Community engagement through the lens of intersectionality

Despite the growing interest in community engagement as an alternative way of building evidence in public health and its potential to address health disparities in marginalized populations, there is a dearth of knowledge and evidence of the ways in which participatory approaches, such as community-based participatory research (CBPR), engage and impact people with lived experience of mental illness. Although CBPR offers the promise of addressing factors associated with mental health inequity, it faces its own set of ethical and methodological concerns related to the authenticity of community participation and a lack of understanding of the ways in which active engagement in CBPR affects community members. For people with psychiatric diagnoses, mental health inequities are a reflection of persistent and intertwined social and structural inequities rooted in historical exploitation and ongoing systemic subjugation through psychiatrization, criminalization and stigmatization of mental distress. While people with lived experience of mental illness face similar mental health inequities, the way they experience or respond to oppression is contingent on the ways it intersects with different social locations, such as gender, social status or race and power relations, such as sanism. Thus, an exploration of engagement from the participants’ perspective and a critical examination of multiple and intersecting social factors and underlying power relations are needed. In this Master’s thesis, I apply a critical lens of intersectionality to a CBPR case study (Imagining Inclusion) to examine the research question: “How do the intersections of social locations and systemic and structural processes shape the experience of engagement in CBPR for people living with mental illness?” Intersectionality-informed analysis of thirteen in-depth individual interviews with people living with a mental illness revealed three major themes: 1) definitions and dimensions of community engagement; 2) tensions around joining Imagining Inclusion and sustaining engagement; and 3) tensions around collaborative relationships. In this project, I contribute to the call for this type of consideration of engagement by employing an intersectionality lens to explore the term engagement and the experiences of engagement in Imagining Inclusion from the perspectives of people with lived experience of mental illness.