Understanding the Role of Mental Health Clubhouses in Promoting Wellness and Health Equity Using Pilinahā—An Indigenous Framework for Health

Abstract

• Clubhouse members and staff in Hawai'i participated in a multi-site photovoice process. • This article describes what members found essential to wellness and how it can be achieved. • Clubhouses provide a space for mental health recovery and transformative change.

Kongera Kwiyubaka (rebuilding ourselves again): Culturally responsive and contextually relevant collective healing in post‐genocide Rwanda

“…Ijambo may have the form of group therapy. The most important difference between the two is that similar to Mental Health Clubhouses (Agner et al, 2020), Ijambo while formal, is spontaneous, less predictable and less structured. The facilitator exists but may not be obvious and is not necessarily an academically trained person but one whom the community collectively trust.…”

“…Similarly, in recent years, researchers and practitioners in the West and especially those serving Indigenous (Gone & Trimble, 2012) and immigrant populations in the United States (Fernández et al, 2020) have also been interrogating the hegemonic and monolithic aspect of the dominant framework of psychotherapy and have started developing more varieties of resources to meet their diverse communities’ demands (Gone et al, 2020; Haines, 2019). For example, at the Mental Health Clubhouses in Hawai'i, clients and staff members engage in nonhierarchical collaboration to collectively define and achieve wellness with dignity and mutual respect (Agner et al, 2020). In Rwanda, a longitudinal study by Kang et al (2020) demonstrated that practices grounded in the people's culture and context such as raising cows together has the potential to promote reconciliation and healing between genocidaires and survivors.…”

Applying Community‐Based Participatory Approaches to Addressing Health Disparities and Promoting Health Equity

“…The articles focused on American Indian contexts discuss culturally rooted approaches guiding the community partnerships to address various health disparities, including work by Gone, Tuomi, and Fox (2020) building a curriculum to promote traditional indigenous spirituality practices supporting overall health in urban American Indians. Agner et al (2020) implemented a multi‐site photovoice intervention in partnership with Native Hawaiian Clubhouses and applied an indigenous rooted framework to support the mental health recovery of severely mentally ill diverse participants. Skewes et al (2020) applied a CBPR approach to foment trust in partnering with and recruiting American Indians to better understand challenges to substance use and recovery support.…”

Community‐engaged Research Approaches: Multiple Pathways To Health Equity

“…Partnership processes can create new cultural narratives regarding health and wellness by, for instance, challenging assumptions regarding audiences for (and contributors to) academic knowledge, or cultural assumptions informing the design and implementation of research (e.g. Agner et al, 2020;Gone et al, 2020). CEnR may also be more resistant to deficit-based models when seeking to address social issues, or in regard to who is capable of having and creating valid knowledge (e.g.…”

“…This orientation to CEnR works better in some contexts than in others. In some cases, participation in and control over the research process have enabled marginalized communities to feel safe engaging with researchers; to reshape harmful cultural narratives about health, culture, and healing (Agner et al, 2020;Gone et al, 2020;Skewes et al, 2020); to acquire desireable research or professional skills (e.g. Espinosa et al, 2020); and to feel a sense of ownership over change-making processes that affect them (e.g.…”