Document Type


Degree Name

Doctor of Philosophy (PhD)


Social Work


Lyle S. Hallman Faculty of Social Work

First Advisor

Anne Westhues

Advisor Role

Dissertation Supervisor


This dissertation discusses a mixed methods research project exploring the patterns of participation in Ontario community mental health services of those who have utilized the mental health system and exploring the characteristics of two Ontario organizations that have high levels of psychiatric survivor participation, particularly in employment. Framed by structuration theory (Giddens, 1984, 1993) and Foucault's (1969/2002, 1980a, 1980b, 1994d) formulations of power/knowledge, this study occurred in two phases. Starting with a survey of community mental health organizations in Ontario, I explored the extent to which psychiatric survivors participate in organizations. Participation was found in this order of prevalence: planning, membership on Boards of Directors, attending staff training, policy creation, staff hiring, teaching at staff training, and being invited to teach at staff training. This survey was followed by in-depth ethnographic studies (Bi-perspectual Focused Institutional Ethnography) of two organizations with high levels of participation of psychiatric survivors, and especially in employment (prosumers), to explore the culture, characteristics, and relationships within these organizations. Many recommendations have arisen from this analysis, including a focus on relationships as a strategy for negotiating the dominant and emerging structures, the importance of relational autonomy to organize relationships between distinct prosumer programs and other services, and the necessity of critical reflectivity in interactions so that we may challenge a dominant structure. In addition, the two organizations in this study have provided concrete strategies for supporting and encouraging prosumer employment. Strategies focused on hiring practices, working conditions, and attitudes. As this study suggests, there are some exciting examples of survivor voices influencing organizations in Ontario. At the same time, there are challenges to the extent to which psychiatric survivors meaningfully participate in organizations. In part, as this study suggests, these challenges represent a negotiation of the identity of the dominant structure constituting community mental health services in Ontario.

Convocation Year


Convocation Season