270006 Experiencing Integration: How Individuals with Serious Mental Illnesses Define Community

Monday, October 29, 2012 : 11:30 AM - 11:50 AM

Elizabeth Bromley, MD, PhD , Semel Institute Center for Health Services and Society, University of California, Los Angeles, Los Angeles, CA
Sonya Gabrielian, MD, MPH , MIRECC, West Los Angeles VA, Los Angeles, CA
Benjamin Brekke , School of Social Work, University of Southern California, Los Angeles, CA
Rohini Pahwa, MA, MSW , School of Social Work, University of Southern California, Los Angeles, CA
Kathleen Daly, MD , Adult Justice, Housing, Employment, and Educational Services, Los Angeles County Department of Mental Health, Los Angeles, CA
John Brekke, PhD , School of Social Work, University of Southern California, Los Angeles, CA
Joel Braslow, MD, MPH , Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA
     
Purpose Community integration is frequently discussed as a crucial component of recovery from serious mental illness (SMI) and an area of particular challenge for individuals with SMI. While the construct of community integration can be measured with structured instruments, we know little about the definitions and concepts of community that matter to people with SMI. Methods We conducted semi-structured interviews with 30 individuals with SMI treated in two public mental health clinics. Participants were asked to describe places and groups with which they identify and to discuss the larger meaning of community in their lives. We asked participants to comment on feelings of belonging, welcome, and comfort, which are often used to assess community integration. Results We describe four themes about community that are salient for our sample: (1) the helping community, (2) the threatening community, (3) the stigmatizing community, and (4) the redemptive community. Participants seek communities that provide reliable emotional support; and they describe the need to manage contact with communities to protect themselves from symptom exacerbation and stigma experiences. Conclusions Our data suggest that the experience of having a serious mental illness may shape social identity and perceptions of community. Our participants emphasize the importance of consistent support. Ties to mental health treatment settings are often described as valuable for these reasons. Results offer preliminary suggestions that mental health communities facilitate the efforts of persons with SMI to experience a sense of community. They also suggest opportunities for the development of new assessments of community integration.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Social and behavioral sciences

Learning Objectives:
1) State four kinds of communities the individuals with SMI we interviewed described 2) Name three limitations of current assessments of community integration 3) Characterize the potential roles of mental health communities in the lives of individuals with SMI 4) Identify questions about community integration in need of further research

Keywords: Sever Mental Illness, Community Involvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a psychiatrist and health services research trainee who worked on this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3157.0: Mental Health and Mental Illness: Communities Supporting Resilience and Recovery