Community Psychology and Transformative Policy Change in the Neo-liberal Era PDF

Am J Community Psychol (2013) 52:211–223 DOI 10.1007/s10464-013-9591-5 ORIGINAL ARTICLE Community Psychology and Transformative Policy Change in the Neo-liberal Era Geoffrey Nelson Published online: 23 July 2013 Society for Community Research and Action 2013 Abstract I present ideas about how community psychol- of community psychology had neglected policy and urged ogists, as researcher-activists, can influence public policy. I it to become more involved in this arena. He also argued begin by describing the current neo-liberal era, noting the that in the policy realm, community psychologists need to immense obstacles it poses to progressive policy change. be activists, as well as scholars and scientists. Next I contrast two approaches to understanding policy It is a strange and difficult role because one walks a formation, evidence-based policy and discursive policy tightrope between partisanship, on the one side, and analysis, and argue that transformative policy change can the desire to learn, on the other side, and to make that benefit from both approaches. I then propose three types of learning public in a way that allows others to examine policy outcomes that community psychology research and critically what one thinks one has learned. Activism, activism should aim to promote: (a) shaping problem defi- in this sense, is not an immediately practical and nition, (b) controlling channels for debate and participation, applied endeavor but a way of furthering one’s and (c) allocating resources. I use examples from community development and contributing to knowledge. (Sara- psychologists’ involvement in policy, mostly in Canada, to son 1984, p. 207) illustrate how such policy change can be both achieved and constrained. I conclude by discussing implications for theory Shinn (2007) likened researchers’ engagement with and practice related to policy change. policy-makers to ‘‘waltzing with a monster’’; Serrano- Garcı́a (2013) noted the tension between partisanship for Keywords Community psychology Policy social change and science in policy-making; and Solarz Transformative change Neo-liberalism (2001) described the different communities or cultures of academic researchers and policy-makers. These differences are captured well in the parable of the researcher and the Introduction policy-maker. A man in a hot air balloon realized he was lost. He In his article, ‘‘Community Psychology and Public Policy: reduced altitude and spotted a woman below. He Missed Opportunity,’’ Sarason (1984) asserted that the field descended a bit more and shouted, ‘‘Excuse me, can you help me? I promised a friend I would meet him This article was originally presented as a Distinguished Contribution an hour ago, but I don’t know where I am.’’ The to Theory and Research in Community Psychology Award address at woman below replied, ‘‘You are in a hot air balloon the Biennial Conference of the Society for Community Research and hovering approximately 30 feet above the ground. Action, Division of Community Psychology of the American You are between 40 and 41 degrees north latitude and Psychological Association, in Miami on June 29, 2013. between 59 and 60 degrees west longitude.’’ ‘‘You G. Nelson (&) must be a researcher,’’ said the balloonist. ‘‘I am,’’ Department of Psychology, Wilfrid Laurier University, replied the woman, ‘‘how did you know?’’ ‘‘Well,’’ Waterloo, ON N2L 3C5, Canada answered the balloonist, ‘‘everything you told me is e-mail: [email protected] 123 212 Am J Community Psychol (2013) 52:211–223 technically correct, but I have no idea what to make oneself and the market rather than on the state (Mahon 2008). of your information, and the fact is I am still lost. These values are contrary to the community psychology Frankly, you’ve not been much help so far.’’ The values of collective empowerment and social justice (Nelson woman below responded, ‘‘You must be a policy- and Prilleltensky 2010). As Margaret Thatcher once stated, maker.’’ ‘‘I am,’’ replied the balloonist, ‘‘but how did ‘‘there is no such thing as society. There are individual men you know?’’ ‘‘Well,’’ said the woman, ‘‘you don’t and women, and there are families. And no government can know where you are or where you are going. You do anything except through people, and people must look to have risen to where you are due to a large quantity of themselves first.’’ hot air. You made a promise that you have no idea This neo-liberal narrative about rugged individualism, how to keep. You expect someone else to solve your and the policies that accompany it, have led to the privati- problem. And the fact is you are in exactly the same zation of public goods, the development of public–private position you were in before we met, but now, partnerships, an increase in market forces, a diminished role somehow, it’s my fault.’’1 for governments, and the implementation of austerity mea- sures by government. Critical analysts (Klein 2007; Stiglitz In this paper, I present ideas about how community 2012) have shown the dark side of neo-liberalism, including psychologists, as researcher-activists, can influence public the widening gap between the rich and poor, the degradation policy. My aim is both to inspire hope that policy change is of the natural environment, poor working conditions, the possible, as well as providing a sober assessment of the erosion of labor unions, high levels of unemployment (e.g., limitations of policy change work in the current context. I youth unemployment in Spain and Greece in excess of begin by describing the current neo-liberal era, noting the 50 %), diminished social capital, the hollowing out of social immense obstacles it poses to progressive policy change. programs, and global trade agreements that give more power Next I contrast two approaches to understanding policy to transnational corporations and less power to governments formation, evidence-based policy and discursive policy to regulate these corporations. analysis, and argue that policy change can benefit from an The neo-liberal emphasis on markets has taken capital- integration of both approaches. I then propose three types ism to new levels—a capitalism on steroids, with shocking of policy outcomes that community psychology research increases in economic inequality, fueled by new discourses and activism should aim to promote. I use examples from of austerity. From the late 1940s through the early 1970s, community psychologists’ involvement in policy, mostly in income growth in the US was quite equal across income Canada, to illustrate how such policy change can be both groups (Bartels 2008). Following the adoption of neo-lib- achieved and constrained. I conclude by discussing impli- eral policies, Bartels (2008) reported that over a 30-years cations for theory and practice related to policy change. period from the mid-1970s to 2005 the cumulative income growth was 10.3 % for the lowest 20th income percentile, but 42.9 % for the top 20th income percentile. But it is The Neo-liberal Era people at the very highest levels of income that have gained the most. In 2008, the top 1 % in the US collected Beginning in the late 1970s and early 1980s, Margaret 24 % of the national income (McQuaig and Brooks 2010), Thatcher in the UK, Ronald Reagan in the US, and Brian and the top 99.99 percentile obtained a five-fold increase in Mulroney in Canada, ushered in a new era of neo-liberalism. income from 1981 to 2005 (Bartels 2008). Similar trends Business and financial organizations, such the Treasury and have been reported in Canada (Yalnizyan 2013). McQuaig Federal Reserve Board in the US, the Business Council on and Brooks (2010) argued that extreme levels of inequality National Issues (now called the Canadian Council of Chief lead to financial instability, including the stock market Executives) in Canada, and the International Monetary Fund crashes of 1929 and 2008. On the other hand, lower levels and World Bank, all played instrumental roles in promoting of income inequality are associated with stronger consumer policies of market fundamentalism (Barlow and Campbell demands for goods and services and more shared political 1995). In contrast to classical liberalism, more commonly power (Stiglitz 2012). known as conservatism, which focuses on freedom and the These rising levels of inequality have serious conse- protection of individual rights, and social liberalism, which quences. Coburn (2004) hypothesized that differential focuses on the creation of opportunities, neo-liberalism is access to housing, employment, and education, which based on the assumption that unfettered markets are the best stems from economic inequality and diminished social way of allocating resources in a society and globally, and capital, contributes significantly to health inequalities. emphasizes individualism, competition, and reliance on Using data from the Organization for Economic Coopera- 1 I learned of this parable from my colleague, Ray DeV. Peters of tion and Development (OECD), he found that social Queen’s University. democratic regimes in western countries, based on social 123 Am J Community Psychol (2013) 52:211–223 213 liberalism (e.g., the Scandinavian countries), have the based approach is that policy should be based on the best lowest level of economic inequality and, correspondingly, available research evidence (see Table 1). Evaluation the lowest rates of infant and adult mortality, while neo- research using experimental and quasi-experimental liberal regimes (e.g., UK, US, Canada) in western countries designs and systematic, meta-analytic, and realist literature have the highest rates of economic inequality and the reviews, such as those conducted for the Campbell Col- highest rates of infant and adult mortality. This is the case, laboration, are particular tools that are used to influence Coburn (2004) argued, because social democratic regimes policy (Pawson 2006). As well, there is an emphasis on ‘‘decommodify citizens’ relationships to the market’’ knowledge transfer to promote evidence-based policy (p. 44), which means that the state provides citizens with (Mitton et al. 2007). Recognition of the challenges of financial means to enjoy a decent quality of life. incorporating evidence into policy decisions has led to a Many of the social problems with which community psy- number of strategies to increase the influence of scientific chology is concerned have been exacerbated by neo-liberal evidence in the policy-making process (e.g., Bogenschne- policies. Furthermore, government’s role in addressing social ider and Corbett 2010; Choi et al. 2005; Gormley 2011). problems has been reduced. For example, in Canada, the The primary stakeholders in this approach are researchers Progressive Conservative Mulroney government eliminated and policy-makers, like in the balloon parable. Finally, the federal funding for affordable housing in the 1980s, and the evidence-based approach has grown out of the field of Liberal Chretien government downloaded responsibility for medicine to a large extent and emphasizes policy formu- housing to the municipalities in the 1990s. Fewer than 1,000 lation based on evidence (Sackett et al. 1996). units of low-income housing were created from 1993 to 2000, Given psychology’s roots in empiricism, it is not surprising compared with 25,000 units that were created in 1980 alone that community psychology is well acquainted and allied with (Nelson and Saegert 2009). It is within this context of neo- the evidence-based policy approach, particularly in the areas liberalism and the political right’s demands for austerity of prevention science and community mental health. And measures that Sarason’s (1984) injunction for community there is much to be said for an enlightened approach that psychologists to engage in public policy becomes both more brings reason and research evidence to bear on public policy compelling and more challenging. (Weiss 1999). However, policy-making sometimes has little to do with evidence, but more with ideology and political interests. For example, the Progressive Conservative Harper Two Approaches to Policy government in Canada has legislated a number of ‘‘tough on crime’’ bills, including mandatory minimum sentencing, that Westhues (2012) defines social policy as follows: will likely have no impact in reducing crime, but will put more people in correctional facilities, thus leading to greater costs, Social policy is a course of action or inaction chosen by all in a context of declining crime rates in Canada (Cook and public authorities to address an issue that deals with Roesch 2012). Another example is Prime Minister Harper’s human health, safety, or well-being. These public actions to silence Canadian scientists, particularly around authorities include those who work directly with service issues of environmental degradation (Gatehouse 2013). For users, bureaucrats working in international organiza- example, scientists with Environment Canada are required to tions and at all levels of government, and elected offi- obtain approval from government before speaking to the cials. Policy decisions at the international and media about their research (Linnitt 2013). governmental levels reflect the values acceptable to the As a way of understanding the policy-making process and dominant stakeholders at the time that the policy deci- creating policy change, the evidence-based approach has sion is taken. Decisions taken by front line workers may been critiqued on several grounds: its roots in empiricism, its reinforce the intent of these policy decisions, or may assumption that there are technical solutions to objective resist it when they are understood to be inconsistent with social problems, its inattention to values and the political the values of the front-line professionals. (p. 6) context, and its over-reliance on quantitative data provided In this section of the paper, I discuss two different by research experts (Fischer 2003; Rappaport 2005; Stan- approaches to policy analysis. hope and Dunn 2011). While it is important to base policy on evidence about what works, there is a danger that exclusive Evidence-Based Policy reliance on research evidence privileges the voices of researchers and professionals while diminishing the voices The language and concept of ‘‘evidence-based policy’’ has of disadvantaged citizens (Nelson et al. 2008). Given these recently gained prominence in policy-making (Bog- criticisms of the evidence-based policy approach, an alter- enschneider and Corbett 2010; Pawson 2006). Rooted in native discursive approach has emerged to provide another rational empiricism, the central notion of the evidence- lens on the policy-making process. 123 214 Am J Community Psychol (2013) 52:211–223 Table 1 A comparison of evidence-based and discursive approaches to policy Dimension Evidence-based approach Discursive approach Epistemology Rational empiricism Social constructionism Focus Empirical evidence Values, politics, language Methods Program evaluation, systematic reviews, knowledge Analysis of discourse, frames, narratives transfer Stakeholders Researchers and policy-makers Multiple stakeholders, including citizens, discourse coalitions, policy entrepreneurs Emphasis Policy formulation Critical policy analysis Discursive Policy Analysis ‘‘policy making arena’’ has an apt connotation of the place where contests are waged and some team or A discursive approach to policy analysis is anchored in the interest comes out the winner. In policy making, the epistemology of social constructionism and draws attention contest is called ‘‘politics.’’ Multiple interests collide to values, politics, language, and meaning-making (Fischer and seek advantage. (p. 477) 2003) (see Table 1). Discourse, according to this perspec- In its analysis of power, the discursive approach points tive, does not reflect objective social problems and solu- to the importance of the participation of multiple actors, tions, but is a reality in itself that needs to be explained. including those who are often excluded from such discus- Fischer (2003) stated that ‘‘words and language, especially sions, in the policy-making drama (Fischer 2003). when combined with power, are recognized themselves to Finally, the discursive approach has drawn attention to be a form of action, and thus important data for political individuals who have been called policy ‘‘operatives’’ and policy analysis’’ (p. viii). Similarly, Greenhalgh and (Hilgartner and Bosk 1988) or policy ‘‘entrepreneurs’’ Russell (2005) argued that: (Kingdon 2005; Mintrom and Norman 2009). These indi- The selection and presentation of evidence for policy viduals are well-positioned and skilled in knowing how to making, including the choice of which questions to advance particular social problems and solutions in the ask, which evidence to compile in a synthesis and policy arena, in which multiple problems compete for which syntheses to bring to the policy making table, attention. Kingdon (2005) argued that policy entrepreneurs should be considered as moves in a rhetorical argu- take advantage of policy windows, or opportunities for mentation game and not as the harvesting of objective change, when three different streams—problems, politics, facts to be fed into a logical decision-making and policies—converge. During such conditions, multiple sequence. (p. 31) stakeholder groups, including government insiders and activist outsiders, form a discourse coalition that comes The analysis of policy discourse, frames, and narratives together on a problem definition and policy solution are methods used to understand policy formulation (Fischer (Fischer 2003). The importance of timing and providing the 2003). right information in a timely matter is important for policy Operating from a constructionist, discursive perspective, change (Choi et al. 2005). Whereas the evidence-based Hilgartner and Bosk (1988) argued that social problems approach is action-oriented in emphasizing policy formu- must compete with one another for attention. Different lation, the discursive approach is more analytical in stakeholders in policy arenas must make claims about the understanding how policy is formulated. importance of the particular problems that they want addressed. Others have also used the metaphors of ‘‘policy Summary arenas’’ (Weiss 1999) or ‘‘policy drama’’ (Greenhalgh and Russell 2005) as ways of thinking about the policy-making While evidence is important, I argue that it is also impor- process. Furthermore, a discursive approach emphasizes tant to examine the values and assumptions on which that the policy-making process is intensely political and policy is based, and the political context in which it is value-laden. As Weiss (1999) states: formulated (Nelson et al. 2008). Values provide the moral Most fundamentally, policy making is the arena foundation of policy. I see the evidence-based and dis- where all the conflicting pressures in a society come cursive approaches to policy as potentially complementary, to bear. Policy making deals with a choice of direc- rather than as incommensurate. In fact, one of the early tions. And some groups will be advantaged and oth- formulations of evidence-based medicine noted the ers disadvantaged by the choices made. The phrase importance of values and expertise, as well as evidence, in 123 Am J Community Psychol (2013) 52:211–223 215 medical decision-making (Sackett et al. 1996). As Green- dominates; individuals need to be changed, not their social halgh and Russell (2005) stated, ‘‘we need better evidence, circumstances. In contrast, during periods of social reform, but we also need better awareness by policy makers of the a situational mode of problem definition becomes more language games on which their work depends’’ (p. 31). prominent; social conditions, not individuals, need to be Similarly, Weiss (1999) argued that it is not just informa- changed. A recent Canadian example of different ways of tion that shapes policy, but also interests, ideologies, and framing problems is an exchange between Prime Minister institutions. I believe that a critical pragmatist approach Harper and the new federal Liberal leader, Justin Trudeau, that is at the service of transformative social change is the son of former Prime Minister, Pierre Trudeau. In the wake kind of policy framework that we need in community of the recent 2013 Boston Marathon bombing, Trudeau psychology (see Nelson and Evans, in press, for more on suggested that it is important to determine the ‘‘root cau- this approach). What is important is the acknowledgement ses’’ of such actions. Trudeau was rebuked by Harper, who of values and power for the promotion of progressive social stated that it was ‘‘not the time to commit sociology,’’ change. In the next section I outline some of the markers of meaning that individual terrorists should be held account- transformative policy change and provide examples of how able for their actions. such change may or may not be achieved. Homelessness is another social problem that is subject to contested viewpoints. Framing homelessness as a structural problem of income inequality, housing advocates in Can- Transformative Policy Change ada have pushed for renewed federal involvement in the creation of affordable housing (Nelson and Saegert 2009). Watzlawick et al.’s (1974) distinction between first-order In contrast, when he was campaigning for the Ontario and second-order change was introduced to community Progressive Conservative leadership in 2002, Jim Flaherty, psychology by Rappaport (1977). First-order change is now Minister of Finance in the federal government of ameliorative in its focus on technical solutions to social Canada, called for homeless people to be jailed. But in the problems, while second-order change seeks to fundamen- lead up to the 2010 Winter Olympics in Vancouver, the tally transform the underlying values, assumptions, and federal government had a major political problem on its power dynamics of systems (Nelson and Prilleltensky hands—the visibility of homeless people with mental 2010). Gaventa’s (1980) framework for understanding health and addiction issues in the downtown eastside of power suggests some potential outcomes of transformative Vancouver. Michael Kirby, former Senator and Chair of policy change. According to Gaventa, there are three the newly minted Mental Health Commission of Canada, dimensions of power: (a) shaping problem definition, used his political capital and acted as a policy entrepreneur (b) controlling channels for debate and participation, and to obtain $110 million in federal funding for a 4-year (c) allocating resources. I provide examples of policy project to address homelessness and mental health in five change that pertain to each of these three dimensions. Canadian cities (Macnaughton et al. 2013). Kirby believed that a social movement needed to develop if progress was Shaping Problem Definition to be made on mental health issues in Canada. The homelessness and mental health initiative, At Home/Chez Shaping problem definition is one key element of power in Soi, became a research demonstration project, administered Gaventa’s model that is important for policy formulation. through the Mental Health Commission, using the Housing The way social problems and their solutions are often First model developed by community psychologist Sam defined is in terms of individual deficits, which lead to Tsemberis (2010) in New York City. Kirby quickly con- victim blaming (O’Neill 2005). Problem framing is of nected with Dr. Paula Goering, a well-respected mental critical importance to policy formulation because the way a health services researcher, as the Research Lead for the problem is framed often dictates the solutions that will be project. She played an important role in framing the project implemented to address the problem (Hilgartner and Bosk as an evaluation of Housing First, based on research evi- 1988; O’Neill 2005; Seidman and Rappaport 1986; Wat- dence about this approach (Macnaughton et al. 2013). In zlawick et al. 1974). Seidman and Rappaport (1986) pro- addition to the positive outcomes of this program for the vided numerous examples of how community people being served, there is evidence that the initiative has psychologists have reframed social problems to focus on also begun to transform the way communities and systems the social context, rather than the individual. Levine and frame services for this population in the five cities (Goering Levine (1992) argued that the way problems are framed and Tsemberis, in press). depends on the zeitgeist or socio-political context. In a In the US, Stanhope and Dunn (2011) described the conservative political context, such as the current neo-lib- uptake of the Housing First model by President George W. eral era, an intrapsychic mode of problem definition Bush as a ‘‘curious case,’’ because Housing First has 123 216 Am J Community Psychol (2013) 52:211–223 research evidence to support it and is based on progressive attention to procedural justice, which includes ‘‘… partic- values (e.g., choice, community integration) that can ipatory decision making processes… and a fair and inclu- potentially transform services for homeless people from sive process in all interactions’’ (p. 7). Meaningful citizen shelters to permanent housing. Phillip Mangano, a policy participation strives to include disadvantaged citizens in entrepreneur, was able to frame homelessness as a costly, policy debates, going well beyond token consultation in chronic, and highly visible problem, focusing particularly which decision-making rests with those in power (Arnstein on the sub-population who account for the majority of 1969). shelter use, as popularized in Malcolm Gladwell’s (2006) An example of a policy change that focuses on citizen Million Dollar Murray story (a homeless individual with a participation is the story of the mental health consumer/ high rate of utilization of services resulting in high costs to survivor development initiative (CSDI) in Ontario (Kloos the system), that could be solved through Housing First. et al., in press; Trainor and Reville, in press). This is an This curious case illustrates the socially constructed nature interesting and important story because it focuses on how a of responses to homelessness. Interestingly, Stanhope and population that was previously socially excluded began to Dunn (2011) concluded that the adoption of the Housing participate in society in meaningful ways. Up until the First approach was ‘‘… a victory for social justice advo- 1970s, mental health policy in Ontario was extremely cates’’ (p. 277), while at the same time, David Frum ‘‘unbalanced,’’ with numerous psychiatric hospitals, but (2013), Bush’s former speechwriter, claimed that reducing little in the way of community mental health alternatives homelessness in the US is a legacy of President G. (Simmons 1990). During the early days of deinstitutional- W. Bush, the most neo-liberal leader in US history. ization, mental health ‘‘consumer/survivors,’’ which is the What this story about Housing First tells us is that term that they use to refer to themselves, began to organize progressive approaches to homelessness can be framed in into self-help, social movement organizations in Toronto, such a way that are palatable both to those of us who Ontario (Everett 2000), inspired by the Vancouver mental pursue social justice and conservatives who believe in so- patients association (MPA) (Chamberlin 1978). At the called ‘‘fiscal responsibility.’’ In this vein, Rappaport same time, John Trainor, a social worker, David Reville, a (1981) noted that there are sometimes ‘‘strange alli- survivor activist, Ed Pomeroy, a community psychologist, ance(s) between fiscal conservatives and social reformers’’ and Kathryn Church and Bonnie Pape spearheaded the (p. 11), a point that was echoed by Linney (1990) years Framework for Support project through the Canadian later. While we are not satisfied that a fuller debate on the Mental Health Association’s (CMHA) National Office, moral foundations of a society based on neo-liberalism that based in Toronto. This framework and other CMHA leaves citizens living on the streets has not occurred, and National projects and reports emphasized the need for self- that a concern with cost savings seems to have replaced help and consumer/survivor and family participation in a compassion in policy debates (Shinn 2007; Stanhope and reformed mental health system (Church and Reville 1989; Dunn 2011), we take some solace in seeing the imple- Trainor and Church 1984; Trainor et al. 1999). mentation of a progressive approach that has provided The framework was very influential for senior civil thousands of vulnerable people with permanent housing of servants working in mental health policy in the Ontario their choice. Moreover, we have learned that skilled policy Ministry of Health and was adopted by the Ontario gov- entrepreneurs can use rhetoric to frame and advance evi- ernment as the centerpiece of mental health reform. Con- dence-based solutions in a neo-liberal context. cretely, the policy reform document, Putting People First, mandated 30 % consumer/survivor participation and 20 % Controlling Channels for Debate and Participation family participation on all district and regional planning bodies in mental health in the province (Ontario Ministry Controlling channels for debate and participation is the of Health 1993). Furthermore, this document came after a second dimension of Gaventa’s (1980) model of power that community mental health services legislation committee is relevant to transformative policy change. Fischer (2003) held hearings about mental health across the province. Not contends that citizen participation in policy-making is vital only did activist consumer/survivors participate as mem- to a democratic society and a cornerstone of the discursive bers of this committee, but David Reville and others approach to policy analysis. Citizen participation has long organized consumer/survivors to attend these hearings and been a key value and concept in community psychology tell their stories, raw and painful as they were, and say what (Wandersman and Florin 2000). In Seidman and Tseng’s they wanted changed (Church 1995). (2011) model of social change, participation, along with Another significant change occurred when the New norms and interactions, is one important aspect of the Democratic Party (NDP), a relatively left-leaning political social processes that lead to social change. Similarly, party, won the 1990 Ontario provincial election. Prior to Prilleltensky’s (2012) theorizing about social justice draws the election, Reville had been a member of the NDP caucus 123 Am J Community Psychol (2013) 52:211–223 217 of the provincial government for 5 years and had earned a were able to take advantage of the increasingly visible reputation for advancing policy to create mental health problem of deinstitutionalized people with inadequate systems change. As new Premier Bob Rae’s special advisor support in the community and the opening up of a policy and having a positive relationship with the provincial window with the election of a new government that was health minister, Reville was able to provide inside support favorably inclined to make mental health reforms. for the idea of the CSDI as a special project that govern- ment would fund. Reville’s colleague, John Trainor, who Allocating Resources was the key person behind the previously mentioned framework, was seconded to work with the Ontario Min- Bargaining power and resources are another component of istry of Health to launch the CSDI, including the creation Gaventa’s (1980) analysis of power. How resources are and funding of a network of local consumer/survivor ini- allocated in a system is an element of the ecological model tiatives (CSIs), which now total around 60 across the (Trickett et al. 1972) and Seidman and Tseng’s (2011) province. CSIs could take many different forms depending model of social change. Similarly, Prilleltensky (2012) upon the local context but were expected to adhere to three asserted that distributive justice ‘‘refers to the fair and main guidelines: (a) utilize a non-services approach; (b) be equitable allocation of burdens and privileges, rights and independent; and (c) be member-driven. responsibilities, and pains and gains in society’’ (p. 6). As My colleagues with the then Centre for Research and Rappaport (1981) stated: ‘‘Having rights but no resources Education in Human Services (now the Centre for Com- and no services available is a cruel joke’’ (p. 13). Below, I munity Based Research) and I collaborated with the CSDI relate stories about the issue of resource allocation in two and Trainor to conduct an evaluation of four CSIs using a different social policy issues in Canada. participatory action research approach that focused on the Quite recently, the government of Canada renewed two main goals of CSIs: self-help/mutual aid and systems funding of the federal Homelessness Partnering Strategy transformation (Nelson et al. 2010). In line with these two (HPS), which provides financial support for services for main goals, we not only found positive impacts of partic- homeless people in more than 60 Canadian communities. ipation in CSIs on the members themselves (Nelson et al. This funding announcement came 1 year earlier than 2007), but also positive impacts of consumer/survivor expected and extended HPS funding for 5 years. The participation in education, planning, action research, and renewed funding occurred in the context of discussions advocacy in creating broader systems and community between the Mental Health Commission and the Prime change (Janzen et al. 2007). Minister’s Office around continued federal funding for At The CSDI story is instructive not only because it Home/Chez Soi project and explicitly cited the results from involved citizen participation in formulating policy, but the this study as the rationale for ‘‘repurposing’’ HPS. As well, resulting policy further promoted the participation of a there was pressure from advocacy groups like the Canadian population that was previously excluded from participation Alliance to end homelessness. It is quite ironic that federal in civil society. Despite evidence about the positive bene- Finance Minister Flaherty, who, you will remember, called fits of the CSDI, the CSIs remain poorly funded, and some for jailing homeless people in 2002, announced the renewal have lost their independence by being absorbed into larger of HPS in the federal budget for the next 5 years and a shift in mental health organizations (Trainor and Reville, in press). the programs to be funded by HPS to a Housing First model. While it is desirable that peer support and consumer/sur- While this policy change is a positive step, it is limited in vivor participation have become mainstream, there is a terms of Gaventa’s (1980) resource dimension of power. The very real danger of co-optation of this liberation movement total amount allocated to HPS, $119 million per year for and the muting of the voices of its more radical members. 5 years, falls far short of what is needed to implement It is also important to note that the CSDI was not created Housing First on a widespread basis to end homelessness in out of an evidence base, but more out of a value base about Canada, and is actually a reduction of $20 million in the the rights of mental health consumer/survivors to have a funding envelope per year for HPS. Besides shifting to a voice and be able to participate meaningfully as citizens Housing First approach, there is also a simultaneous need to rather than as patients. However, the creation of the CSDI increase the supply of affordable housing, both for people enabled it to develop an evidence base. Consistent with the who are vulnerably housed and for the implementation of discursive approach to policy formulation, the development Housing First with chronically homeless people. Gaetz of the CSDI occurred through the activities of a nascent (2010) noted this problem and posed the question ‘‘How consumer/survivor liberation movement and insider/out- effective can Housing First be if there is no affordable sider policy entrepreneurs who were able to forge part- housing to move people into?’’ (p. 25). nerships between progressive mental professionals and A more encouraging example of resource allocation in mental health consumer/survivors. These stakeholders policy formulation comes from the province of Québec in 123 218 Am J Community Psychol (2013) 52:211–223 the area of early childhood learning and care (see Evans discourse, and policy entrepreneurship to make transfor- et al., in press). Early childhood learning and care has come mative policy change in Québec. Bouchard chaired a to be framed as a social justice issue by international working group and wrote a report for the government of organizations, such as UNICEF and WHO (Commission on Québec that recommended investment in high quality the Social Determinants of Health, WHO 2008; Schraad- childcare environments for children from birth through age Tischler 2011; Siddiqi et al. 2012; UNICEF 2012). As a five (Bouchard et al. 1991). This report helped to influence social justice issue, it is believed that all children have the the development of progressive family policies, including a right to health, nutrition, child protection, social protection universal licensed, childcare network that costs parents $7 and welfare, and education (Hertzman and Siddiqi 2013). a day, and a generous parental leave program. Bouchard Research has shown income gradients for access to early (2005) notes that these policies were also ‘‘… in response childhood learning and care resources and various domains to years of claims-making by the Québec feminist move- of child development (e.g., health, academic achievement) ment’’ (p. 465). The province subsequently enacted a law in both developing nations and more developed nations for the reduction of poverty and social exclusion in 2002, (Hertzman et al. 2010; Schraad-Tischler 2011; Siddiqi which was implemented in 2004 in response to pressure et al. 2012); the higher the income level, the better access from a broad-based and active coalition of 22 advocacy to resources and the better child development outcomes. groups (Bouchard 2005; Noël 2002). These policies came Across countries, income gradients vary in terms of how about when the Parti Québecois, a left-leaning party, steep or flat they are. Those nations with flatter gradients, formed the government of Québec. Bouchard, a Professor which are due to lower levels of economic inequality, such in Community Psychology at l’Université du Québec à as the Scandinavian countries, have more favorable child Montréal, ran for the Parti Québecois and was elected in and family policies and better child development outcomes 2003, holding a position in the National Assembly of (McCain et al. 2007; Siddiqi et al. 2012). Québec until he resigned in 2010. This framing and evidence suggests that it is important The aforementioned policies led to increased participa- for countries to invest in early childhood learning and care tion of women in the workforce and generated $1.05 to the interventions (Schraad-Tischler 2011; Siddiqi et al. 2012). province and $.44 to the federal government for every Indeed, research on such programs outside of North dollar invested. They also reduced the poverty rate, low- America has shown that they promote positive develop- ering the low-income cut off rate (after tax) from 17.6 % in mental outcomes for children (Nores and Barnett 2010), 1995 to 9.4 % in 2009, a drop of more than 46 % in the and that they appear to flatten the afore-mentioned gradi- poverty rate (Canada Without Poverty 2012; Fortin et al. ent, ‘‘… as children from less advantaged backgrounds 2012; McCain et al. 2011). benefited more than those from more advantaged back- In just a decade, Québec has gone from the bottom to ground’’ (Melhuish 2011, p. 300). However, as McCain the top on many important social indicators. From et al. (2007) have asserted: having Canada’s lowest female labour participation, To work, programs must be universal. Vulnerable it now has the highest. Where Québec women were children are found in all SES groups but populations once less likely to attend post-secondary education are not evenly distributed between groups. The larg- than their counterparts in the rest of Canada, today est numbers of children overall are found in the they dominate. At the same time, student scores on middle groupings. The lowest SES group has a standardized test have gone from below the Canadian greater percentage, but a smaller number, of vulner- average to above. Despite working more, Québec able children. Conversely, children in the middle SES women are also having more babies, and Québec groups are less likely to be vulnerable, but because of dads are more involved in child rearing. Eighty-two the size of the group, this is where the most vulner- percent take paid leave after the birth of their infants, able children are found. Restricting programs to compared to just 12 percent of fathers in the rest of vulnerable children in the low SES group therefore the country. In addition, childhood programs that misses the majority of children experiencing diffi- allow mothers to work have slashed Québec’s child culties. (p. 46) poverty rates by 50 percent. Finally, in an analysis that should catch the attention of policy makers So, programs targeted at low-income children and everywhere, Montreal economist Pierre Fortin families cannot flatten the gradient because too many revealed that the tax revenues from mothers who are vulnerable children, roughly 60 % in the middle and able to work because of low cost children’s pro- affluent classes, are not reached. gramming pay for the entire cost of Québec’s system. Enter Canadian community psychologist, Camil Bou- (McCain et al. 2011, p. 2) chard, who brings together evidence-based policy, policy 123 Am J Community Psychol (2013) 52:211–223 219 Now that’s what I call a transformative policy change! related may have been successful because they are con- In a reflection 20 years after the publication of this ground- gruent with the aims of neo-liberalism. Housing First for breaking report, Bouchard (2012) noted that the title of the people with addictions and mental health issues focuses the report evoked ‘‘un frisson,’’ which roughly translates as a problem as people with complex needs, not a lack of shiver, a very emotional response, from the people of affordable housing. Also, the solution in Housing First lies Québec. In a discursive tour de force, he entitled the report in the private housing market, which has the support of Un Québec fou de ses enfants (Québec crazy about its landlords and property owners, not in the expansion of children). He joked that if he had named the report Un affordable housing, which has been cut back by neo-liberal Québec fou de ses banquiers (bankers) that the report policies (Nelson and Saegert 2009). The development of would not have had the same resonance value for people. mental health consumer/survivor participation and CSIs Other provinces are trying to catch up with Québec. occurred in the context of deinstitutionalization, which Through the work of Charles Pascal (2009), another psy- resulted, in part, because institutions were becoming chologist policy entrepreneur who was special advisor to expensive to operate (Nelson 2012). Consumer/survivor former Liberal Premier Dalton McGuinty, the government participation and CSIs, on the other hand, cost government in Ontario is in the process of implementing full-day early very little. And, if consumer/survivors are brought into and learning in junior and senior kindergarten, along with Best paid by the system, they may less likely to ‘‘rock the boat.’’ Start Child and Family Centres for preschool children. Paid Finally, the investment in early childhood learning and care parental leave is another recommendation of Pascal’s in Québec may have also been supported for economic report, With Our Best Future in Mind. However, Canada reasons. These programs have saved both the provincial has a long way to go on this front. In a 2008 study of the and federal governments money. Moreover, Québec’s birth top 25 economically advanced countries, UNICEF found rate, which was low before these initiatives, has risen, and that Canada ranked at the bottom on 10 benchmarks for Québec now has more women in the work force, which is early learning and care services for children (Adamson good for neo-liberalism. It may be useful to theorize about 2008). policy changes that promote community resilience in the face of neo-liberalism, such as those reviewed in this paper, and those that directly challenge and strive to reverse neo- Implications for Theory and Practice liberalism. The policy stories, frameworks, and dimensions of trans- Practice formative outcomes that I have related have implications for community psychology theory and practice related to Here I suggest different roles that community psychologists policy change. can play and activities that we can undertake to promote policy change. First, the examples that I have provided and Theory the evidence-based approach to policy-making certainly indicate that community psychologists have important Watzlawick et al.’s (1974) first-order and second-order roles as researchers/evaluators both to inform and to study change focus on types of change. While the idea of the policy-making process. Evidence is important for pol- transformative or fundamental change of a system is icy and needs to be widely shared in accessible forms with appealing to community psychology, this categorical way different policy stakeholders, including those most affected of thinking may limit our understanding of change. by the issue, other citizens, advocacy organizations, and Thinking about policy change along different dimensions, government decision-makers. Policy relevant research such as those presented here, may be more useful. More- evidence was certainly a key piece in the formulation of the over, change on one dimension (e.g., participation) does At Home/Chez Soi project for homeless people with not necessarily mean that change will occur on another mental health challenges and Québec’s universal child care dimension (e.g., resource allocation), which points to the program. Moreover, research can also confer scientific value of a multi-dimensional approach. legitimacy on policy decisions, as was the case with the Another theoretical concern is that the types of policy research that was conducted with the CSDI initiative in change described here do not challenge larger neo-liberal Ontario (Trainor and Reville, in press). It’s also important policies. This is exemplified in the title of Hertzman and to consider what type of evidence is considered valid. Siddiqi’s (2013) recent chapter, ‘‘Can communities suc- While evidence-based policy research has rested on ceed when states fail them? A case study of early human experimental and quasi-experimental trials, increasingly development and social resilience in a neo-liberal era.’’ In qualitative and mixed methods approaches are being fact, the examples of the three types of changes that I incorporated into policy research. Both the At Home/Chez 123 220 Am J Community Psychol (2013) 52:211–223 Soi project and the CSDI studies used mixed methods changes. Roosevelt is reported to have said, ‘‘You’ve approaches. Many research funding bodies and universities convinced me. I would like to push forward these changes. still look skeptically on community-based participatory Now go out and make me do it.’’ I believe that we must action research and qualitative research, seeing such have a broad social movement and sustained advocacy to approaches as ‘‘soft’’ or ‘‘subjective.’’ While we face create policy change that challenges neo-liberalism. institutional constraints and prejudices about what counts The final role that I believe we should undertake is that as research, I think we are making progress on this front. of boundary spanner, partnership maker, or insider/out- A second role is that of program innovator. Many sider (Bond and Keys 1993; Nelson and Prilleltensky community psychologists have created innovative pro- 2010). Sometimes the roles that I have described above grams that have been well conceptualized, rigorously intersect and policy entrepreneurs have the opportunity to evaluated, and scaled up to other communities or enshrined work both inside and outside for change with different in broader social policies. The previously mentioned policy stakeholder groups. Michael Kirby did this both in Housing First program (Tsemberis, 2010) and the work of his role as Chair of the Mental Health Commission and in José Ornelas, who created the AEIPS program in Lisbon, his past role as a Canadian Senator, drawing upon his Portugal (Ornelas et al., in press) are exemplars of this role. experience as an insider in the federal Liberal government. A third role is that of the public intellectual. We have an In Ontario, David Reville had connections with the con- important obligation to speak out on social issues. This can sumer/survivor liberation movement and became the Pre- involve public speaking, writing articles for newspapers mier’s special advisor. In Québec, Camil Bouchard played and popular magazines and newsletters, talking with the all of the roles that I have described, eventually entering media, and using social media to express positions on the realm of elected representative. Individuals who can important public policy issues. In this role, we need to play this insider/outsider role have the potential to make a present research evidence to educate the public, but also to policy deal that satisfies many different stakeholder groups. contest the framing of policy positions that blame the In conclusion, neo-liberalism poses major challenges to victim. This means reframing social problems and solu- making progressive policy changes, but that is all the more tions in terms of alternatives to neo-liberalism. This is reason for community psychology to engage in the policy where our values and theories also come in as part of a arena. Both evidence-based and discursive approaches broader project of enlightenment and social change. provide tools for framing social problems and solutions, A fourth role is that of policy advisor. Elsewhere, we enhancing citizen participation, and allocating resources have called this working in the ‘‘belly of the beast’’ (Nelson more fairly in policy-making. I hope that the examples that and Prilleltensky 2010). I recognize that there are many I have related provide some encouragement that transfor- constraints on working inside government or closely with mative policy change is possible, as well as some government (Fox 2010). However, there is evidence that instruction about the ways we conceptualize policy change policy-makers value having advisors, inside or outside of and the roles that we can play to create such change. government, on whom they can rely for ideas and evidence about policy (Waddell et al. 2005). Without some of the Acknowledgments I thank the following people for their helpful comments on a previous draft of this paper: Tim Aubry, Camil people mentioned throughout this paper, who have taken Bouchard, Rachel Caplan, Peter Dunn, Paula Goering, Bret Kloos, on the role of policy entrepreneur, we would not have had Timothy Macleod, Eric Macnaughton, José Ornelas, Isaac Prillel- some of the important policy changes in homelessness, tensky, John Trainor, David Reville, Manuel Riemer, and Kathleen mental health, and early childhood learning that I Worton. described. Being an ally to progressive social movements is a fifth References role we can play. 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