A participatory approach to the evaluation design of a case management program for the long-term mentally ill

Resistance by clinical staff is a problem frequently encountered in the course of implementing an evaluation. This paper examines the process of developing a comprehensive evaluation for a case management program for the long-term mentally ill in Metropolitan Toronto. A participatory approach was used in the design and implementation of this evaluation. Parties involved included Ministry of Health officials, hospital administrators, outside consultants, the case manager co-ordinator, case managers, and the evaluators. The goal was to elicit both understanding and support from these key actors. The advantages of this approach are highlighted, as are the limitations and problems encountered.