What social entrepreneurship can teach us

My initial thinking about the rationale for social entrepreneurship as a lens for mental health interventions arose in the winter of 2004 - long before I'd ever heard of the term. I was doing clinical work as a psychologist out of a Toronto service for sex trade involved homeless youth. These youth are among the most marginalized - struggling with adversity at many levels including trauma and very high rates of suicide. Conventional services are just about completely ineffective for these youth. This included my own efforts at evidence-based therapy in this setting.

What did work was something less conventional - offering arts based programming (e.g.,‘Whose line is it anyway?’ skits, sculpture) and working in intervention components 'around the side'. We addressed trauma, substance abuse, and depression in small pieces - after group sessions and in short interactions during groups. We ran one of the best attended groups in the history of the organization and seemed to be making a difference.

Mainstream services such as hospitals and outpatient clinics have long struggled to develop effective responses to diversity and marginalization. In an effort to fill this gap some countries have moved towards an effort to support local, relevant communities in building supports (e.g., the 'Big Society' strategy in the UK). This idea seems sensible in some respects, but does not account very well for how resources to support community efforts are best allocated. In a nutshell, we know that good approaches are happening in our towns and cities, but we seldom know how best to find them, how they work, and what their impacts are.

Enter here the concept of "social entrepreneurship." Social entrepreneurs are individuals who:¹

1. identify and develop a solution that addresses an unmet need
2. are “relentless” in their effort to create social value
3. are continuously engaged in innovation and modification and act despite adversity and resource limitations
4. are highly embedded in the communities and networks related to their work
5. generate social capital
6. have developed sustainable and transferable solutions

When I learned of this concept and the organizations that supported social entrepreneurs (most notably Ashoka), I saw a model that held great potential for capturing the essence of effective community-based interventions for marginalized groups. With a grant from the Ontario Population Health Improvement Research Network, my colleague Kwame McKenzie and I set out to test this potential.

Partnering with Ashoka Canada we employed their extremely rigorous approach to identifying social innovation - with a focus on services addressing the mental health of marginalized groups. We identified and conducted intensive case studies with 5 Toronto organizations. The organizations focused on transgender, Aboriginal, immigrant, refugee, and homeless populations. 

What we found was that despite very different types of services working across a wide range of groups these highly recognized services, and the individuals that ran them, operated in very similar ways. Most obviously, they did not operate in the bureaucratic, risk and change averse nature of mainstream services. They did, however, have 5 key commonalities.² These were:

1. the personal investment of leaders within a social justice framework
2. a very active period of clarifying values and mission, engaging partners, and establishing structure
3. applying a highly innovative approach
4. maintaining focus, keeping current, and exceeding expectations
5. acting more as a service working from within a community than a service for a community

What we took from this effort is that social entrepreneurship is a model that can capture how highly effective and efficient mental health interventions work. It can be used to guide people in the development of their efforts in this sector and it can also guide decision makers in their efforts to allocate funding to the most promising approaches. What is needed next is to tie this model with evidence of effectiveness and to look at how it applies in a broader global context. This is where we are going with a new research project supported by Grand Challenges Canada - looking at social entrepreneurship in low income contexts.

While social entrepreneurship is a concept that can be a bit difficult to grapple with, at its core lies a set of strategies that might well enable fragmented systems to connect around common approaches and reduce the wheel re-invention so common to community intervention sectors.

References

1. Paredo, A., & McLean, M. (2006), “Social entrepreneurship: A critical review of the concept.” Journal of World Business, Vol. 41, pp.  56-65.
2. Kidd, S.A., & McKenzie, K.J. (2014). Social Entrepreneurship and Services for Marginalized Groups. Ethnicity and Inequalities in Health and Social Care, 7(1), 3-13.

Learn More

Sean Kidd is a Clinical Psychologist, Independent Clinician Scientist, and educator based in Toronto. Visit the Social Entrepreneurism in Mental Health (SEMH) website for more on this work, and read Sean's blog post on the Centre for Addiction and Mental Health (CAMH) website. You can also read an editorial by William Drayton, the founder of Ashoka, for more on global health and social entrepreneurship. 

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