Conceptualizing community: the experience of mental health consumers.

Wong YL, Sands RG, Solomon PL.  University of Pennsylvania School of Social Policy & Practice, 3701 Locust Walk, Philadelphia, PA 19104, USA. ylwong@sp2.upenn.edu  Qual Health Res. 2010 May;20(5):654-67. Epub 2010 Feb 12.

In this article we describe a focus group study of the perspectives of diverse groups of mental health consumers on the concept of community. We identify the core domains that constitute the notion of community, and commonalities and differences in the perception of community along the lines of ethnicity and sexual orientation/gender identity. Seven focus groups were conducted with a total of 62 participants. Transcripts were analyzed using the grounded theory approach. Two domains–togetherness and community acceptance–emerged as common to four types of communities that were most frequently mentioned in the focus group discussion. Our findings show that identities other than those associated with mental illness and the role of service user are critical to the understanding of the psychological sense of community among persons with psychiatric disabilities. We suggest that mental health providers empower consumers to expand their “personal communities” beyond that of mental health clients using their diverse identities, and design interventions for addressing the stigma emanating from identities that are discriminated against by the wider society.

Passing for “normal”: features that affect the community inclusion of people with mental illness.

Flanagan EH, Davidson L.  Yale Program for Recovery and Community Health, Department of Psychiatry, Yale School of Medicine, New Haven, CT 06513, USA. elizabeth.flanagan@yale.edu  Psychiatr Rehabil J. 2009 Summer;33(1):18-25.

OBJECTIVE: The purpose of this study was to investigate specific features that indicate to community members that a person has a mental illness and the emotional reactions elicited by these features, in hopes of understanding barriers to the community integration of people living with mental illnesses.

METHOD: Participants were 15 community members who had considerable experience with people with mental illnesses but no extensive clinical training (e.g., store clerks, landlords, clergy). A mixed qualitative-quantitative design elicited 1) participants’ subjective experience of interacting with people with mental illness and 2) participants’ ratings of specified features of people with mental illness.

RESULTS: Interpretive phenomenological analysis of qualitative interviews suggested that a person’s mental illness was only apparent from afar if s/he was responding to internal stimuli or wearing bizarre or inappropriate clothing. The person’s illness usually became apparent through interacting with the community member. Participants reported feeling kind benevolence towards people with mental illness and rated the likelihood of people with mental illness to be threatening or violent as very low. Overall, participants’ ratings of features of people with mental illness corroborated qualitative themes.

CONCLUSIONS: These data suggest that stigma is not elicited simply by the presence of a person with a mental illness, and that the presence of a mental illness in most cases only becomes apparent through social interaction. Also, these data support conclusions that personal experience with people with mental illness reduces fear and increases benevolence and that personal contact should be integral to community integration and anti-stigma campaigns.