Northern Initiative for Social Action: an occupation-based mental health program

Northern Initiative for Social Action (NISA) is a consumer-run, occupation-based, nonprofit organization located in northeastern Ontario, Canada. The NISA organization has grown in response to research revealing few opportunities for participation in personally meaningful and socially valued occupation for persons with mental illness living in the community of study. This article describes a mixed-design research study conducted by the ParNorth Research Unit of NISA and an occupational therapist. The study purposes were to (a) better understand the emerging characteristics of the NISA program and identify which the participants found helpful; (b) evaluate whether participation in NISA improved members' quality of life; and (c) ascertain whether participation reduced members' need for more traditional and costly methods of care (e.g., hospitalization, crisis services). Focus groups, daily participant observation, a quality of life interview, a consumer member survey and objective review of hospitalization data were used for data collection. Qualitative results indicated that NISA helped to meet participants' being, belonging, and becoming needs. Quantitative data indicated that overall, NISA members perceive an improvement in their subjective quality of life and sense of well-being. Their perceptions are supported by minimal use of crisis services and hospitalization, improved socioeconomic status, and several members' success in obtaining paid employment either within or outside NISA. Future challenges include the need to clearly describe the evolving NISA model and to ensure that the growth of this new organization does not exceed secured human or fiscal resources.