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Background Recovery-oriented programs provide individuals with opportunities for well-being through community integration processes that enhance the degree to which individuals could live, work, and recreate in their community. The current evaluation assessed how tenants experience their home environment after the modernization of Homes for Special Care (HSC) to Community Homes for Opportunity (CHO) in Southwest Ontario, Canada. Our study identifies existing policies and practices that could interfere with or promote the modernization process. Methods We applied ethnographic qualitative techniques to purposefully recruit 188 participants with severe mental illness from 28 group homes. Focus groups were conducted at three time points, i.e., at pre-implementation/Baseline/Time I – spring 2018; Transition/Time II – fall 2018, and Final/Time III – winter 2019. Results Study findings suggest that the transition of HSC to CHO supports activities that empower tenants towards personal growth and development. Participants were largely satisfied with the support they were getting in relation to the program-related services. Tenants disclosed that their quality of life and well-being had been enhanced through participating in the program, and that their social interaction and support for each other had also improved. Most tenants demonstrated autonomy in terms of personal and financial independence. The enhanced financial support for tenants did not only improve their quality of life, but also helped to raise their purchasing power, decision making, sense of responsibility and accountability towards healthy spending of their resources. Despite tenants’ good impression about the CHO, some still encountered problems and provided suggestions to further improve the program. Conclusion It is expected that a more effective and expanded CHO will lead to tenant empowerment and successful social integration.

Background The global extant literature acknowledge that housing serves as a key social determinant of health. Housing interventions that involve group homes have been found to support the recovery of persons with mental illness and those with addiction issues. The current study explored the views of homeowners in relation to a supportive housing program called Community Homes for Opportunity (CHO) that modernised a provincial group home program (Homes for Special Care [HSC]) and provided recommendations for improving the program implementation in other geographical areas of Ontario. Methods We applied ethnographic qualitative techniques to purposefully recruit 36 homeowner participants from 28 group homes in Southwest Ontario, Ontario Canada. Focus group discussions were conducted at two time points, during CHO program implementation (Fall 2018, and post implementation phases (Winter 2019) respectively. Results Data analysis yielded 5 major themes. These include: (1) general impressions about the modernization process, (2) perceived social, economic and health outcomes, (3) enablers of the modernization program, (4) challenges to implementation of the modernization program, and (5) suggestions for implementation of the CHO in future. Conclusions A more effective and expanded CHO program will need the effective collaboration of all stakeholders including homeowners for successful implementation.

Background Homelessness is becoming an international public health issue in most developed countries, including Canada. Homelessness is regarded as both political and socioeconomic problems warranting broad and consistent result-oriented approaches. Methods This paper represents the qualitative findings of a project that explored risk factors associated with family homelessness and strategies that could mitigate and prevent homelessness among families using a focused ethnographic study guided by the principles of participatory action research (PAR). The sample includes 36 family members residing at a family shelter who participated in focus groups over two years (between April 2016 and December 2017). Most of the participants were single-parent women. Results The analysis yielded five major themes including, life challenges, lack of understanding of the system, existing power differentials, escaping from hardship, and a theme of proposed solutions for reducing family homelessness in the community. Conclusion The findings illustrated the complex nature of family homelessness in Ontario; that the interaction of multiple systems can put families at risk of homelessness. Findings from this study underscore the need for urgent housing protocols aimed at educating homeless families on how to navigate and understand the system, enhance their conflict resolution skills, and develop strategies beyond relocation to help them to cope with difficulties with housing.

Perceived rejection is moderated by a person’s coping orientations and sensitivity to discriminatory behaviors embedded in stigma and unfair treatment within the social space. The current study, therefore, examined the extent to which internalized stigma, anticipated discrimination, and structural violence influence the rejection sensitivity of persons with mental illness. A non-experimental cross-sectional study examined how anticipated discrimination, internalized stigma, and injustice experiences influence rejection sensitivity among 330 outpatients in Sub-Sahara Africa. Hierarchical multiple linear regression results demonstrate the non-significant relationship between anticipated discrimination and rejection sensitivity (β = .015, p = .775, 95% CI [−0.789, 1.057]). However, the relationship between internalized stigma and rejection sensitivity (β = .148, p = .029 [0.119, 2.146]) and structural violence (β = .165, p = .015 [0.014, 0.134]) were significant. While social interactions may threaten the existence of highly rejection-sensitive persons, supportive social interactions act as agents of inclusion and social empowerment for persons with a mental illness. Our study findings have further implications for health care and social welfare policy. Examining Relationships Between Rejection Perceptions, Anticipating Discrimination, Self-Stigma and Experiences of Social Injustice Among Persons With Mental Illness Perceived rejection is influenced by a person’s coping abilities and sensitivity to societal discriminatory behaviors. The current study, therefore, examined the extent to which self-stigma, anticipated discrimination, and social injustice influence the rejection perceptions of persons with mental illness. We collected data from 330 persons over 18 years receiving Mental healthcare in Sub-Saharan Africa. Hierarchical multiple linear regression analysis results demonstrated no significant relationship between anticipating discrimination and rejection perceptions. However, the relationship between self-stigma, rejection perceptions, and social injustice was significant. While social interactions may threaten and affect persons who are highly sensitive about rejection, supportive social relationships act as agents of inclusion and social empowerment for persons with a mental illness. Our study findings have further implications for healthcare and social welfare policy decisions.

Persons with mental illness (PWMI) continue to encounter stigma from the public with negative outcomes. Recent stigma discourse points to power differentials as key in shaping stigma related to mental illness within social settings. The perceived social injustice towards PWMI is known to exist both anecdotally and in documented discourses. Stigma constitutes the product of public attitudes and behaviors that characterize labeling, stereotyping, prejudice, cognitive separation, status loss, and discrimination that lead to responses that may include stress and esteem‐related appraisal of experienced, anticipated, perceived, or personal endorsement of societal actions that are anchored by existing power relational differentials. The potential consequence of such societal injustices (unfair treatments) towards PWMI may result in stigma and its sequels, including low socioeconomic status, stress, low self‐esteem, unemployment, homelessness, exclusion, and human rights abuse. This paper proposes an Interprofessional Health Education framework and discusses the implications of such unfair social treatments for Professional knowledge development and practice among healthcare professionals, with the view to improving collaboration and patient care outcomes. A more collaborative model of care, where service users and clinicians regard each other as knowledgeable with shared power to achieve healthy outcomes, empowers patients even more in areas where they fall short.

Mixed methods research has become an important approach to research worldwide. The combination of qualitative and quantitative research methods has made it possible for a deeper and broader understanding of multifaceted phenomena, thereby offering readers more confidence in research findings and conclusions. The use of mixed method designs became more established in the 1980s and early 1990s, but some controversies surrounding the approach remain. Nonetheless, experts in the field of mixed methods research have continued to work on the central premise that the use of qualitative and quantitative approaches, in combination, provides a better understanding of research problems than either approach alone. This concept paper discusses some of the known controversies around mixed methods with the aim of providing useful insights to emerging researchers interested in learning the methodology.

Introduction. Stigma is noted to be one of the greatest barriers to the recovery of persons with mental health problems. Stigma has been acknowledged as both an individual and a social orchestration that has an overpowering impact on the social standing of marginalized persons in a society. This study examined the extant literature to ascertain if any evidence(s) suggested a relationship between perceived public attitudes, religious and cultural beliefs, and structural violence in perpetuating stigma against persons with mental illness. Method. We applied a five-step scoping review framework by Arksey and O’Malley to examine evidence in the literature that suggests relationships between perceptions, religious and cultural beliefs, and structural violence in perpetuating stigma. The researchers systematically conducted a literature search from six databases, including CINAHL, Ovid MEDLINE(R), ProQuest Dissertations & Theses Global, Sociology Collection, PsycINFO, and Sociological Abstracts, using search terms that included stigma, mental illness, perception, religious and cultural beliefs, and structural violence. Results. An initial search in six databases yielded 1223 articles. Checking in the Google Search engine yielded 30 more articles. After removing 25 duplicates, 1198 articles remained for title and abstract screening. After a full-text review, 1143 articles were removed. Overall, 30 articles were selected for data extraction. Thematic analysis of the extracted data resulted in three main themes. These include perceptions about mental illness, perceptions about stigma and discrimination, and forms of stigma perception. Conclusion. This study revealed that individual perceptions of public attitudes contributed to their construction of stigma. It is incumbent on everyone to play their part in mitigating all the negative outcomes that stigma brings, especially to persons with mental illness.

There is a lack of research on stigma as a socio-cultural, religious, and moral phenomenon. This study aimed to test a Dynamic Stigma Model of Mental Illness (DYSMO) among a cohort of outpatients. We used structural equation modeling techniques to examine hypothesized relationships within the DYSMO in a cohort of 330 participants. Confirmatory factor analysis produced a model with five latent variables and 17 indicators. All factor loadings were significant at p = .05). Mediation analysis on the full structural model produced standardized fit indices that include the following: (χ2/df = 335.403 (105)), p = .000; RMSEA = 0.08 (90% CI: [0.072, 0.092]; CFI = 0.921; SRMSR = 0.059; TLI = 0.90). Overall, the study revealed that religiocultural, and structural violence perspectives can promote and damage perceptions about mental illness. Plain language summary Factors that predict stigma perception and appraisal: Testing a stigma model of mental illness Not only does stigma affect people with mental illness (PWMI), but also their family relatives, and all who care for them. There have been many studies on stigma over the years. However, researchers have a gap in studying the stigma of mental illness as a sociocultural, religious, and moral phenomenon. The purpose of this study was to test a model named the “Dynamic Stigma Model (DYSMO)” among a convenience sample of 330 persons receiving care in Ghana. The cross-sectional study examined relationships within the newly developed stigma model using statistical analysis techniques. The analysis found that religious and cultural beliefs positively influenced extreme social injustice, otherwise known as structural violence towards PWMI. The study also revealed that existing religious and cultural belief systems influenced how much a person appraised stigma as positive or negative. The study further found that stigma perceptions of PWMI influenced their anticipation of discrimination and subsequent social withdrawal, especially when in public places. Overall, the study revealed that factors such as religious, cultural, and structural violence can promote and damage perceptions about individuals with mental health problems. All stakeholders, including mental health practitioners, policymakers, and community members, must gain increased awareness and knowledge of the role religious and cultural beliefs play in the perpetuation and outcomes of mental illness stigma.

Introduction: Literature has established a bidirectional relationship between housing stability and mental health. Globally, there is a lack of affordable, safe, and appropriate housing for people with mental illness, and Canada is no exception. The current study explored the views of home staff on their experiences regarding the process of modernizing group homes (Community Homes for Opportunity [CHO]). It provided recommendations for further improvement of the implementation process. Method: We used ethnographic techniques to purposefully recruit 51 home staff from 28 group homes in Southwest Ontario, Canada. Focus group discussions were conducted at two‐time points (baseline: spring 2018 and postimplementation: winter 2019). Results: Data analysis produced four major themes. These include a general impression of the modernization process, facilitators, challenges to the implementation, and suggestions for improving the modernization program. Conclusion: Group homes such as CHO positively impact the well‐being and quality of life of persons with mental health and addiction problems while enhancing their independence and social integration for improved recovery outcomes.

Racism and discrimination are among the factors perpetuating the persistent disparities within the Canadian health sector and related social and community services. Addressing issues of racism in Canada is crucial to reducing the mounting mental health disparities that subsequently impact the psychological well-being of diverse groups of people, particularly racialized and Black individuals. While some research has been conducted on mental illness-related stigma, very few peer-reviewed studies have attempted antistigma interventions to address mental health disparities in Black families and communities in Canada. This study aims to generate critical knowledge to reduce mental health disparities and mental illness stigma experienced by Black families and communities and engage them in cocreating a best-practice model to guide policy and programming. Our study intends to engage individuals living with or affected by mental illness, service providers, and community leaders in Black communities who are interested in stigma reduction activities and advocacy in Ontario, particularly in the Greater Toronto Area (GTA), including Durham and York Regions, London, Ontario, Brampton, and Ottawa. Informed by population health promotion approaches, critical race theory, and an intersectionality framework underpinned by social justice principles, this mixed methods study will engage individuals of Caribbean and African descent in 5 cities in Ontario. We will use online self-reported surveys with Black individuals (335/431) to assess depression, anxiety, stress, mental health knowledge, racial discrimination, and mental health stigma. We will also engage Black individuals (40/431) and service providers and community leaders (16/431) in focus groups and individual interviews (10/431). Results from the survey and focus groups will inform concept mapping activities with cross-sector leaders, decision makers, and community advocates (30/431) to cocreate a best-practice model to improve mental health outcomes in Black families and communities. Quantitative data will be analyzed using descriptive and inferential analyses through SPSS (IBM Corp). Qualitative data will be transcribed verbatim, and NVivo software (Lumivero) will be used for data management. We will apply Braun and Clarke's framework of 6 phases in thematic analysis. As of September 2024, the study has received ethical approval in Canada. We have completed data collection for phase one of the study and plans are far advanced to start recruitment for phases 2 and 3. Results from the study are expected in the last quarter of 2025 and the first quarter of 2026. This project will generate a novelty of knowledge to contribute to effective ways of addressing mental illness stigma and promoting mental health literacy in Black families and communities and other vulnerable populations. In addition, the knowledge gained from this study will be taken back to Black communities to empower affected individuals and their families. DERR1-10.2196/66851.