Community Integration Research: Mental Illness

Social integration of people with serious mental illness: network transactions and satisfaction.

Wong YL, Matejkowski J, Lee S.  School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA 19104-6214, USA.  J Behav Health Serv Res. 2011 Jan;38(1):51-67. Epub 2010 Jan 6.

Social integration involves a process through which an individual establishes and maintains meaningful interpersonal relationships characterized by mutual exchange with community members in nonclinical settings. Using self-report data from a probability sample (n=252) of supportive independent housing residents, transactional (i.e., support exchanges) characteristics of social networks, paying particular attention to reciprocation of exchanges between residents and their network members, were analyzed. The study also examined the extent to which transactional characteristics are related to satisfaction with social relations. Findings indicated considerable reciprocity in social relationships. Controlling for sociodemographic variables and network structure characteristics, mutual exchanges of tangible and problem-solving support were positively associated with network satisfaction. Results suggest that supported socialization services aimed at network and resource development with this population could facilitate more frequent exchanges of tangible resources and problem-solving opportunities between consumers and network members, which, in turn, might promote social integration.


A theory of social integration as quality of life.

Ware NC, Hopper K, Tugenberg T, Dickey B, Fisher D.  Department of Social Medicine, Harvard Medical School, Boston, MA 02115, USA.  Psychiatr Serv. 2008 Jan;59(1):27-33.

OBJECTIVE: Quality of life, once a priority in caring for people with severe mental illness, has since been eclipsed by other concerns. This article returns attention to quality of life by offering a theory of social integration (as quality of life) for persons disabled by severe mental illness.

METHODS: Data collection for this qualitative study consisted of 78 individual, unstructured interviews with 56 adults who have been psychiatrically disabled. Field observations and interviews with staff and service users were carried out during eight ethnographic visits to service sites working to promote social integration. Data were analyzed with an inductive strategy based on grounded theory methodology and framed theoretically by the capabilities approach to human development. Goals were to identify personal capacities needed for integration, characterize occasions for capacity development in mental health care, and develop a working theory.

RESULTS: Six personal capacities were identified: responsibility, accountability, imagination, empathy, judgment, and advocacy. Occasions were characterized in terms of their defining mechanisms: contradiction, reinterpretation, rehearsal, raising expectations, and confrontation. A working theory was constructed to characterize the process of capacity development for social integration through exposure to increasingly challenging occasions for growth in the context of mental health care.

CONCLUSIONS: Capacities for social integration can be effectively developed as part of the everyday routines of mental health care. Eventually, the process shifts from development to the exercise of capacities and to participation as full citizens in the social world beyond treatment.


Group and organizational involvement among persons with psychiatric disabilities in supported housing.

Wong YL, Nath SB, Solomon PL.  School of Social Policy and Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA, 19104-6214, USA.  J Behav Health Serv Res. 2007 Apr;34(2):151-67. Epub 2007 Mar 15.

This study examined the patterns and correlates of group and organizational involvement among persons with psychiatric disabilities using a cross-sectional, probability sample of 252 residents in supported independent housing (SIH). Groups and organizations were classified according to whether or not they have a behavioral health focus. Demographic, clinical, and service use characteristics were examined as potential predictors of membership using Poisson regression models. Findings indicated that 60% of the sample was involved in some kind of behavioral or nonbehavioral health organization. Similar to the findings from the general population, higher rates of membership were found among older persons, Blacks, those with more years of education, and those with higher incomes. Other correlates specific to the SIH sample included prior homelessness, perceived discrimination, substance abuse history, psychiatric symptoms, psychiatric diagnosis, and contact with service providers. Implications of study findings for developing intervention strategies to enhance organizational membership and for future research are discussed.