CHAPTER 4

Social Enterprises and the Integration of Persons with Mental Disabilities in the Greek Society: A Case-Study of Koispe Athena-Elpis

Aikaterini Argyrou, Tineke Lambooij, Robert Blomme, and Henk Kievit

Social Enterprises and Participatory Governance

The concept of “social enterprises” has been the subject of various theoretical definitions that vary in the scholarship produced by scholars from different disciplines and nationalities. Kerlin (2006, p. 248) introduces a broad definition that comprises a very wide range of organizations that constitute “a continuum” of different types of social enterprises that encompass: (i) profit-oriented businesses engaged in socially beneficial activities including also the concept of corporate philanthropies and the concept of corporate social responsibility; (ii) hybrid organizations that are dual-purpose businesses that mediate profit goals with social objectives; and (iii) nonprofit organizations engaged in mission-supporting commercial activities with a social purpose. The continuum of social entrepreneurial types is addressed in various other studies (­Galera and Borzaga 2009; Johnson 2000; Roper and Cheney 2005; Mair and Marti 2006). Nonetheless, currently in Europe, there is a common understanding among scholars and politicians, regarding the ideal type of social enterprises, in a normative manner, and regarding the operational characteristics that define and distinguish social enterprises from ordinary entrepreneurial entities and organizations (EC COM 2011 682 final, pp. 2–3, consultation activities of GECES at ec.europa.eu). Accordingly, social enterprises constitute economic operators of the social economy sector that pursue the fulfillment of a principle social objective. They are thus, private organizations with a “problem solving nature” concerning social issues (Galera and Borzaga 2009, p. 212) that they adopt as their social and economic mission, as opposed to public organizations that are predominantly subject to objectives of public benefit and nonprofit activities (Haugh 2005, p. 2). However, the pursuit of a social objective by a social enterprise is also understood to produce a social impact rather than to make a profit. The accomplishment of social impact implies a tangible social performance that can be assessed, evaluated, and measured (EC COM 2011 682 final, p. 8; Ebrahim and Rangan 2014; Austin et al. 2006; Bagnoli and Megali 2011; Sharir and Lerner 2006).

Additionally, social enterprises are commercial organizations that operate in the market by providing goods and services, by means of profit-making activities. The outcome of social enterprises should be primarily reinvested to fulfill the social objective in pursuit. Financial sustainability is a prerequisite for social enterprises, which should be independent and thus not reliant on state-funding and philanthropic aid (Haugh 2005, p. 2). On the contrary, through their trading aim they strive to generate socially tangible outcomes (Haugh 2005). Other than this, social enterprises while pursuing social objectives and social impacts should exhibit a high level of accountability to their beneficiaries regarding the produced outcomes (Dees 1998, p. 4). This requires social enterprises to be managed in a socially responsible manner, which is primarily participatory and inclusive and it mainly involves employees, consumers, and all the types of stakeholders that are affected by any social enterprise’s commercial activity (EC COM 2011 682 final, p. 8).

Participatory governance is an imperative element of social ­enterprises in a normative context. Social enterprise use legal models that encourage the involvement of different actors with various stakes in the pursuit of the entrepreneurial objectives but also care to include various actors in the organizational affairs and governance (Huybrechts, ­Mertens, and Rijpens 2014, p. 158; Larner and Mason 2014; Spear, Cornforth, and Aiken 2009, pp. 261–62; Low 2006; Mason, Kirkbride, and Bryde 2007). As Campi, Defourny, and Gregoire (2006) note, participatory governance “suggests that the involvement of stakeholders leads to their having a real voting power and not just a symbolic one” in the social enterprise (pp. 38–39). However, following the empirical evidence by Campi, Defourny, and Gregoire (2006, pp. 38–39), the participatory governance of social enterprises’ stakeholders is mainly exercised “in a formal level” whereas social enterprises are characterized “by a high degree of informality, often affecting the decision-making processes as well.” This means that the formal participation in social enterprises’ ­decision-making bodies might be insufficient for stakeholders to participate in decisions made outside of the governing bodies or for stakeholders who do not have access to the governing bodies (Campi, Defourny, and Gregoire 2006). The authors, in previous studies elaborated on the concept of stakeholder participation in Greek social enterprises that are social cooperatives and particularly on the participation into membership, ownership, and governance of a significant stakeholder category, that is, the employees (Argyrou et al. 2016; Argyrou and Lambooy 2016).. Subject to the cooperative’s tradition in which the decision-making power of members is equal and democratic on the basis of the “one man one vote rule,” employees may acquire a substantive role when participating in the affairs of the organization and in decision-making activities ­(Argyrou and Lambooy 2016, forthcoming; Argyrou et al. 2016). The concept of participatory governance from a legal perspective as developed in the authors’ previous studies encompasses the different roles of various categories of social enterprises’ stakeholders in decision-making processes as well as the legal rights provided to stakeholders in tailor-made ­legislation for social enterprises, that is, ownership rights, voting rights, consultation rights, rights to information (Argyrou and Lambooy 2016; Argyrou et al. 2016). These rights allow them to participate in the decision-making processes of the social enterprises in various ways (various stakeholder mechanisms). The different ways as observed in other studies conducted by the authors have been clustered in the categories of direct and indirect participation, formal and informal participation, structural and ad hoc participation.

Social Enterprises of Work Integration

International academic scholarship notes the role and function of social enterprises, which could be closely associated, complement, or even take over a significant part of the economic responsibilities of the public sector, such as: (i) the allocation and production of quasi-public goods and services in a redistributive manner, through the provision, of services to deprived people; (ii) the task of assisting deprived people, who are at risk of permanent exclusion from the labor market, to return back to work (Defourny 2001, pp.1–2; Defourny 2014, p. 20). This role is reflected since the 1990s, in a significant social enterprise type, that is, the “work integration social enterprises” (WISE) (Huybrechts, Mertens, and Rijpens 2014, pp. 166–67; Campi, Defourny, and Gregoire 2006, p. 31; Spear and Bidet 2005, p. 197). The WISE paradigm exists in various national jurisdictions, in particular laws on social entrepreneurship, that is, the Finnish Law on Social Enterprises 2003, the Polish Law on Social Co-operatives, and even the Greek Social Entrepreneurship Law 2011 (Defourny and Nyssens 2010, p. 37). Cafaggi and Iamiceli (2009, p. 27) point at the emerging evolution of legislation in various EU countries, in which the legislators have acknowledged the development of social enterprises as new economic operators. These countries have defined in legal instruments the concept of social enterprises and their distinctive status, that is, they have developed “tailor-made legislation for social enterprises” (Argyrou and Lambooy 2016, forthcoming; Argyrou et al. 2016 Springer; Argyrou et al. 2016; Lambooy and Argyrou 2014). These tailor-made laws, regardless of the legal model conferred to the WISE, contain rules and policies that support the employment of persons with disabilities, groups of long-term unemployed or other particular deprived and vulnerable groups in need of socioeconomic integration (such as ex-convicts or drug addicts for instance) (Defourny and Nyssens 2010, p. 37).

Social enterprises with their inherent “problem solving nature” in respect of social challenges and particularly the WISE paradigm of social enterprises has been a legal vehicle, which is fruitful for the development of contemporary public policies that facilitate entrepreneurial responses to social issues while also providing employment opportunities to vulnerable societal groups, such as the people with physical, mental, or other disabilities.

Legal Models for Work Integration Social Enterprises in Greece

In Greece, the Law on the Social Economy and Social Entrepreneurship 2011 (hereinafter, the “Social Entrepreneurship Law 2011”) introduces the concept of social entrepreneurship in the Greek legal system (Social Entrepreneurship Law 4019/2011, Off.Gov. Gaz. 216/30.09.2011). The Social Entrepreneurship Law 2011 contains public policies that aim to strengthen and empower the social cohesion of the Greek population in an ongoing-crisis environment through the provision of labor opportunities, work rehabilitation, and the promotion of social entrepreneurship activities of vulnerable social groups (Explanatory Notes to the Law 4019/2011 on the Social Economy and Social Entrepreneurship, August 2011, p. 2). Among other legal provisions, in the Social Entrepreneurship Law 2011, a special type of social cooperative following the WISE paradigm is introduced, that is, the Social Cooperative Enterprise of Integration (Koinsep of Integration) (Argyrou et al. 2016; Argyrou and Lambooy 2016, forthcoming; Arts 1(3) and 2(2)(a) Social Entrepreneurship Law 4019/2011). This new legal model has a social purpose that aims to the social and economic integration of individuals and groups through labor and employment, which are considered as vulnerable in the Greek society. In legislation, “vulnerable groups” constitute those groups of individuals who belong to the weakest and most excluded parts of Greek society. The Social Entrepreneurship Law 1999 subsequently defines these groups as the groups whose integration into the social and economic life is hindered, by physical and psychological constraints or due to delinquent behavior. The legislation offers indicative examples by referring to the “vulnerable groups,” such as among others, the people with disabilities (physical, mental, or sensory). Other groups mentioned in the broader category of vulnerable groups are the “dependent or detoxified from substances” persons, the people with HIV, any prisoners, convicts and ex-prisoners and, finally, young offenders. The legislation also prioritizes the promotion of individuals belonging to these groups into the labor market by introducing a minimum mandatory employment quota of 40 percent in the Koinsep of Integration.

However, the public policy that promotes the socioeconomic integration of persons with disabilities, and especially mental disabilities, is not a new one. In 1999, the Greek legislator introduced a legal model, the so-called “Limited Liability Social Cooperative” (hereinafter “Koispe”), which employs solely persons with mental disabilities and psychosocial problems (Law 2716/1999, concerning the Reformation and Modernisation of Mental Health Services, Off.Gov. Gaz.96/17.03.1999). The Koispe model of social enterprise is simultaneously a mental health unit and a commercial enterprise that supports people with severe ­psychosocial problems (people who suffer from severe mental disorders) through vocational rehabilitation, integration, and training. Koispe are social cooperatives that seek to promote the social and economic integration of persons with psychosocial problems in contribution to their treatment and their economic self-sufficiency and independence in life. People with mental disabilities and psychosocial problems generally suffer from ­psychiatric problems that impede their participation and equal contribution to the economic and social life. Psychosocial problems have, respectively, resulted in the creation of significant barriers for these people to enjoy a social and economic life that is further translated into employment constraints, long-term unemployment, lack of education (people often fail to be trained in institutions of higher education), or termination of education due to the mental disorder.

The Koispe legal model is a private legal entity with a commercial status, the members of which enjoy limited liability. The Koispe legal model is also subject to the latter Social Entrepreneurship Law 2011, which requires that all Koispe organizations are eligible to maintain their legal personality and the legal characteristics that Law concerning the Reformation and Modernisation of Mental Health Services 1999 initially provided, however, must comply with all the additional requirements regarding the Koinsep legal model included in the Social Entrepreneurship Law 2011 with respect to registration, governance, accountability, and so on (Art. 2(2)(a), Social Entrepreneurship Law 4019/2011). Other than this, the Social Entrepreneurship Law 2011 stipulates that all Koispe should “automatically adhere” to the rules applicable to the latter special legal model, that is, Koinsep of Integration included in the Social Entrepreneurship Law 2011.

Koispe are mental health units and parts of the mental health sector in Greece. Subsequently, although private and commercial characters, Koispe have a hybrid character and they are also subject to the authorization, monitoring, and supervision of the Ministry of Health in Greece and particularly the Mental Health Division. Additionally, the Law concerning the Reformation of Mental Health Services 1999, requires Koispe, to be incorporated as mental health units that are geographically and ­demographically designated. In the context of the Law, the geographical extent of Greece has been divided into 64 Mental Health Divisions, which allow a numerus clausus in the incorporation of 64 Koispe per ­Mental Health Division.1

The Koispe Legal Model and Participatory Governance

Koispe’s legal model ownership and governance structure is complicated. The cooperative capital of Koispe is divided into shares that may be acquired by multiple (three in total) types of members and corresponding member categories (Article 1(4) Law concerning the Reformation of Mental Health Services 2716/1999, Articles 3(1)-(6) Social Entrepreneurship Law 4019/2011 and Law 1667/1986 of Law concerning Civil Co-operatives). However, all Koispe members, regardless of the member category to which they will eventually adhere to, are obliged to acquire at least one mandatory cooperative share following a complex set of rules in the Law concerning the Reformation of Mental Health Services 1999, the latter Social Entrepreneurship Law 2011, and the applicable legal framework regarding civil cooperatives in Greece (Law 4019/2011, Law 2716/199, Law 1667/1986). Accordingly, the corresponding member categories are divided as follows:

  1. The members of Category A comprise natural persons including adults and young persons, who are at least 15 years old, and who due to mental disabilities are in need of rehabilitation, regardless of their diagnostic category, stage of the disease, residence, and legal capacity to act (including contractual capacity). The Koispe cooperative members of this category should constitute at least 35 percent of the total sum of members and cooperative shareholders. The members of this category may be also employed and receive remuneration by the Koispe.
  2. The members of Category B comprise adults who are mental health professionals, such as occupational therapists, trainers, psychiatrists, or psychologists. Type B members cannot exceed 45 percent of the total number of the Koispe members. These members are additionally allowed to offer either full- or part-time services subject to rules included in the Koispe statute of association, constitutional documents, and rules of operation.

Finally, the members of Category C cannot exceed 20 percent of the total number of the Koispe members. Category C comprises members who are natural or legal persons from the public and/or private sphere such as municipalities, communities, companies, or in particular the ­hospitals, such as psychiatric hospitals, general hospitals, or any ­private organization that belongs to the mental health sector. Category C ­members are also subject to additional rules including the constitutional documents and the statutes of association of each Koispe and the applicable legal framework. For instance, although, in the latter Social Entrepreneurship Law 2011, it is stipulated that the Koinsep legal model is subject to a limitation regarding the participation of legal entities in Koinsep as members, which may not exceed the rate of one-third of the total amount of members, there is an exception regarding the Koinsep of Integration (in Article 3(3) of Law 4019/2011). The general rule is that the participation of public and local authorities as members in the ownership of the organization is not permitted in order to protect their entrepreneurial autonomy and commercial capacity; however, this does not apply to the Koinsep of Integration and consequently to Koispe. The legislation stipulates that legal public authorities may participate as members in the Koinsep of Integration and consequently in the Koispe legal model subject to the approval of the institution that supervises them (Article 3(3) of Law 4019/2011).

Respectively, governance in the legal model of Koispe is jointly exercised by three governing bodies, the General Meeting of the Members (GMM) including all the members from Category A,B,C, the Management Board, and the Supervisory Board. The GMM is the competent body to make the most important decisions of the Koispe regarding the amendment of the terms in Koispe’s constitutional documents, the management, the financial control, and the execution of operations (Article 12(11) of Law 2716/1999). All members are entitled to attend the GMM and vote following the “one man one vote” ruling, which allows the democratic and equal participation of all the participants with one vote regardless of the number of shares they own. For instance, the GMM not only appoints and elects both the members of the Management Board and the Supervisory Board but also supervises and controls the members comprising these governing bodies. In case of any infringement, of the members of the Management Board and the Supervisory Board, the GMM is competent to discharge their liability or terminate the membership at any time for a good reason that would constitute breach of duty or inability to exercise good governance. The GMM finally makes the decisions regarding the financial position and strategy of the Koispe. It approves the annual balance sheet and the annual accounts. In extraordinary circumstances, such as in the occasion of exceptional losses, it can change the amount of the mandatory cooperative share.

The management board is in charge of the daily management. Its competence is subject to Koispe’s articles of association and the applicable legal framework regarding civil cooperatives. For instance, the management board coordinates the economic management of the organization (Article 12(9) of Law 2716/1999 and Article 7(4) of Law 1667/1986 concerning civil cooperatives). This competence requires the administration among others, of the purchase of assets and consumable goods, the hiring or dismissal of staff, the representation with public authorities and third parties, and the conclusion of contracts with partners. However, except for the managerial decisions, the management board has a more significant role in convening the regular and extraordinary GMM, in determining the issues to be discussed, in preparing the annual accounts for approval, and in admitting new members in accordance with the provisions of the statute of association and the Koispe legislation (Article 12(11) of Law 2716/1999). The GMM appoints the members of the Koispe’s management board by voting. The Law concerning the Reformation of Mental Health Services 1999 requires that the board should comprise seven members from different member-categories, that is, Category A, B, or C of which five must belong to the Categories B and C and two of them must belong to Category A, that is, the persons with mental disabilities. Respectively, Category A members are only permitted to become members of the management board depending on whether they are in full privative judicial assistance, that is, to have their legal capacity limited and deprived and accordingly to be in a position in which they cannot carry out any legal transactions (Article 12(9)(1) Law 2716/1999). Furthermore, although, the management board is convened and its members vote openly to appoint a president, a vice president, a secretary, and a treasurer, Category A members are explicitly excluded from acquiring these positions, following Article 12(4) of the Law concerning the Reformation of Mental Health Services.

In the Koispe legal framework, it is stipulated that Category A members, that is, persons with mental disabilities who are under a status of full privative judicial assistance cannot carry out the necessary legal transactions that their position might require and they are thus deprived from the right to be appointed as members of the Koispe management board. Additionally, all the appointed representatives of Category A members, regardless of their status as legally capacitated or not, are excluded from acquiring the higher managerial positions in the management board. The deprivations are justified as necessary, in the Explanatory Notes of the Law concerning the Reformation of Mental Health Services 1999, to safeguard the perceived legality and the legal certainty of transactions performed by the managers’ representatives of the Koispe with third parties (Explanatory Notes to the Law 2716/1999).

Category A members are also excluded from their appointment as members of the supervisory board. As it is explained in the Explanatory Notes of the Law concerning the Reformation of Mental Health Services 1999, the extent of responsibility of this supervising body cannot be carried out by Category A members, due to its extensive and important character (Article 12(10) of Law 2716/1999. Explanatory Notes to the Law 2716/1999). The competence of the supervisory board rests on the control of the actions of the management board in compliance with the decisions produced by the GMM. The members of the supervisory board have accordingly the right and the obligation to inspect the ­accounting books, any document or materials produced by the Koispe administration and operation, to carry out ad hoc controls, and monitor the financial and operational position of Koispe. Hence, Type A members are precluded from the task of supervising the organization subject to the explicit limitation of the Law concerning the Reformation of Mental Health Services 1999.

Persons with mental disabilities and psychosocial problems although admitted into Koispe’s ownership, membership (Category A) and thus governance, do not enjoy equal rights with the other members in the Koispe organization regardless of being legally capable or not. Although Category A members may exercise the majority of rights in the ­decision-making processes of the Koispe—that correspond to ownership of the cooperative capital and admittance into membership—such as ­exercising their voting rights in the GMM, appointing or be appointed as members of the management board, they are not yet equally and fairly included in the governance of the Koispe legal model. They are unjustly excluded by law from the positions of the management board on the basis of their legal capacity and from the higher positions of management, with arguments that are not convincing and discriminatory on the basis of disability and legal capacity. Those arguments are not only contrary to the existing normative framework regarding the human rights of persons with disabilities in all aspects of life (Convention on the Rights of Persons with Disabilities 2007-CRPD), which recognizes that “persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life” but they could also have negative effects in the process of socioeconomic integration of persons with mental disabilities (UN General Assembly, Convention on the Rights of Persons with Disabilities: resolution/ adopted by the General Assembly, January 24, 2007, A/RES/61/106).

The precarious effects of the provisions that exclude Category A members from the management of Koispe can be noticed in the following empirical study of a Greek scholar. Adam (2009), in her doctoral thesis, examining empirically the multi-stakeholder character and the governance of 16 Koispe organizations concluded that the multi-stakeholder character of the Koispe legal model does not entail the formal participation of stakeholders into the governance of Koispe (contrary to Campi et al. findings), especially as regards the persons with mental disabilities (Category A members) and the local partners (Category C members). Particularly, with respect to Category A members, Adam (2009) found that the greatest advantage of the multi-stakeholder structure of Koispe’s management board is their empowerment and determination in the socioeconomic life through participation as they gain ground and power in the organization, while also obtaining a more comprehensive view of the cooperative operation (Adam 212, pp. 167–71). However, Adam revealed that the equal participation of Category A members with other members, from categories B and C, in the management board is mainly perceived by these managers as detrimental to the functioning of the organization due to (i) the special characteristics of Category A members. For instance, in Adam’s study the managers predominantly claimed that Category A members are unstable and they might relapse during the decision-making processes due to their mental disability and their psychiatric institutionalization background. Other managers, claimed that Category A members are low-class individuals with lower education and socioeconomic standing; (ii) the lack of maturity of the Greek legal framework to embrace equality and the human rights of mentally disabled people, showcasing the actual stigmatization of persons with mental disabilities in Greece through law; (iii) the underlying risk for the mental health status and safety of Category A members, if they have knowledge of sensitive information that might relate to their mental health status or the status of others; (iv) the knowledge of the weak financial position of Koispe and the lack of financial sustainability, which might generate uncertainty and frustration in the mental health status of Category A members (Adam 2012, p. 172). Particularly, the vast majority of Category B members, that is, mental health professionals admitted that the difficulty of integrating Category A members in managerial positions is a result of their lack of social skills and their lack of training. None of the managers, however, admitted that the difficulty is caused by the lack of willingness of Category A members to participate in the governance (Adam 2012, p. 278). Additionally, Adam notes that Koispe miss a uniform and systematic process that promotes the confidence of Category A members to participate in governance. In this respect, Category B members indicated that the mainstream way for Category A members to participate in the governance as members and employees is through the formal bodies of governance, that is, the management board and the GMM. Likewise, Category A members indicated the processes of the management board as the most essential, due to the importance of their content and the greater frequency of meetings.

The undermined position of the persons with mental disabilities and psychosocial problems in the management of the Greek Koispe and the discriminatory rules included in the Koispe legal framework are thus evident. It is our objective though to investigate, through the development of an in-depth case study, how the current implementation of the stipulated legal provisions regarding governance and management from a selected Koispe has shaped the participatory governance of the selected Koispe and whether other systematic processes have been developed to provide a fair participation of persons with mental disabilities and ­psychosocial problems to the higher levels of governance. The research question asks for the examination of the exerted influence of legislation (the legal model and the rules included in the applicable framework) over one selected social enterprises. Through the empirical research process we aim to examine how the implementation of legal provisions affect and shape the governance of one social enterprise. Our aspiration is to showcase using empirical techniques the concrete role of various types of stakeholders in governance and thus unravel the concept of participatory governance, and to provide insightful proof regarding the effectiveness of law regarding the participatory governance of social enterprises.

Method

The single case study presented in this article contributes to the development of a larger research project in which, the authors through the ­development of various single or multiple case study reports, imitate the same method in the development of the theoretical framework, the ­collection of empirical data, and the analysis of the collected data (Argyrou et al. 2016 Springer; Argyrou et al. 2016; Lambooy et al. 2016; Yin 1984; Corbin and Strauss 2014; Crabtree and Miller 1999). The research method used for this study commences with the examination of tailor-made legal ­models for social enterprises in various jurisdictions, such as Greece which is the country of interest for this chapter. Other countries in the research scope of the authors are United Kingdom, ­Belgium, and the Netherlands. A preliminary legal research on the legal models and its theoretical elaboration furnish a meaning to the applicable rules and if any existing case law regarding various special legal model of social enterprises under examination such as the Greek Social ­Cooperative Enterprise (Koinsep) and its precursor, the Koispe, the Belgian Vennootschap met Sociaal Oogmerk (VSO), and the British Community Interest Company (CIC). Subsequently, we investigate through the development of in-depth case studies the shape and the functioning of participatory governance in the examined tailor-made legal models (Argyrou et al. 2016 Springer; Argyrou et al. 2016).

Accordingly, the authors collected data from various sources, that is, through interviews conducted with respondents from one selected Greek social enterprise, that is, the “Koispe Athena-Elpis” (hereinafter KAE). The collected information was triangulated with information that was collected from relevant documents, such as the constitutional documents of the selected social enterprise, for example, articles of association, any reporting documents, for example, annual reports and recent publications, and through feedback that the interviewees provided to the authors during processing the data and developing the case study. The interviews were conducted on the basis of a protocol with persons from different organizational layers to safeguard the plurality of perspectives and insights in the responses. The persons involved in the interviews are: (a) one member and owner of the organization; (b) one stakeholder; (c) one manager; and (d) one employee, and they have been coded (as owner, stakeholder, manager, employee). Indicatively, the majority of our respondents are professionals of mental health with a background in Medicine, Business administration, and Management of Health Care Units. Only one respondent albeit having basic education, he has a long working experience in a bank and in a retail company. Additionally, two of the respondents have been previously involved in social entrepreneurial initiatives and one of the respondents is a founding member of another Koispe organization. The data that we collected through interviews were processed using the constant comparison method, that is, coding technique that was then followed by a template analysis method (King 2004). We thus developed ancillary a priori template codes that we deduced from the legal analysis that the authors refined them with inductive codes from the data. These codes were then combined into themes (see Table 4.1).


Table 4.1 Codes and themes

Template codes that emerged from legal analysis

Initial coding categories

Themes

Koispe organization

size of organization

Hybridity

social impact

economic impact

duality

multifaceted mission

Functional activities

integration and treatment

Recipients of mental health and employees

beneficiaries of the policy

emotions play a role

engagement in entrepreneurial activities

psychological support and treatment at work

organizational structure

services in the market

Ownership rights

policy challenges

Hesitant Category A members and owners of the organization

legal form challenge

unjust exclusion

justification of exclusion

multi-membership is a challenge

Governing bodies

participation in the management board

Unfairly excluded decision makers

participation in the general assembly

participation in administration

conformity in decision making

Voting rights

democratic participation

Information rights

members’ access to information

nonmembers’ access to information

Employee participation

direct participation

formal participation

informal participation

indirect participation

regular participation

Structured process

Stakeholder participation


Results: The Participation of Category Members in the Function and Governance of the Koispe Athena-Elpis

The Hybrid Function of Koispe Athena-Elpis

KAE is a Koispe incorporated in 2012. The statutory purpose of KAE is the integration of people with severe psychosocial problems into the labor market and their psychosocial rehabilitation to the extent that they reach an independent living and economic self-sufficiency. Respectively, the organization is characterized by a duality in the purpose, which is simultaneously economic and social. This is reflected in the organizations’ public mission that states: “We operate with a social orientation.” The economic element of the purpose has a twofold essence. According to KAE, the organization aims primarily to operate as a distinguished social enterprise in the local economy, which offers labor opportunities, quality working conditions, and adequate remuneration to persons with mental disabilities. Additionally, the organization aims to achieve financial viability and effectiveness through offering membership opportunities to local and institutional partners and by reinvesting any generated profits to the organization’s purpose for further growth and development. The social element of the purpose is demonstrated in the organization’s objective to develop an integrated psychotherapeutic rehabilitation process through the employment of people with severe psychosocial problems, which primarily aims to reduce their symptoms and improve their social and professional skills. The provision of labor opportunities to mentally disabled persons and their participation in entrepreneurial activities will increase their autonomy and ­self-sufficiency and it will finally mitigate their exclusion, discrimination, and stigma in society. The social element of the therapeutic rehabilitation and social integration is realized via “on the job” treatment and professional training of these persons. However, according to one respondent, KAE is primarily a mental health unit and secondarily an undertaking [interview with 1.1, 16 Oct 2014]. Therefore, the social element of the purpose is perceived as more important than the economic element.

KAE was founded by 112 members. Currently it comprises a total of 125 members divided into three categories of members as the Law concerning the Reformation of Mental Health Services 1999 requires, that is, (i) over 50 Category A members who are persons suffering from psychosocial problems and they are, thus, the recipients of mental health treatment and rehabilitation; (ii) a maximum of 45 Category B members who are the mental health professionals; and (iii) a maximum of 20 Category C members who are natural or legal persons from the public and/or private sphere, among them four NGOs, two public hospitals, a community mental health center, a private elderly care unit, and the Athens Association of Alzheimer’s Disease and Related Disorders. The increase of membership, since the Koispe was initially established, is perceived by the founding members as an indication of the society’s intention to support Koispe’s activity by contributing and assisting with tangible resources in the fulfillment of the organization’s purpose [interview 2.2, 13 Sept 2014]. However, KAE is rather a small business organization. It comprises only 35 employees of whom 18 are recipients of mental health services. They also constitute in their majority Category A members of the cooperative. The participation of employees in membership is not mandatory, neither all Category A members are Koispe’s employees. According to one respondent, employment and membership coincide with Koispe’s objective to create job opportunities for people with serious psychosocial problems while also assisting them to a broader psychosocial rehabilitation in community structures [interview 3.3, 16 Oct 2014]. Accordingly, persons with mental disabilities have the following roles in the KAE. They are:

  1. Recipients of mental health services and of vocational training.
  2. Employees-providers of commercial services.
  3. Members (Category A) and owners of the organization.
  4. Decision makers and appointed managers.

The Various Roles and Rights of the Mentally Disabled in the Functioning and in the Decision Making of the Organization

The Mentally Disabled as Recipients of Mental Health Services and of Vocational Training

Persons with mental disabilities are recipients of mental health services that the KAE offers as a mental health unit. These persons are also the beneficiaries of the public policy regarding a broader psychosocial rehabilitation and integration through vocational training and ­employment. The organization is dealing with the mental health of person with mental disabilities during their training and after they have been employed. Persons with mental disabilities are in need of special support from the mental health professionals while engaging in difficult and complicated labor activities and in training. A respondent mentions: “We need this type of support to control the recipients’ expectations at the beginning regarding the processes of new entrepreneurial initiatives, that might ultimately move slowly or not move at all, creating feelings of frustration and disappointment to them” [interview 2.2, 13 Sept 2014]. This perspective notes the emotional engagement of entrepreneurially risky operations for persons with mental disabilities involved in Koispe organizations as Adam also notes (see above). Accordingly, KAE has developed in its organizational structure a supportive counseling department, that is, a group of mental health professionals and doctors, such as ­psychiatrists, ­psychologists, social workers, health visitors, and general practitioners. The main function of the supportive counseling department is the development and the implementation of an integrated “on the job” psychotherapeutic process and support. This process entails the psychotherapeutic assessment, monitoring, management, ­counseling, and support of the trainees and employed individuals with mental ­disabilities including also the involvement of their families in the ­counseling process. The function of the supportive ­counseling department is autonomous during the ­psychotherapeutic process. ­However, the department has an obligation to inform the higher levels of management and ­administration, ­regarding the progress of the recipients of mental health services. During the ­psychotherapeutic process, the supportive counseling committee does not substitute or replace the treating doctor of the mental health recipients nor any pre-existing therapeutic framework. Primarily, KAE’s supportive counseling committee considers the therapeutic treatment and ­medication of any recipient and potential trainee or employee with mental disabilities. It, respectively, refers to the administration and ­management of the organization to investigate the possibility of training and eventually employment. When a candidate is confirmed as eligible to proceed to the next step, he/she submits to KAE an ­application and a confirmation letter of his/her treating doctor that he/she is in a position to work and offer services. KAE attracts and receives many candidates who are hospitalized in mental health units and ­hospitals that are Type C members of KAE. Any candidate’s application has information regarding the educational background and the working experience. Following the job application, a medical file is developed for each ­employee-candidate. Koispe’s general practitioners and psychologists evaluate the physical and mental health of the candidate. On the basis of the candidate’s profile, Koispe’s administration suggests the position of the candidate and ­provides recommendations regarding the working days and the hours. The vocational training is done on the job. The candidates are hired on the basis of their ­professional experience. The recipients are trained for two months together with professionals and assigned instructors. Following the training, the recipients’ working hours are increased and accordingly the performance is monitored. The ­supervisors and instructors ­supervise the entire process. One respondent mentioned that clear rules and structured processes in the organization assist the recipients of mental health to have a better ­performance and a clearer understanding of their ­responsibilities with respect to ­operations. It also assists the organization to account to the Ministry of Health on the basis of documentation and records regarding all the aspects of administration and daily operation of the organization.

The Mentally Disabled as Employees and Providers of Commercial Services

KAE comprises the following organizational departments (see Figure 4.1): (i) the administration; (ii) the supportive counseling committee; and (iii) the business operations. The persons with mental disabilities are employed to support positions in business operations and in the administration.

Image

Figure 4.1 KAE’s organizational structure

KAE currently runs three operational projects; that is, cleaning services, catering services, and shop in shop retail. Each project integrates into the workplace the persons with mental disabilities and the professionals of mental health. In detail, with respect to the provision of cleaning services and services of spatial management, the KAE has developed a professional cleaning crew that offers services predominantly to large public institutions such as the National School of Public Health. Other than this, KAE offers catering services in receptions, weddings, and other festivities. Finally, the organization has established small shops within other shops (shop in shop retail), such as the establishment of a copy store and a help desk in the premises of the National School of Public Health that offers printing services to students. Moreover, KAE has developed a small canteen in the facilities of a private elderly care unit, which offers catering services to the elderly, their visitors, and the employees of the unit. In return, the elderly care unit has admitted into the ownership and membership of the organization as a Category C member.

The Mentally Disabled as Members and Owners of the Organization

Although, multi-stakeholder membership and ownership is an important element of the Koispe legal form, in the start-up phase of the KAE, was proved burdensome and detrimental. A respondent mentioned, “we had to involve more than 100 members from three different categories A, B and C” [interview 2.2, 13 Sept 2014] showcasing the difficulty to bring together a significant number of persons with diverse stakes and ­characteristics in an entrepreneurial accomplishment. Koispe ­employees are in their majority Koispe recipients of mental health services and additionally Category A members (18 out of 35 employees). They are thus beneficiaries of the psychotherapeutic treatment and beneficiaries of ownership rights over the enterprises’ capital. Their participation in the ownership and membership of the organization makes them subject to significant rights and duties included in the Law concerning the Reformation of Mental Health Services 1999, such as among others the right to participate in the governance of the organization and the right to be informed regarding the Koispe’s financial affairs (see above). However, there are also employees in the organization who albeit being recipients of mental health services, are not members of the organization. Similarly, there are Category A members of the organization who albeit being recipients of mental health services, have not been employed by the organization due to their lack of skills. Only 18 employees are Category A members out of a maximum total of Category A members, which exceeds the 50 members. This fragmentation shows that the KAE’s objective to fulfill simultaneously the socioeconomic integration of persons with serious psychosocial problems, while also assisting them to a broader inclusion in the basic structures of the organization is not successful. One Category A member-employee considers that “it is obviously right, that the employees who are not members, should become members […] once they become members, they will be able to have a voice” [interview 3.3, 16 Oct 2014]. However, the nonmember employees are equally invited by the members to participate in the decision-making processes of the organization [interview with 1.1, 16 Oct 2014]. They are allowed to attend the GMM sessions in order to acquire information and they have the right to freely express their opinion, following the requirements of the Law concerning the Reformation of Mental Health Services 1999 without exercising any voting. Thus, nonmembers are also active actors of the organization and they acquire knowledge regarding all the decisions that are made. However, those Koispe employees who are not as yet admitted into membership, “they haven’t become members because it is possibly something stressful for them” [interview 3.3, 16 Oct 2014] one respondent said, who is a Category A member, indicating again the emotional engagement of persons with mental disabilities in entrepreneurial operations. The financial consideration is also a concern in becoming a Category A member who commonly belongs to disadvantaged groups in terms of income and education. The financial burden that membership entails is a minimum of 100 euros for the purchase of one mandatory cooperative share [interview 3.3, 16 Oct 2014]. For others, the participatory character of the organization might be a burden to care and participate more in the organization’s affairs and decision making beyond their employment responsibilities [interview 3.3, 16 Oct 2014]. For instance, a GMM is time-consuming and it takes an entire day or a minimum of four to five hours at least, because it is a process that includes the perspectives of all members in the organization. A respondent stated: “the members come especially in the accounting sessions and it takes time because there are discussions, questions. We spend too much time on the discussion regarding what we can do. Everybody says his/her ideas” [interview 3.3, 16 Oct 2014].

The Mentally Disabled as Decision Makers

KAE claims that it is governed by the basic cooperative principles of democratic and equal participation. A respondent, who is a Category A member, said: “No I don’t feel that I have a greater influence on the decision making [than the others]. Because, the influence, is reflected in the vote. If everyone has the right to vote, he/she can actually vote against” [interview 3.3, 16 Oct 2014]. Democratic participation is also a means for the organization to achieve the social element of its purpose. One respondent indicatively mentioned that “the democratic participation of the members is a means and an end in itself. In Koispe, we are contributors to the psychiatric reform. We do not want to only act for the recipients, but we want to give a role to the recipients and a voice in the decision-making […] This is non-negotiable. We stand for democratic participation and consultation among all and before all […]” [interview with 1.1, 16 Oct 2014]. The same respondent mentioned the example of the vice president of the Pan-Hellenic Federation of Koispe (POKOISPE), who is also a person with mental disabilities [interview with 1.1, 16 Oct 2014]. However, this is not the case with respect to the promotion of Category A members into the higher managerial positions of the KAE. Indeed, although Category A members, following the Law concerning the Reformation of Mental Health Services 1999 and Koispe’s Athena-Elpis articles of association, are allowed to appoint two members out of seven and/or to be appointed as members of the Koispe management board, they are not allowed to engage in the higher ­managerial positions of the organization, for example, position of president, vice president, secretary, treasurer of the management board, and in any position of the supervisory board. Category A members, who constitute a majority among the members in the ownership of the organization, constitute a minority in the governance body that exercises the daily management of Koispe’s ­operations and financial affairs. Respectively, they are substantially deprived control and from contributing equally in the ­governance of the organization and fairly in the management of Koispe’s affairs in which they have invested a significant financial contribution. This is not through an omission in the articles of association of the KAE but a ­restriction stipulated in legislation. Indicatively, a respondent indicated that the exclusion of ­Category A members from the higher positions of the ­management board and ­supervisory board is the “legislators’ decision” [interview 2.2, 13 Sept 2014]. ­According to the rationale of the ­respondent, the legislators ­considered that the participation in high managerial positions, of mentally disabled people, that is, Category A members, who are fully or partially judicially assisted or lack a legal capacity, might be conflicting with the applicable cooperative legislation [interview 2.2, 13 Sept 2014]. He mentions that this “is a more polite way of the legislator not to exclude the group from the board of the Koispe but to avoid any conflict with the existing [civil] legislation” [interview 2.2, 13 Sept 2014]. Another respondent mentioned that Category A members are literally “excluded from the position of president. A recipient of mental health services he/she cannot be a president of the Koispe. This is stipulated in legislation” [interview with 1.1, 16 Oct 2014], with which the organization should comply. It is understood, apparently, that the provisions of the Law concerning the Reformation of Mental Health Services 1999, regarding the Koispe legal form, does not safeguard the equal enjoyment of rights by persons with mental disabilities reflected in the current normative framework; and (ii) although progressive and inclusive as regards the role of persons with mental disabilities in the Koispe ownership and membership, it does not safeguard their fair position and activity in the organization.

Toward a Structured Process for the Participation of the Mentally Disabled in the Koispe Governance Structure

Adam noted the lack of a structured process in the Koispe organizational form to promote the participation of Category A members in the governance, and subsequently their determination and empowerment in the organization. The realization of the participatory governance in KAE, albeit fragmented for the mentally disabled, is understood to contain elements that could be categorized under the following taxonomy: (i) formal or informal participatory mechanisms, by being prescribed or not in legally binding instruments such as the law or the articles of association; (ii) direct/indirect participatory mechanisms, by allowing or not allowing stakeholders to physically participate in the decision-making processes of social enterprises; and (iii) structural/nonstructural (ad hoc) participatory mechanisms, by taking place or not on a routine basis (see also Table 4.2).


Table 4.2 Participatory and inclusive stakeholder mechanisms

Stakeholder participation mechanisms

Formal

Informal

Structural

Nonstructural

Direct

Indirect

Participation of members in the GMM

X

X

X

Participation of nonmembers in the GMM

X

X

X

Participation of members in the management board

X

X

X

X

Supervisors-employees seminars

X

X

X

Biweekly supportive counseling committee meetings

X

X

X

Newsletters and feedback to public information

X

X


Formal and Direct Participation of the Mentally Disabled in the Koispe Governance

The research shows that Category A members, that is, persons with mental disabilities participate at the GMM and at the processes of management board through elected representatives. This is stipulated in legislation and in the Koispe’s articles of association, and it constitutes a formal means of participation that takes place regularly. Every year, over 50 Category A members participate at the GMM of KAE. The GMM is the highest governing body of the organization and it meets ordinarily once a year or extraordinarily whenever it is called by the management board. Whether ordinary or not, the GMM meetings have to produce decisions. In the meeting, Category A members exercise their voting rights on the basis of the rule “one man one vote.” If necessary, at the GMM, voting is formally organized with polls, screens, and ballots. There is also an election committee formulated. However, most of the times there is great conformity in decision making. In essence, the members set goals and any controversy might only occur regarding the way the goals will be implemented. There might be differences in the approach of implementation and with respect to solution for complex problems. A Category A member mentioned that “although the GMM comprises members who come to attend the accounting sessions, the process is inefficient” [interview 3.3, 16 Oct 2014]. He stated that:

It takes time because there are discussions and questions. I noticed in the last two GMMs, that the members who are not employees have many suggestions. We spend too much time on the discussion regarding what we can do [for the organisation]. I just might have advance information [due to my position]…Beyond that there is participation. [Interview 3.3, 16 Oct 2014].

Once a year, prior to the regular meetings of the GMM, invitations are sent electronically to all members including information regarding the balance sheet of the KAE, the net income of the cooperative, the profits, and the losses. During the GMM sessions, all members have an equal right to expose their opinion freely, regarding current management and the organizational methods that the administration uses. At the management board the structure is mixed. This Koispe’s management board comprises seven members in total of which five members are elected and appointed representatives of the Category B and C members, whereas two members are elected by Category A members. One respondent says: “Category A members are not just asked [to participate], they are involved in the decision-making process. They become decision-makers” [interview with 1.1, 16 Oct 2014].

Informal and Indirect Participation of the Mentally Disabled in the Koispe Governance

The research shows that Category A members, that is, persons with mental disabilities participate in the governance of the organization in a more informal and indirect manner that is relatively structured. For instance, regular information regarding the Koispe’s affairs is provided on the Koispe’s website and it is accessible to everyone. Additionally, KAE regularly circulates newsletters to the members and employees. A Category A member who is not an elected representative of the management board mentioned another common practice of informal but direct participation during the management board sessions. He explained that:

The management board is the formal decision-making organ. Part of my job is to support the I.T. facilities [during the meetings of the management board]. However, exactly because the directors apparently discuss I can also speak informally [..] I will jump in the discussion and I will say I think we can do this [..] The members of the management board say their opinion on the basis of the experience that anyone has through work and I can say my opinion. I will say it by my own and I will be also asked to do so. I feel that there is freedom and participation. [Interview 3.3, 16 Oct 2014]

Informal and indirect is also the influence of Category A members over the organization’s decisions through the use of the supportive counseling committee. The role and function of this committee is not included in the Koispe’s article of association. The supportive counseling committee has the responsibility to meet the employees and trainees biweekly, to support them psychologically, while collecting their problems and claims that are conveyed to the administration. If there are individual requests, employees can arrange individual appointments with the mental health professionals who comprise the supportive counseling committee. There is also a coordination between the supportive counseling committee and the administration. These two bodies meet biweekly. The administration communicates to the supportive counseling committee the decisions made by the higher management using a top-down approach, whereas the supportive counseling committee explains using a bottom-up approach the employees’ issues, problems, and requests, and notifies the administration accordingly in an attempt to reconcile issues. The supportive counseling committee operates as an internal confidential grievance mechanism for the organization. For instance, a respondent mentioned that: “sometimes the employees seek something that they would not say to the supervisor or to their instructor. There is also more confidentiality between the supportive counseling committee and the mental health recipients.” Additionally, daily operations and the implementation of the Koispe’s managerial decisions, require actions from the employees and changes on activities that they already do. These are communicated informally by the supervisors in every operational section. The supervisors communicate or implement in practice the decisions made by the management and the administration. For instance, a respondent mentioned that:

Somebody’s working hours will change or we will hire a new employee who needs guidance or [the supervisor] should announce to employees something [that it was decided]. Even regarding practical issues he will provide information. He will try to consult with them [with the employees]. Obviously, you cannot inform 35 people simultaneously. You inform each operational group about its own issues. Most of the issues do not concern everyone. Different issues concern each group. [Interview 3.3, 16 Oct 2014]

On the occasion that an issue affects the employees collectively, KAE organizes informal seminars. A respondent mentioned: “for instance we organised a seminar regarding safety at work. We gathered everyone [..] we gave presentations at the plenary to all the employees. We saw some videos on what to be careful of [..] how to be safe [..] how to clean carefully [..] what we should be aware of [..]” [interview 3.3, 16 Oct 2014].

Discussion and Concluding Remarks

Adding to Campi, Defourny, and Gregoire (2006) and Adam’s (2012) empirical studies, stakeholder participation in the Koispe organizations might be translated into Category A members’ formal and direct voting power only for the decisions made in the GMM. The multi-stakeholder character of the Koispe legal form entails a restrained formal participation of Category A members, that is, the persons with mental disabilities, in the daily management and higher administration. It also entails informal and indirect means of participation that are semi-structured in standard processes. However, the formal and informal equal participation of Category A members in the governance of the Koispe organization, with the members of the other categories, will not only contribute to their empowerment and determination to be more engaged in the entrepreneurial or labor activities. It will actually provide them with concrete roles and responsibilities regarding core managerial issues, on the basis of clear rules and a fairer position in the organization and consequently in the society. The emotional engagement of Category A members is an important determinant of their attitude in the organization, but it is more a factor to be considered rather a special distinguishing characteristic that can cause a detrimental effect in the functioning of the organization. It can be mitigated through the development of internal supporting and counseling structures such as those that KAE developed. Legislation, and the provisions that exclude Category A members from the higher managerial positions, is also an inhibitor of Category A members’ participation in the function and in the governance of Koispe, and it is not compatible with the international human rights framework that considers mentally disabled people as equals in society. Although, Koispe organizations might develop internal and informal stakeholder mechanisms and processes to encourage the participation of Category A members in the governance and decision making, these do not have a uniform shape or a structure. According to the author’s view, these mechanisms can be structured on the basis of a taxonomy, which outlines (i) their formality (stemming from legislation as an obligation or it can be found in the constitutional documents of the Koispe); (ii) the extent of participation, whether the mechanisms are direct or indirect in the form of representation; and finally, (iii) their regularity and repetition.

The research is limited to the development of a single case study, in which the authors elaborated on qualitative data, that is, narratives and reflections collected from interviews with various respondents. The collected data were validated and verified with additional supporting evidence from relevant documents and feedback that the authors collected from the respondents during data processing. The authors decided to elaborate on a single case study because it comprehensively demonstrates how the evidence can support theory development and contribution. The selected case study is an illuminative one regarding the problem at hand. However, the results stemming from a single case study might only be heavily case-bound and pertinent to the relevant subjects in the case. Through the development of multiple case studies to a greater extent and in the context of the larger research project that this article is part of, the authors plan to develop generalizable theory from cumulative case studies with a repetitious method. This replication logic has allowed the development by the authors of research papers that investigate other legal models of social enterprises in various other jurisdictions such as Belgium and the Netherlands (Argyrou et al., 2016 Springer; Argyrou et al. 2016; Lambooy et al. 2016) and future research that will examine the participatory governance of the governance of the U.K. special legal form for social enterprises, that is, the community interest company.

This case study also contributes in a practical manner to the development of a better understanding of the Koispe as work integration legal form for social enterprises in Greece for practitioners and academics. It sheds light in a part of the function of Koispe and in the issues related to the participatory governance structure that are problematic. The case study, finally also raises a very significant question of a humanistic nature. From an anthropocentric view, an important question that can be addressed in future research is how and whether participatory governance and decision-making processes in social enterprises can safeguard, maintain, and invigorate the human dignity and virtue of vulnerable groups by means of more ethical and fairer decision making.

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1 However, from the 64 that could be potentially developed since 1999, only 20 have been developed as of 2014, of which the last 5 were developed in the first semester of 2014.

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