SEMH and Grand Challenges Canada
With funding from Grand Challenges Canada a group from Ashoka and the University of Toronto, have been working together over the last two years to develop a strategy for more effectively spreading and scaling up efforts to address mental health internationally. Working closely with experts in business, technology, social innovation, and healthcare sectors, this was an opportunity to help individuals and communities build responses to mental health challenges.
This project was very helpful in our effort to flesh out the key attributes and activities of leading social entrepreneurs working in this space. Key outputs from the project included a scoping review, an in depth qualitative analysis and theoretical model that captures this type of work in low-middle income countries, and a practical guide for people working in the field developed from that analysis.
Kidd, S.A., Madan, A., Rallabandi, S., Cole, D., Muskat, E., Raja, S., Wiljer, D., Aylward, D., & McKenzie, K. (2016). A Multiple Case Study of Mental Health Interventions in Middle Income Countries: Considering the Science of Delivery. PLOS ONE. 11(3): e0152083.
Kidd, S.A., Kerman, N., Cole, D., Madan, A., Muskat, E., Raja, S., Rallabandi, S., & McKenzie, K. (2015). Social Entrepreneurship and Mental Health Intervention: A Literature Review and Scan of Expert Perspectives. International Journal of Mental Health and Addiction, 13,776-787.
SEMH: A Snapshot
There is every indication that social entrepreneurism has the potential to move the mental health equity dialogue forward in a meaningful way. In each area of shortcoming in current models of care social entrepreneurs have clear strengths:
(i) They are highly effective in creating linkages across systems that do not normally communicate with one another.
(ii) Their solutions are fundamentally community-based and grounded in the creation of social capital.
(iii) By offering highly effective and engaging solutions they are able to generate change in contexts characterized by long histories of apathy and adversity.
(iv) They operate effectively in contexts in which there are very limited material resources.
While SE is a framework that has seen an extensive uptake in the generation of solutions to pervasive social problems in the past 20 years, investigation into its applicability to health is very limited.
One exploratory study that examined the work of rural healthcare providers from a SE perspective noted the importance of factors such as the credibility of the providers and their ability to bridge different sectors/stakeholders (Farmer & Kilpatrick, 2009). Another study in Holland examined the use of "health brokers" for marginalized groups and likewise emphasized their role in building social capital, noting the importance of "systemic entrepreneurship" – SE principles embedded in service systems (Harting et al., 2010). Our own work in Toronto found that the SE model was highly relevant to innovative approaches to community mental health and identified several common aspects of implementation for SE-oriented services (Kidd et al., 2014; Kidd & McKenzie, 2014). Overall, and as was the case in a recent systematic review (Short, Moss, & Lumpkin, 2009), research into social entrepreneurship in health is minimal to date.
See Bill Drayton's commentary on the need to incorporate SE frameworks into the healthcare dialogue: Drayton in the WHO Bulletin.
For a review of the concept of SE see Paredo, A., & McLean, M. (2006). Social entrepreneurship: A critical review of the concept. Journal of World Business, 41, 56-65.
Farmer, J., & Kilpatrick, S. (2009). Are rural health professionals also social entrepreneurs? Social Science & Medicine, 69, 1651-1658.
Harting, J., Kunst, A., Kwan, A., & Stronks, K. (2011), "A ‘health broker' role as a catalyst of change to promote health: An experiment in deprived Dutch neighbourhoods", Health Promotion International, Vol.26, pp. 65-81.
Kidd, S.A., McKenzie, K., & Abai, M. (2014). A social entrepreneurship framework for mental health equity: The program model of the Canadian Centre for Victims of Torture. In L. Simich & L. Anderman (Eds.) Refuge and Resilience: Promoting Resilience and Mental Health among Resettled Refugees and Forced Migrants. (pp. 155-166). New York: Springer.
Kidd, S.A., & McKenzie, K.J. (2014). Social Entrepreneurship and Services for Marginalized Groups. Ethnicity and Inequalities in Health and Social Care. 2014, 3-13.
Short, J., Moss, T., & Lumpkin, G. (2009). Research in social entrepreneurship: Past contributions and future opportunities. Strategic Entrepreneurship Journal, 3, 161-194