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The primary objective was to understand the process of insight development in early psychosis, us... more The primary objective was to understand the process of insight development in early psychosis, using narrative analysis and grounded theory. Given the growing interest in "narrative insight", the study's use of a qualitative research design was deemed appropriate for shedding light on this emerging phenomenon. Twentyfour data-gathering sessions were conducted; 12 participants from a Vancouver, BC early psychosis clinic wrote a narrative of their pathway into care, and were then interviewed. The results of the analysis, which used qualitative research, consisted of four "doorways" to positive insight development: "becoming demoralized", "finding a fit", "experiencing an impact", and "envisioning illness in the background" of life. The "core process" of narrative insight development in early psychosis thus involves "coming to an acceptable, adaptive explanation" of one's problem. The implications are that interventions should seek to help people find an explanation that resonates with their psychosis experience, and which is appraised as relevant to restoring their envisioned life trajectory.
This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright a b s t r a c t An interesting question concerns how large-scale (mental) health services policy initiatives come into being, and the role of evidence within the decision-making process behind their origins. This paper illustrates the process by which motivation to address homelessness, in the context of the upcoming 2010 Vancouver Olympics, was leveraged into a pan-Canadian project including sites in Vancouver, Winnipeg, Toronto, Montreal and Moncton, New Brunswick. The aim of the initiative was to implement and evaluate an intervention, Housing First, to provide housing and support to previously homeless people with mental illness. This qualitative case study was conducted between December 2009 and December 2010, employing grounded theory, and drawing on archival documents and interviews with 19 key in-formants involved in the conception of the project. Overall, the findings affirm that policy-making does not follow a rational, linear process of knowledge translation/exchange (KTE) and implementation, whereby evidence-based " products " are brought forward to address objectively determined needs and then " placed into decision-making events " (Lomas, 2007, p. 130). Instead, evidence-based policy making should be understood within the much more complex context of " policy entrepreneurship " (Kingdon, 2003; Mintrom & Norman, 2009) which entails taking advantage of windows of opportunity, and helping to bring together the " streams " of problems, politics, and policy ideas (Kingdon, 2003).
The primary objective was to understand the process of insight development in early psychosis, us... more The primary objective was to understand the process of insight development in early psychosis, using narrative analysis and grounded theory. Given the growing interest in "narrative insight", the study's use of a qualitative research design was deemed appropriate for shedding light on this emerging phenomenon. Twentyfour data-gathering sessions were conducted; 12 participants from a Vancouver, BC early psychosis clinic wrote a narrative of their pathway into care, and were then interviewed. The results of the analysis, which used qualitative research, consisted of four "doorways" to positive insight development: "becoming demoralized", "finding a fit", "experiencing an impact", and "envisioning illness in the background" of life. The "core process" of narrative insight development in early psychosis thus involves "coming to an acceptable, adaptive explanation" of one's problem. The implications are that interventions should seek to help people find an explanation that resonates with their psychosis experience, and which is appraised as relevant to restoring their envisioned life trajectory.
This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright a b s t r a c t An interesting question concerns how large-scale (mental) health services policy initiatives come into being, and the role of evidence within the decision-making process behind their origins. This paper illustrates the process by which motivation to address homelessness, in the context of the upcoming 2010 Vancouver Olympics, was leveraged into a pan-Canadian project including sites in Vancouver, Winnipeg, Toronto, Montreal and Moncton, New Brunswick. The aim of the initiative was to implement and evaluate an intervention, Housing First, to provide housing and support to previously homeless people with mental illness. This qualitative case study was conducted between December 2009 and December 2010, employing grounded theory, and drawing on archival documents and interviews with 19 key in-formants involved in the conception of the project. Overall, the findings affirm that policy-making does not follow a rational, linear process of knowledge translation/exchange (KTE) and implementation, whereby evidence-based " products " are brought forward to address objectively determined needs and then " placed into decision-making events " (Lomas, 2007, p. 130). Instead, evidence-based policy making should be understood within the much more complex context of " policy entrepreneurship " (Kingdon, 2003; Mintrom & Norman, 2009) which entails taking advantage of windows of opportunity, and helping to bring together the " streams " of problems, politics, and policy ideas (Kingdon, 2003).