Abstract
This qualitative study examines the perceptions of young adults with mental health disorders of community integration. Fifty-nine young men and women participated in 12 focus groups whose aim was to gain understanding of what community integration means to them. Focus group questions also explored barriers and supports for their community integration, as well as their goals for the future and advice to others facing similar challenges. Themes that emerged were reported within the multiple domains that participants used to describe their experiences of community integration (or the lack thereof). This study highlights the desires of these young people to achieve goals in education and employment and to have friendships. Participants identified a pervasive lack of understanding of mental health and prevalent stigmatizing attitudes as resulting in challenges to their community integration. Implications of the study discuss roles for behavioral health services in encouraging empowerment, choices, and connections so that young people with mental health disorders may achieve their preferred levels of community integration.
Similar content being viewed by others
References
Stroul BA, Friedman RM. A System of Care for Children and Youth with Serious Emotional Disturbances. July 1986 Revised Edition 1994. Washington, DC: Georgetown University Child Development Center.
Jacobson N, Greenley D. What is recovery? A conceptual model and explication. Psychiatric Services. 2001;52(4):482–485.
McColl MA, Davies D, Carlson P, et al. The community integration measure: development and preliminary validation. Archives of Physical Medicine and Rehabilitation. 2001;82:429–434.
Minnes P, Buell K, Nolte ML, et al. Defining community integration of person with brain injuries as acculturation: a Canadian perspective. NeuroRehabilitation. 2001;16:3–10.
Bond GR, Salyers MP, Rollins AL et al. How evidence-based practices contribute to community integration. Community Mental Health Journal. 2004;40(6):569–588.
Prince PN, Gerber GJ. Subjective well-being and community integration among clients of assertive community treatment. Quality of Life Research. 2005;14(1):161–169.
New Freedom Commission on Mental Health. Achieving the Promise: Transforming Mental Health Care in America. Final Report; 2003. Rockville, MD: DHHS Pub. No. SMA-03-3832, 5.
Salzer MS. Introduction. In: Salzer MS, ed. Psychiatric Rehabilitation Skills in Practice: A CPRP Preparation and Skills Workbook. Columbia, MD: United States Psychiatric Rehabilitation Association; 2006:2–4.
Aubry TM, Myner J. Community integration and quality of life: a comparison of persons with psychiatric disabilities in housing programs and community residents who are neighbors. Canadian Journal of Community Mental Health. 1996;15:5–20.
Segal SP, Aviram U. The Mentally Ill in Community-Based Shelter Care: A Study of Community Care and Social Integration. New York: John Wiley; 1978.
Kruzich JM. Community integration of the mentally ill in residential facilities. American Journal of Community Psychology. 1985;13:553–564.
Hardiman ER, Segal SP. Community membership and social networks in mental health self-help agencies. Psychiatric Rehabilitation Journal. 2003;27(1):25–33.
Fellin P. The Community and the Social Worker (3rd. ed.). Itasca, IL: F.E. Peacock; 2001.
Delman J, Jones A. Voices of Youth in Transition: The Experience of Aging Out of the Adolescent Mental Health System in Massachusetts. Dorchester, MA: Consumer Quality Initiatives, Inc; 2002.
Collins ME. Transition to adulthood for vulnerable youths: a review of research and implications for policy. Social Service Review. 2001;75:271–291.
Federation of Families for Children’s Mental Health. Blamed and Ashamed: The Treatment Experiences of Youth with Co-occurring Substance Abuse and Mental Health Disorders and their Families. Alexandria, VA: Federation of Families for Children’s Mental Health; 2001.
Vander Stoep A, Davis M, Collins D. Transition: A time of developmental and institutional clashes. In: Clark HB, Davis M, Eds. Transition to Adulthood: A Resource for Assisting Young People with Emotional or Behavioral Difficulties. Baltimore, MD: Paul H Brookes; 2000:3–28.
Blackorby J, Wagner M. Longitudinal postschool outcomes of youth with disabilities. Findings from the National Longitudinal Transition Study. Exceptional Children. 1996:399–413.
Levin-Epstein J, Greenberg M. Eds. Leave No Youth Behind: Opportunities for Congress to Reach Disconnected Youth. Washington, DC: Center for Law and Social Policy; 2003.
Baxter EA, Diehl S. Emotional stages: consumers and family members recovering from the trauma of mental illness. Psychiatric Rehabilitation Journal. 1998;21(4), 349–355.
Johnson B, Montgomery P. Chronic mentally ill individuals reentering the community after hospitalization. Phase II: The urban experience. Journal of Psychiatric Mental Health Nursing. 1999;6(6):445–451.
Ochocka J, Nelson G, Janzen R. Moving forward: negotiating self and external circumstances in recovery. Psychiatric Rehabilitation Journal. 2005;28(4):315–322.
O’Day B, Killeen MB, Sutton J et al. Primary care experiences of people with psychiatric disabilities: barriers to care and potential solutions. Psychiatric Rehabilitation Journal. 2005;28(4):339–345.
Young SL, Ensing, DS. Exploring recovery from the perspective of people with psychiatric disabilities. Psychiatric Rehabilitation Journal. 1999;22(3):219–232.
Morgan D. Focus Groups as Qualitative Research. Newbury Park, CA: Sage Publications; 1988.
Farquhar C. Are focus groups suitable for ‘sensitive’ topics? In: Barbour RS, Kitzinger J, eds. Developing Focus Group Research: Politics, Theory, and Practice. London: Sage Publications; 1999:47–63.
Jarrett R. Focus group interviewing with low-income minority populations: A research experience. In: Morgan DL, ed. Successful Focus Groups: Advancing the State of the Art. Newbury Park; 1993:184–201.
Blankertz L. The value and practicality of deliberate sampling for heterogeneity: a critical multiplist perspective. American Journal of Evaluation. 1998;19(3):307–324.
Luborsky MR, Rubenstein, RL. Sampling in qualitative research. Research on Aging. 1995;17(1):89–113.
McMiller WP, Weisz JR. Help-seeking preceding mental health clinic intake among African-American, Latino, and Caucasian youths. Journal of the American Academy of Child and Adolescent Psychiatry. 1996;35(8):1086–1094.
Breland-Noble AM. Mental healthcare disparities affect treatment of Black adolescents. Psychiatric Annals. 2004;34(7):534.
N6 qualitative analysis software. Melbourne, Australia: QSR International Pty. Ltd.; 2002.
Glaser B, Strauss A. The Discovery of Grounded Theory. Chicago: Aldine; 1967.
Lincoln YS, Guba EG. Naturalistic Inquiry. Thousand Oaks, CA: Sage Publications; 1985.
Rodwell MK. Social Work Constructivist Research. New York: Garland Publishing; 1998.
Erikson EH. Identity: Youth and Crisis. New York: Norton; 1968.
Arnett JJ. Emerging adulthood: a theory of development from the late teens to the early twenties. American Psychologist. 2000;55:469–480.
Duchnowski AJ, Kutash K, Friedman, R. Community based Interventions in a System of Care and Outcomes Framework. In: Hoagwood, K, Burns, B, eds. Community Treatment for Youth: Evidence-Based Interventions for Severe Emotional and Behavioral Disorders. New York: Oxford University Press; 2002:16–37.
Davis M. Issue Brief. Supporting the Transition to Adulthood. Massachusetts: Center for Mental Health Services Research, University of Massachusetts Medical School; 2004;1(4):1–2.
U.S. Department of Health and Human Services. The Comprehensive Community Mental Health Services for Children and their Families Program, Annual Report to Congress, 2002–2003. Washington, DC. Center for Mental Health Services, Substance Abuse and Mental Health Services Administration; 2003. http://systemofcare.samhsa.gov/newinformation/docs/CongReport20022003FINALPUBLICATION.pdf Retrieved 11/11/2006.
Burchard, JD, Bruns, EJ, Burchard, S. The Wraparound Approach. In: Hoagwood K, Burns B, eds. Community Treatment for Youth: Evidence-based Interventions for Severe Emotional and Behavioral Disorders. New York: Oxford University Press; 2002:69–90.
Luthar S. Resilience and Vulnerability: Adaptation in the Context of Childhood Adversities. New York: Cambridge University Press; 2003.
Werner EE, Smith RS. Vulnerable but Invincible: A Longitudinal Study of Resilient Children and Youth. New York: McGraw-Hill; 1982.
Burns BJ, Costello EJ, Angold A et al. Children’s mental health service use across service sectors. Health Affairs. 1995;14(3):147.
Landrum TJ, Tankersley M, Kauffman, J.M. What is special about special education for students with emotional or behavioral disorders? Journal of Special Education. 2003;37(3):148.
Wagner M, Kutash K, Duchnowski A et al. The children and youth we serve: a national picture of the characteristics of students with emotional disturbances receiving special education. Journal of Emotional and Behavioral Disorders. 2005;13(2):79–96.
Farmer EMZ, Farmer TW. The role of schools in outcomes for youth: implications for children’s mental health services research. Journal of Child and Family Studies. 1999;8(4):377–396.
Armstrong KH, Dedrick RF, Greenbaum PE. Factors associated with community adjustment of young adults with serious emotional disturbance: a longitudinal analysis. Journal of Emotional and Behavioral Disorders. 2003;11(2):66–76.
Mowbray CT, Collins M, Bybee D. Supported education for individuals with psychiatric disabilities: long-term outcomes from a longitudinal study. Social Work Research. 1999;23(2):89–100.
Berman S, Strauss S, Verhage V. Treating mental illness in students: A new strategy. Chronicle of Higher Education. 2000;46(41):B9.
Carter EW, Wehby JH. Job performance of transition-age youth with emotional and behavioral disorders. Exceptional Children. 2003:69(4):449–465.
Schulze B, Angermeyer MC. Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Social Science & Medicine. 2003;56(2):299–312.
Acknowledgments
This research was supported by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education, and the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services (Grant #H133B040038). The content does not necessarily represent the views or policies of the funding agencies. The authors wish to thank Jan Lacy and Lacey Vankirk for their valuable contributions to the project and study participants for sharing their experiences and perspectives.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jivanjee, P., Kruzich, J. & Gordon, L.J. Community Integration of Transition-Age Individuals: Views of Young with Mental Health Disorders. J Behav Health Serv Res 35, 402–418 (2008). https://doi.org/10.1007/s11414-007-9062-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11414-007-9062-6