brief case history of transference of the principles and practices of Citizenship to that region. The “take home message” of this work is that concepts being brought from one sociocultural and national context to another, must focus on contextualization in the ‘adoptee’s’ practices, including the balance between personal involvement and professional rigor, the involvement of key actors, and ongoing evaluation of actions taken.
Highlights
PRINCIPLES AND PRACTICE TRANSFER BETWEEN CONTEXTS AND REGIONSTransferring innovative principles and practices to different sociocultural contexts has often been analyzed from the policy transfer and mobility perspectives, i.e., the scientific study of the implementation of public policies in places not of their origin (Stone, 2012; Cook, 2015)
Previous research points to difficulties during the process of transference in areas such as the understanding of novel concepts, their applicability in a different environment, and the most suitable strategies and approaches to their effective implementation (Tervonen-Gonçalves and Lehto, 2004; Simms, 2010)
Participatory action research methods including peers as researchers were employed to develop an individual measure of Citizenship (Rowe et al, 2012) with seven dimensions of Citizenship—Personal Responsibilities, Government and Infrastructure, Caring for Others in Community, Civil Rights, Legal Rights, Choices and Stewardship
Summary
Transferring innovative principles and practices to different sociocultural contexts has often been analyzed from the policy transfer and mobility perspectives, i.e., the scientific study of the implementation of public policies in places not of their origin (Stone, 2012; Cook, 2015). Participatory action research methods including peers (service users) as researchers were employed to develop an individual measure of Citizenship (Rowe et al, 2012) with seven dimensions of Citizenship—Personal Responsibilities, Government and Infrastructure, Caring for Others in Community, Civil Rights, Legal Rights, Choices and Stewardship This measure has been validated for use with persons with mental illness receiving public care (O’Connell et al, 2017). The other two strategic actions that have been considered appropriate to foster within the present project and that match the objectives of other users’, families,’ and professionals’ groups, are training and hiring peer support staff and carrying out awareness activities and training for professionals In this regard, some of the associations within the Veus federation already provide training to moderators of mutual support groups and perform different awareness-raising activities for mental health professionals, including a yearly lecture series for all mental health trainees in Catalonia. People offering peer support need to be able to conduct other activities, such as helping people navigate the mental health system including psychiatric hospitals
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