Professional Documents
Culture Documents
Kidd 2014
Kidd 2014
(2013),"Social entrepreneurship theory and sustainable social impact", Social Responsibility Journal, Vol. 9 Iss 2 pp. 188-209
http://dx.doi.org/10.1108/SRJ-07-2011-0013
(2014),"Social entrepreneurship and post conflict recovery in Uganda", Journal of Enterprising Communities: People and
Places in the Global Economy, Vol. 8 Iss 4 pp. 300-317 http://dx.doi.org/10.1108/JEC-02-2014-0001
(2011),"A conceptual model for social entrepreneurship directed toward social impact on society", Social Enterprise Journal,
Vol. 7 Iss 2 pp. 130-149 http://dx.doi.org/10.1108/17508611111156600
Access to this document was granted through an Emerald subscription provided by emerald-srm:198285 []
For Authors
If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service
information about how to choose which publication to write for and submission guidelines are available for all. Please visit
www.emeraldinsight.com/authors for more information.
About Emerald www.emeraldinsight.com
Emerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of
more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online
products and additional customer resources and services.
Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication
Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation.
based at Centre for Addiction Design/methodology/approach – Using a rigorous SE search process and a multiple case study design,
and Mental Health, core themes underlying the effectiveness of five services in Toronto, Canada for transgender, Aboriginal,
Department of Psychiatry, immigrant, refugee, and homeless populations were determined.
University of Toronto, Findings – It was found that the SE construct is highly applicable in the context of services addressing
mental health inequities. In the analysis five core themes emerged that characterized the development of
Toronto, Canada.
these organizations: the personal investment of leaders within a social justice framework; a very active
Dr Kwame McKenzie is a
period of clarifying values and mission, engaging partners, and establishing structure; applying a highly
Professor, based at innovative approach; maintaining focus, keeping current, and exceeding expectations; and acting more as a
Department of Social and service working from within a community than a service for a community.
Epidemiological Research, Practical implications – These findings may have utility as a guide for individuals early in their trajectories
Department of Health Systems of SE in the area of mental health equity and as a tool that can be used by decision maker “champions” to
and Health Equity Research, better identify and support SE endeavours.
Centre for Addiction and Originality/value – In a context characterized by increasing attention given to models of SE in health equity,
Mental Health, this study is the first to directly examine applicability to mental health equity.
Department of Psychiatry, Keywords Community, Inequalities, Diversity in health and social care provision
University of Toronto, Paper type Research paper
Toronto, Canada.
Background
Mental health services across the world face the twin challenges of tight fiscal governance
while delivering equitable services for increasingly diverse populations and marginalized
sub-populations (Standing Senate Committee on Social Affairs, Science and Technology, 2006;
Department of Health UK, 2005; Department of Health UK, 2009; Mental Health Commission of
Canada, 2012). In this context, marginalized groups face greatly heightened morbidity and
mortality as a function of poor mental health (Cochran and Mays, 2009; Kirmayer et al., 2007;
Roy et al., 2004) and there are indications of heightened risk among immigrant groups,
particularly visible minority migrants (Cantor-Graae and Selton, 2005).
Such findings, while reflective of the many determinants of health that lead to differing
needs and poorer outcomes, also reflect the shortcomings of service systems (Department of
Health UK, 2005). Mainstream services have struggled to develop an effective service response
to diversity and marginalization despite substantial service, policy, research, and personal
resources expended (Senate Committee, 2006; Department of Health UK, 2005, 2009; Mental
Health Commission of Canada 2012). Clinical trials are scarce (Aisenberg, 2008), and the
evidence for some of the most commonly discussed interventions, such as example cultural
This study was supported by a
grant from the Population Health
competence training, is modest (Bhui et al., 2007).
Improvement Research Network
of Canada. Appreciation is also
One strategy for trying to deal with the challenge of improving services without significantly
extended to Ashoka Canada. increasing costs is for mainstream providers to support local communities to develop
DOI 10.1108/EIHSC-03-2013-0004 VOL. 7 NO. 1 2014, pp. 3-13, C Emerald Group Publishing Limited, ISSN 1757-0980 j ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE j PAGE 3
and deliver better supports. For instance, in the UK, The Big Society is a centre-piece policy
idea. The UK Government’s stated aim is to create a climate that empowers local people
and communities: “Only when people and communities are given more power and take
more responsibility can we achieve fairness and opportunities for all” (The Cabinet Office,
2010, p. 1). The priorities are: to give communities more powers and encourage people to
take an active role in their communities, transfer power from central to local government,
and to support co-ops, mutuals, charities, and social enterprises (The Cabinet Office, 2010).
The Canadian mental health strategy echoes the theme by calling for mainstream services
to “Support immigrant, refugee, ethno-cultural and racialised community organisations in
assessing local mental health needs and strengths and in taking action on local priorities,
in collaboration with mental health and other service systems” (Mental Health Commission of
Canada, 2012, p. 87).
There may be concerns about whether hard-pressed marginalized communities have the
capacity and can garner the resources to build the required services. In addition, those who
develop services in marginalized groups often do not document their models, processes,
and outcomes, which makes them hard to evaluate and less attractive to systems that are invested
in offering high quality evidence-based interventions (Drake et al., 2001). Furthermore, services
developed by community groups may have a modest longevity. However, at least anecdotally,
many service providers, clients and families can readily identify a provider, programme,
or service that has very effectively addressed the mental health needs of a minority or marginalized
community. These are providers have found innovative ways to engage communities and groups
Downloaded by New York University At 07:32 26 March 2016 (PT)
that experience mental health inequity, successfully navigating the complexity of the individual,
social, and political problems faced with few resources and in some cases active opposition
to their efforts.
The concept of SE emerged in the early 1980s, growing largely out of Bill Drayton’s work in
identifying and supporting individuals who were addressing major social problems in developing
countries (Bornstein, 2007). He and others sought to identify persons who had developed
innovative ways of unraveling complex systems of oppression, apathy, and dependency to
mobilize communities and effect change. These were persons who employed highly leveraged
approaches – having identified a focused effort that might yield large systemic change.
While there is some contention as to the meaning of SE, it is generally taken to be the equivalent
of a business entrepreneur albeit one who focuses on creating social value in their efforts rather
than monetary gain. These are individuals and groups who identify and develop a solution that
addresses an unmet need; are “relentless” in their effort to create social value; are continuously
engaged in innovation and modification and act despite adversity and resource limitations;
are highly embedded in the communities and networks related to their work; generate social
capital; and have developed sustainable and transferable solutions (Paredo and McLean, 2006;
Myers and Nelson, 2011; Shaw and Carter, 2007).
SE and health
There have been several recent calls for the use of the SE framework to address health equity
(e.g. Drayton et al., 2006; Germak and Singh, 2010; Savaya et al., 2008; Wei-Skillern, 2010),
in large part driven by its applicability to the problems underlying health inequity. Social
j j
PAGE 4 ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE VOL. 7 NO. 1 2014
entrepreneurs are highly effective in connecting multiple sectors and bridging siloed systems
(Drayton et al., 2006; Harting et al., 2011). Such an approach is directly relevant to mental health
equity which is a function of many health determinants and suffers in most contexts due
to fragmented and poorly coordinated service systems. Social entrepreneurs also generate
community-based solutions to problems, an approach that is relevant if not necessary to
effectively addressing mental illness in many ethno-cultural contexts.
While SE is a framework would seem useful in articulating models through which mental
health equity can be addressed, investigation into its applicability to health is very limited. One
exploratory study that examined the work of rural healthcare providers from an SE perspective
highlighted factors such as the credibility of the providers and their ability to bridge different
sectors (Farmer and Kilpatrick, 2009). Another study in Holland examined the use of health
brokers for marginalized groups and likewise emphasized their role in building social capital,
also noting the importance of systemic entrepreneurship – or SE principles embedded in
service systems (Harting et al., 2011). Overall, and as was the case in a recent systematic
review (Short et al., 2009), research into SE in health is minimal and we were unable to find a
single example that focused specifically on mental health.
Study aims
The aim of this study is to examine the meaning of SE in the context of mental health services for
persons experiencing mental health inequity and to examine which SE components are present
in services that have proven to be effective and sustainable.
Downloaded by New York University At 07:32 26 March 2016 (PT)
Methods
Context
This project focused on services targeting Aboriginal, homeless, LGBTQ, immigrant, and
refugee groups as each of these groups face pervasive inequity in many domains including
mental health. In this search we concentrated on services operating in Toronto, Ontario.
The population of Toronto is 5.5 million and it is one of the most diverse cities in the world with
half of this population having been born outside of Canada (City of Toronto, 2011).
Participating organizations
The first step of this project was to use a purposeful sampling strategy to identify service
providers who could be considered among the most effective social entrepreneurs working to
promote equity in mental health. The search process was modelled after that of Ashoka
(Bornstein, 2007). A search committee was assembled of nine recognized leaders in service
provision in one or more of the sectors of interest. These committee members had extensive
experience in service delivery and management and also had an extensive knowledge of and
contact with Toronto providers in each sector. They were oriented to the key criteria
characterizing social entrepreneurs and given the task of using their knowledge base and
networks to identify services that aligned with these core criteria.
A total of 46 services were recommended by the committee. Each of these organizations were
contacted, the nature of the project described to them, and they were asked to submit a brief
j j
VOL. 7 NO. 1 2014 ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE PAGE 5
written description outlining the types of services offered, how their work is innovative,
challenges faced and how they have been overcome, how they engage the communities
served, the impact of their work, and their vision for the future of their work. They were advised
that they could be helped to produce the brief. In total, 21 of the services contacted expressed
an interest in participating and provided us with the written description.
The committee reviewed the descriptions provided by the organizations with the goal of
determining services that would go on to be interviewed. A consensus process was used,
reviewing the key components of SE as they applied to each of the organizations making use of
both the written descriptions and the committee’s knowledge about the organizations. Through
this process three organizations in each sector were chosen to participate in interviews to gather
further details about their work.
The directors of the organizations selected for interviews were interviewed by two people
involved in the project – one member of the research team and a member of the committee with
expertise in the relevant service sector. These interviews revolved largely around obtaining story
of their organization – how it emerged and developed, challenges and successes that occurred
in their development, and the model through which they did their work. Through these interviews
we sought elaboration on the key domains of SE and we also sought to determine if they were
able to articulate the process of development clearly. Since a primary goal of this project was to
describe models of SE in mental health equity, if those details could not be derived we would be
much less able to identify key components. The selection process was then based on a nine
Downloaded by New York University At 07:32 26 March 2016 (PT)
1. Is there a coherent story of development, from the beginnings to the present time?
2. Did they begin with few resources and/or substantial barriers and are they able to articulate how they overcame
them?
3. Have they been successful in mobilizing people to support them (community members; organizational leaders;
policy makers)?
4. Have they been effective in developing a service that truly engages their community?
5. Do they have a compelling vision for where their service/services need to go? Do they have a compelling vision
for what is needed to promote equity for the people they are serving?
6. Can the process of development, manner of engaging clients and community, mechanisms of intervention, and
need areas for further development be clearly articulated for this service?
7. Is the intervention/service having a beneficial effect for clients, but also more broadly for the community
(e.g. impacting the work of other organizations, impacting policy, etc.)?
8. Is what they are doing portable? Is it a model that could be replicated elsewhere?
9. Was hearing about their work interesting/engaging/inspiring?
j j
PAGE 6 ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE VOL. 7 NO. 1 2014
5. a multi-service programme with a focus on lower-income, street-involved, homeless,
sex-working, and marginalized members of trans communities.
Case studies
Case studies were conducted with each of the organizations identified in the selection process
in a multiple case study analysis (Stake, 2006). This approach was chosen as it provides an
effective framework for integrating a set of case studies in an instrumental design, one in which
a case or cases are used to provide insight into a broader issue. Since the focus of the project
was on the developmental trajectory of the organizations and their model of service delivery,
the analysis was situated within a narrative/developmental framework. The sources of information
were semi-structured interviews with senior management and direct service staff and a review
of documentation (reports; web sites; policies; mission/values statements). The investigation
did not extend to interviews with clients. In each organization the service leader or leaders
were interviewed, in most cases on multiple occasions over two to three hours, past leaders were
sought out for interviews, and direct service staff (range from two to ten direct service staff
per organization) participated in individual and group interviews. Investigators also attended
meetings and events held by the organization, taking ethnographic field notes. The project was
reviewed and approved by an institutional ethics review board.
In each case, audio recorded interviews, ethnographic observation, and document analysis
focused on obtaining the following. First, a detailed history tracking the trajectories and turning
points in services offered, service structures/models, goals and values, leveraging support,
Downloaded by New York University At 07:32 26 March 2016 (PT)
and relationships with stakeholders, and supporters. Second, identifying instances of adversity and
how they were overcome and instances of achievement and how they were attained. Third,
inquiry into the roles and activities of key people within the organization and external partners.
Fourth, examination of their relationships with other services and place within the larger service
system. Fifth, discussion of the impacts of their work. Sixth, inquiry into their vision for the future
of their organization.
Data analysis
Data analysis proceeded in three stages, using the rigorous content analysis procedure
articulated by Charmaz (1995) in the context of grounded theory, though the analysis in this
study did not extend to theory generation. First, for each of the organizations all of the materials
were analysed for recurrent themes through a content analysis triangulated by source of
information (interview respondent and written materials). Through this content analysis a detailed
organizational narrative was developed, with key themes and processes highlighted with
quotes, field note entries, and extracts from documents. These narratives were further revised
as a second investigator examined the coding structure and in some instances requested further
information and clarification. In the second step the reports were given to the members of the
organizations who were interviewed in a member checking process that led to further revision
and expansion of the content in some areas. In the third step, all of the reports were examined
through content analysis to identify common themes running across all of the organizations with
attention paid to patterns of variability that emerged in some themes/areas of inquiry. This
integrated analysis was in turn reviewed by all of the investigators with feedback given to ensure
reliable linkages with the individual case study data. Feedback on the integrated analysis was
also sought from the directors of each of the participating organizations.
Results
Overview
Five core themes emerged in the analysis:
1. how the service started, including the types of people involved and the problems they
sought to address;
2. a very active period of clarifying values and mission, conceptualizing an approach, and
engaging community and partners;
3. applying a highly innovative approach;
j j
VOL. 7 NO. 1 2014 ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE PAGE 7
4. maintaining focus, keeping current, and exceeding expectations and;
5. acting more as a service working from within a community than a service for a community.
While the five organizations varied widely in the problems that they addressed, their
organizational structure, and in their specific activities, there was a remarkable degree of
similarity in the components that were described as crucial to their effectiveness and success.
These components are as follows.
Almost everybody in that room could name a relative with a negative experience of child welfare
(Interviewee speaking about the founding of the Aboriginal service).
All of the founders of these services had experience in service delivery and they all had an
extensive network of helpful contacts. These were individuals with access to large amounts of
social capital. The founders of all of these organizations knew how to work with political systems,
were angry and passionate while still able to build a broad base of supporters, and they were
both patient and extremely persistent – in some cases maintaining focus through years of
setbacks.
A key component of this effort to clarify their purpose and gain consensus was a close
consultation with their communities. Through both formal research and informal contact all of
these organizations constantly consult and involve their communities. In many ways, these
organizations operate from within the community – through volunteers, former clients coming
back and working as staff, and an active involvement of members of the communities in decision
making. This ranged from staff in essence being the community to services which acted at the
systems level with each member being a leader of a service within a community of services:
The key to our impact is that it is by community for community (Interviewee from the service that
works with trans clients).
Along with the strong community-based and social justice foundations, they had a holistic
approach to their work. None saw their work as being focused on the mental illness of a person,
they all work at individual, family, social, cultural, and political levels in an integrated manner:
What we want to do is help them to build their own community, and slowly move to coalition building
[y] so it is a circle from the individual to the group, from the group to the community, and from
the community to civic responsibility and advocacy (Interviewee from the centre that works with
victims of torture).
j j
PAGE 8 ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE VOL. 7 NO. 1 2014
They also had a strong orientation towards action. In each case– they all are “doers” – preferring
to attempt something that might fail rather than continue to just talk about doing something:
The time for studies is over. There have been numerous studies of Native people already (At a
planning meeting in 1985 for the service for Aboriginal populations).
Another element shared and emphasized by these organizations is the degree to which they
sought out strategic partnerships. Within the organizations, this meant a careful consideration of
the composition of staffing and boards – looking to bring on people with expertise in service
delivery, connections with decision makers, legal experts, and skilled grant writers. What was
most remarkable was the extent to which they all actively if not aggressively pursued
partnerships outside of their organizations. They all worked to develop close relationships with
policy makers, academics, leaders of other service organizations, and community leaders. They
also all actively sought to have a maximum amount of visibility in the community. Holding events
open to the public, getting media attention, and consistently working to raise awareness about
the problem being addressed:
What the (services) has very successfully done is they have built a strong cadre of supporters,
whether its advisors or coordinators or sponsors [y] they continually work to maintain those
relationships (Interviewee from the advocacy organization that influences housing policy).
commonality between the five organizations. Having assembled extremely strong groups,
developed strategic partnerships, and assessed the needs of their communities, the solutions
that they proposed were in each case unique. The service for victims of torture was one of two
such services in the world when it was developed. The Aboriginal service is still the only urban
Aboriginal-run child protection service in Canada. In each case these organizations offered a
solution grounded in the needs of the community that was a fresh approach to the problem and
that was a compelling and convincing alternative.
While all of these organizations successfully maintained a stable focus in their mission, in their
activities and engagement with the communities they serve they are highly reflexive and organic.
In each case, they continued to deepen existing relationships with partners, cultivated
relationships with new partners and communities, and remained sensitive to the ebb and flow of
the communities they serve. This ability to be sensitive to the needs of the community is greatly
enhanced by the blurring of boundaries between “service providers” and “those served”.
Through advisory boards, extensive networks of volunteers from the community, former clients
coming back as staff, and highly active outreach activities, these organizations are embedded
more than connected. For instance, the centre that treats victims of torture was developed for
South American refugees but has embraced each new wave of refugees and their unique needs
whether they came from Eastern Europe or Somalia. In each case, whether they be new
services, new projects, or new methods of working, these organizations carefully do their
research, collaborate, develop an effective practice, and rapidly implement it. For services
working within larger organizations, such flexibility and ability to rapidly implement services was
j j
VOL. 7 NO. 1 2014 ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE PAGE 9
described as being greatly aided by there being in place a “buffer”. This buffer between the SE
service and the large organization allowed for a degree of flexibility that would be lost in the
context of the bureaucratic processes present in large organizations.
Another critical ingredient shared by these five organizations is their effectiveness and efficiency.
In each case they radically outperform what is expected of them by partners, funders, and the
public. The centre that treats victims of torture with a small staff and budget, serves 1,500 clients
annually with their coming from over 100 countries. The trans community service delivered
training on trans issues to 3,000 providers on a budget for 300.
Discussion
Downloaded by New York University At 07:32 26 March 2016 (PT)
This study aimed to articulate, using a SE framework, the characteristics shared by service
organizations that are highly effective in their ability to address mental health inequity for
marginalized groups. This, to our knowledge, is the first research application of an SE approach
in mental health.
The organisations’ creativity, relentless effort to create social value, continuous engagement
despite adversity and limited resources, integration with community, and social capital were
readily evident. The work of the organizations chosen was also reflected in aspects of
entrepreneurial orientation that receive more commentary in the business literature than the SE
literature (Rauch et al., 2009). These include a willingness to take risks by venturing into new and
uncertain domains of service delivery and aggressiveness. While not necessarily framed in the
light of “competitive aggressiveness” (Rauch et al., 2009, p. 763), these services were indeed
aggressive in their advocacy and awareness raising activities (e.g. taking the Province of Ontario
to court on discrimination charges) as well as their outputs.
A major finding of this study lies in the highly strategic and coherent approach to their work.
A complex and nuanced set of characteristics emerged that, while fundamentally grounded in
the communities from which they work, also reads like a guide to effective management. Their
efficiency and effectiveness would seem to be driven by three core attributes.
First, the personal investment and involvement of the leaders and staff in the communities that
they are serving leads them to readily recognize what is needed by the communities they serve;
to recognize the importance of being flexible to those needs and implement changes; to use
highly leveraged approaches in which interventions can have the largest impacts on the many
determinants of health thus increasing efficiency; and to have an intense and personally
invested focus and shared passion about the problems at hand since these are their own
problems– lending to an action orientation and an emphasis upon rapid implementation. All of
these characteristics, aside from personal involvement being highlighted as the key motivator,
are also closely associated with the success of these organizations as they are in business
(Rauch et al., 2009) and organizations in general (Barrett et al., 2005).
Second the work is driven by a social justice framework. All of the organizations focus on
specific problems and work actively to adhere to and maintain their core values through policy,
organization structure, and the longevity of leaders. While adherence to a clear and simple
primary goal is also a characteristic of successful businesses (Heath and Heath, 2007),
it is not surprising that these organizations need to be extremely active in their efforts to avoid
“drift” given the complexity of the problems being addressed, the need to work closely
with and be responsive to a range of funders with at times disparate agendas, and factors
j j
PAGE 10 ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE VOL. 7 NO. 1 2014
such as low pay and extremely high work levels. The latter point would seem to be addressed
both by personal investment and the “family” type of relationships cultivated by staff and
leadership.
The third and final major attribute can be described as social capital. While fundamentally
grounded in the communities served “by the community for the community”, all of these
organizations are extremely active in their efforts to make meaningful and lasting connections
with other providers, policy makers, researchers, and the public. They focused on building
shared interest and investment in their cause and creating large amounts of social capital around
their work. This ability to create bridges between stakeholders has likewise been commented on
by the few other studies examining SE and health (Farmer and Kilpatrick, 2009; Harting et al.,
2011; Myers and Nelson, 2011) and social capital has been found in the business literature to
reduce transaction costs, facilitate information flow, and foster creativity as it did in the present
study (Arregle et al., 2007).
recognize and promote more effective means of addressing mental health equity. First, while the
present study is an initial exploration of these concepts, the components identified here all have
a solid basis in the business and management literatures albeit with a different focus. This work,
while needing expansion, could be used as a guide for those seeking to develop SE-oriented
approaches to mental health equity. All of the services studied here had in many ways arrived in
their success and all agreed that these findings would have been very useful to have had access
to earlier in their trajectories. These findings might also facilitate “champions” better recognizing
social entrepreneurs that they might support be it in policy or within larger organizations. This
latter point is likely the most difficult aspect of transferability. As several selection committee
members in this study commented, large organizations have a tendency to stifle innovation
through bureaucracy and resistance to change. Some potential solutions to this difficulty is to
create “buffered” organizational spaces. In such a context the social entrepreneur can benefit
from the larger structure (e.g. stability, profile, funding) while having a degree of autonomy and
flexibility that is in effect “unhitched” from much of the culture and policies that might otherwise
stifle their work Greenhalgh et al. (2004).
References
Aisenberg, E. (2008), “Evidence base practice in mental health care to ethnic minority communities: has its
practice fallen short of its evidence?”, Social Work, Vol. 53 No. 4, pp. 297-306.
Arregle, J., Hitt, M., Sirmon, D. and Very, P. (2007), “The development of organizational social capital:
attributes of family firms”, Journal of Management Studies, Vol. 44 No. 1, pp. 73-95.
Barrett, H., Balloun, J. and Weinstein, A. (2005), “Success factors for organizational performance:
comparing business services, health care, and education”, SAM Advanced Management Journal, Vol. 70
No. 4, pp. 16-27.
Bhui, K., Warfa, N., Edonya, P., McKenzie, K. and Bhugra, D. (2007), “Cultural competence in mental health
care: a review of evaluations”, BMC Health Research, Vol. 7, No. 15.
Bornstein, D. (2007), How to Change the World: Social Entrepreneurs and the Power of New Ideas, Oxford
University Press, New York City, NY.
(The) Cabinet Office (2010), Building the Big Society, The Cabinet Office, London, available at: www.gov.uk/
government/publications/building-the-big-society (accessed 7 January 2014).
Cantor-Graae, E. and Selton, J. (2005), “Schizophrenia and migration: a meta-analysis and review”,
American Journal of Psychiatry, Vol. 162 No. 1, pp. 12-24.
j j
VOL. 7 NO. 1 2014 ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE PAGE 11
Charmaz, K. (1995), “Grounded theory”, in Smith, J.A., Harre, R. and Langenhove, L.V. (Eds), Rethinking
Methods in Psychology, Sage, Thousand Oaks, CA, pp. 27-49.
Cochran, S. and Mays, V. (2009), “Burden of psychiatric morbidity among lesbian, gay and bisexual individuals
in the California quality of life survey”, Journal of Abnormal Psychology, Vol. 118 No. 3, pp. 647-58.
Department of Health UK (2005), “Delivering race equality in mental health care: an action plan for reform
inside and outside services and the Government’s response to the Independent inquiry into the death of
David Bennett”, available at: www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicy
AndGuidance/DH_4100773 (accessed 21 May 2012).
Department of Health UK (2009), “Delivering race equality a review”, available at: www.nmhdu.org.uk/our-
work/mhep/delivering-race-equality/delivering-race-equality-in-mental-health-a-review/ (accessed 21 May
2012).
Drake, R., Goldman, H., Leff, S., Lehman, A., Dixon, L., Mueser, K. and Torrey, W. (2001), “Implementing
evidence-based practices in routine mental health service settings”, Psychiatric Services, Vol. 52 No. 2,
pp. 179-82.
Drayton, B., Brown, C. and Hillhouse, K. (2006), “Integrating social entrepreneurs into the ‘Health for All’
framework”, Bulletin of the World Health Organization, Vol. 84 No. 8, pp. 591-92.
Farmer, J. and Kilpatrick, S. (2009), “Are rural health professionals also social entrepreneurs?”, Social
Downloaded by New York University At 07:32 26 March 2016 (PT)
Germak, A. and Singh, K. (2010), “Social entrepreneurship: changing the way social workers do business”,
Administration in Social Work, Vol. 34 No. 1, pp. 79-95.
Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P. and Kyriakidou, O. (2004), “Diffusion of innovations
in service organizations: systematic review and recommendations”, The Millbank Quarterly, Vol. 82 No. 4,
pp. 581-629.
Harting, J., Kunst, A., Kwan, A. and 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
No. 1, pp. 65-81.
Heath, C. and Heath, D. (2007), Made to Stick: Why Some Ideas Survive and Others Die, Random House,
New York, NY.
Kirmayer, L.J., Brass, G.M., Holton, T.L., Paul, K., Simpson, C. and Tait, C.L. (2007), Suicide Among
Aboriginal Peoples in Canada, Aboriginal Healing Foundation, Ottawa.
Mental Health Commission of Canada (2012), Changing Direction, Changing Lives: The Mental Health
Strategy for Canada, Mental Health Commission of Canada, Calgary.
Myers, P. and Nelson, T. (2011), “Considering social capital in context of social entrepreneurship”, in Fayolle, A.
and Matley, H. (Eds), Handbook of Research on Social Entrepreneurship, Edward Elgar, Cheltenham.
Paredo, A. and McLean, M. (2006), “Social entrepreneurship: a critical review of the concept”, Journal of
World Business, Vol. 41 No. 1, pp. 56-65.
Rauch, A., Wiklund, J., Lumpkin, T. and Frese, M. (2009), “Entrepreneurial orientation and business
performance: an assessment of past research and suggestions for the future”, Entrepreneurship Theory and
Practice, Vol. 33 No. 3, pp. 761-87.
Roy, E., Haley, N., Leclerc, P., Sochanski, B., Boudreau, J. and Boivin, J. (2004), “Mortality in a cohort of
street youth in Montreal”, Journal of the American Medical Association, Vol. 292 No. 5, pp. 569-74.
Savaya, R., Packer, P., Stange, D. and Namir, O. (2008), “Social entrepreneurship: capacity building among
workers in public human service agencies”, Administration in Social Work, Vol. 32 No. 4, pp. 65-86.
Shaw, E. and Carter, S. (2007), “Social entrepreneurship: theoretical antecedents and empirical analysis
of entrepreneurial processes and outcomes”, Journal of Small Business and Enterprise Development,
Vol. 14 No. 3, pp. 418-34.
Short, J., Moss, T. and Lumpkin, G. (2009), “Research in social entrepreneurship: past contributions and
future opportunities”, Strategic Entrepreneurship Journal, Vol. 3 No. 2, pp. 161-94.
j j
PAGE 12 ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE VOL. 7 NO. 1 2014
Stake, R. (2006), Multiple Case Study Analysis, Guilford, New York, NY.
Standing Senate Committee on Social Affairs, Science and Technology (2006), Out of the Shadows at
Last, Parliament of Canada, Ontario, available at: www.parl.gc.ca/Content/SEN/Committee/391/soci/rep/
rep02may06-e.htm
Wei-Skillern, J. (2010), “Networks as a type of social entrepreneurship to advance public health”, Preventing
Chronic Disease, Vol. 7, pp. 1-5.
j j
VOL. 7 NO. 1 2014 ETHNICITY AND INEQUALITIES IN HEALTH AND SOCIAL CARE PAGE 13
This article has been cited by:
1. Sean A. Kidd, Nick Kerman, Donald Cole, Athena Madan, Elisha Muskat, Shoba Raja, Susmitha Rallabandi, Kwame
McKenzie. 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. [CrossRef]
Downloaded by New York University At 07:32 26 March 2016 (PT)