title: Relentless Incrementalism: Shifting Front-Line Culture from Institutional to Recovery-Oriented Mental Healthcare.
abstract: St. Joseph's Health Care London is a publicly funded hospital that has led mental health service system transformation in south west Ontario following directives from the Health Services Restructuring Commission (HSRC). This paper documents how provincial policy, HSRC directives, organizational planning, research projects, quality initiatives and change management activities drove, shaped and accomplished a cultural shift at the front line to recovery-focused care. Simultaneous to these activities, beds and related ambulatory services were divested to four other hospitals, beds and employment services were closed and two new, state-of-the-art facilities were constructed, adding considerable complexities to achieving cultural change. This paper documents the incremental steps that were taken to achieve that change.
authors: Owner/operator of the consulting firm Client Perspectives and recently retired as the project lead for Mental Health Transformation, St. Joseph's Health Care London. Her research interests include understanding the mental healthcare service user experience in order to improve service delivery and enhance the recovery process and quality of life for persons living with serious and persistent mental illness and the use of smart technology to enhance functioning in the community.
authors: Deborah J
authors: DJ
authors: Corring
authors: Director of Specialty Mental Health Services, Parkwood Institute, St. Joseph's Health Care London, has 18 years' experience in mental healthcare. Professional interests include patient experience initiatives, health service quality and system access and design strategies.
authors: Jennifer
authors: J
authors: Speziale
authors: Psychiatrist currently working at the Southwest Centre for Forensic Mental Health Care in St. Thomas, Ontario. In addition to her interest in First Nations mental health, she has trained in dialectical behavioral therapy (DBT) and is currently involved in studying its efficacy in reducing aggression in forensic psychiatric populations.
authors: Nina
authors: N
authors: Desjardins
authors: Psychiatrist and a philosopher. He is a professor at McMaster University and is psychiatrist-in-chief at St. Joseph's Healthcare Hamilton, Ontario.
authors: Abraham
authors: A
authors: Rudnick
mesh_terms: D017144:Focus Groups; D006291:Health Policy; D006778:Hospitals, Psychiatric; D007407:Interviews as Topic; D001523:Mental Disorders / Q000534:rehabilitation*; D008605:Mental Health Services / Q000458:organization & administration*; D015279:Organizational Culture; D009936:Organizational Innovation; D010865:Pilot Projects