The Significance of Client Contact
Roundtable facilitators all expressed their understanding that a key aspect of their role was to encourage participation from all participants. Despite their efforts however, some group members perceived that clergy contributed more to the discussion than MH staff, especially as it related to presenting burning issues. One MH staff attributed this to two factors; first, there was a slightly larger clergy presence, and second she, as well as some of the other MH staff, were administrators and they therefore had little client contact. Regarding the difference in discussion participation, she said, “one possibility is that I’m an administrator, so I don’t have particularly that much direct client contact. We just didn’t have as much fodder for discussion.”
One repeatedly expressed sentiment was that there seemed to be a high level of mutual regard between the clergy and MH staff who participated in the Roundtable. “I think what I have appreciated and enjoyed is that there does seem to be a high degree of regard and respect for one another,” said one participant. While the Roundtable group may have become unified in their mutual regard, it took time to become unified in their purpose. According to one parent advocate, “it took a while for the whole group to engage and go in the right direction”. An MH staff member describes her experience:
The first few months, it took us a while to really get a sense of what our purpose was, and I think in the last few months is when we really have come together and are sharing a unified purpose. I guess if you follow group dynamics, we kind of had our own forming, storming, norming. So I guess what I’m saying in essence is, I think once a month for a year, we’re probably about where we should be, taking the time to get to know each other, to trust the process, to trust each other, to become familiar with each other. I think it was a process that takes time.
Points of Contention in the Roundtables
RESEARCH. Although everyone interviewed stated that the overall experience was positive, the fact that there was a documentation project on the Roundtable pilot project was an issue that caused concern. Some SPA 6 participants expressed concern that there would be a “research” component to the Roundtable, but this did not trouble participants in the SPA 7 Roundtable.
In our visit to the SPA 6 Roundtable, the participants did not understand the documentation project. They believed that they would be research subjects and that USC researchers were using the Roundtable as a laboratory to extract information about community issues and concerns, and then potentially misrepresent these issues to the public. This perspective also emerged in interviews in which some participants expressed discomfort with any research effort involving the Roundtable. Others stated that although they themselves were not stymied by it, they could see its impact on the group. For example, one mental health program head noted that the research piece made some participants defensive and perhaps drove them away:
[W]hen they heard it was going to be a research project, the fences went up very quickly. And that’s when it was kind of like, “…What do you mean, research? What’s going to be said? Sometimes things have come out negatively that have impacted the community negatively, and we’re concerned about that.” So that particular church did not come back.
The group facilitator had the same perception:
We noticed that there were a few clergy, who are no longer in our meetings, that were a little hesitant to participate. But more than anything they were concerned about the research part of it, concerned that having their opinions and information discussed was going to be misinterpreted at some point during the research study.
The general sentiment from SPA 6 participants was that the purposes and plans for the research component were not explicitly stated at the beginning of the Roundtable, making some people experience difficulty in trusting the entire Roundtable process.
As noted, however, this issue did not emerge in SPA 7. Thus, it is important to note key differences in participant recruiting and organizing methods for the Roundtables, as well as larger differences in their composition. The project consultant created a process to recruit and screen participants for the roundtable project as a whole. The consultant was able to follow the process in SPA 7, but was not able to in SPA 6. In SPA 6, clergy were recruited to participate without a screening process. This, combined with longstanding sensitivities among some communities of color over past research abuses—and the feeling that they are over-studied with no practical outcomes or improvements to their communities—led to the skepticism and distrust that was encountered in SPA 6.
RELIGIOUS DIVERSITY. Many clergy and MH staff expressed an appreciation for the religious diversity of the group because it gave them insight into other faith traditions. In SPA 6, no conflicts with a basis of differences in belief were reported. However in SPA 7, a discussion about the origin of psychosis resulted in one Roundtable member stating the belief that psychosis had a demonic source, and was reluctant to accept that perhaps there might be another explanation. This difference with the group has persisted, although the participant has continued to attend the Roundtable, despite the sometimes contentious atmosphere it creates in the group. Interestingly, participants in SPA 6 did talk about how one might distinguish between demonic possession and schizophrenia, yet rather than being a contentious topic, many noted this as an engaging and rewarding conversation.