Evaluating reach, from effectiveness to social ecology of resilience in mental health promotion
Klasien Horstman (Maastricht University)
Paper short abstract:
Paper long abstract:
Groups characterized by low socioeconomic status (LSES) belong to the hard-to-reach groups defined by the WHO in its report about the 'mental health gap' (2008). This paper presents a project taking a new approach to 'reach'. Classic 'diffusion' approaches to reach, are based on a narrow notion of valid knowledge that should reach LSES groups via evidence based interventions. However, the lack of reach of evidence based intervention can be seen as a limit to the validity in both scientific and normative sense. Mental health promotion deals with sensitive social and normative issues and is therefore not socially modular: what works in experimental social settings may not work in street-interactions in LSES neighborhoods. The health promotion project that we present, does not take the validity of evidence in the social contexts of LSES groups for granted. 'Bianca in the neighborhood', is a community based mixed media project designed to promote mental health and resilience in LSES neighborhoods in the city of Maastricht. Six short films, about social, financial and emotional difficulties, common in the participating neighborhoods, form the central constituents of the media project. Around these films media- and social interactions were organized. We analyze the types of stories and expertise that were included and excluded during 'the making of Bianca'. In addition we analyze the neighborhood deliberations, generated by Bianca about redistributing responsibilities for mental health and social resilience. The analysis is based on an ethnographic study of the project and its embedding.
Technologies of care and participation: Shifting the distribution of expertise and responsibilities