Presently, many individuals with psychiatric disabilities who are living outside the hospital may be said to be in the community, but not of it. They are both isolated and in a very real sense, socially invisible, lacking both meaningful personal contact with non-disabled persons and basic, legitimizing markers of personhood. In contrast to the daily rounds of work, home and/or family life, friends, and leisure that make up most of our lives, the routines of persons with psychiatric disabilities are likely to consist of medication visits, therapy and/or case management visits, trips to service facilities to pick up disability checks, attendance at day programs, etc. Some individuals, however, do manage to achieve a substantial measure of social integration. How do they do it? And: How can mental health services best support and assist them? These are the research questions we address in this all-qualitative study. The overall aim of this three-state project is to build an empirically based theory and conceptual model of social integration for persons who are or have been psychiatrically disabled as the basis for practical action. Representation of the perspectives of these persons is emphasized. Data will be collected through """"""""minimally structured"""""""" interviews from individuals representing three constituencies: (a) persons actively moving toward greater social integration, (b) their significant others, and (c) mental health services providers working at seven service sites in Boston, New York City, and southern Vermont. The research draws upon complementary methodologies and theoretical frameworks to depict social integration for psychiatrically disabled persons. Inductive methods of category construction will be used to characterize processes through which these persons create and sustain ties with others (""""""""connecting processes """"""""). Life chart methods and narrative analysis in six case studies will be used to trace courses of social integration over time. An examination of how particular service providers and organizations foster the development of human capabilities will lay the groundwork for recommending changes toward greater emphasis on social integration that mental health services might make. Though the goal of this project is to build theory, our intent is not to produce knowledge for its own sake. This project is an initial step toward the longer-term goal of designing and implementing one or more theoretically informed services interventions aimed at promoting social integration for persons with psychiatric disabilities.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Special Emphasis Panel (ZMH1-CRB-J (05))
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Hohmann, Ann A
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Harvard University
Other Health Professions
Schools of Medicine
United States
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Dickey, Barbara; Ware, Norma C (2015) Risk is not a four letter word: social integration and developmental growth. Am J Psychiatr Rehabil 18:363-376
Tuller, David M; Bangsberg, David R; Senkungu, Jude et al. (2010) Transportation costs impede sustained adherence and access to HAART in a clinic population in southwestern Uganda: a qualitative study. AIDS Behav 14:778-84
Dickey, Barbara; Ware, Norma C (2008) Therapeutic communities and mental health system reform. Psychiatr Rehabil J 32:105-9
Ware, Norma C; Hopper, Kim; Tugenberg, Toni et al. (2008) A theory of social integration as quality of life. Psychiatr Serv 59:27-33
Hopper, Kim (2007) Rethinking social recovery in schizophrenia: what a capabilities approach might offer. Soc Sci Med 65:868-79
Ware, Norma C; Hopper, Kim; Tugenberg, Toni et al. (2007) Connectedness and citizenship: redefining social integration. Psychiatr Serv 58:469-74