If the most effective approaches to reduce public prejudice and discrimination toward people diagnosed with a mental illness are education and contact, then those methods may be useful methods to help mental health service providers view and engage persons served from a strengths-based recovery and wellness orientation.
Recovery-oriented service systems explicitly value including people with lived experiences of a mental and substance use diagnosis in the design, delivery, and evaluation of those services. Including first-person accounts as part of the education and training of service providers "demonstrates" recovery is possible, promotes empathy, offers insights into the lives of service users, and models a person-centered, person-first approach. More important, it serves as a visual and experiential example of the collegial relationships required for services that are truly recovery-oriented. This column provides recommendations for carefully planning in-person personal narratives as an effective teaching tool.
Objective: Having meaningful social roles and full community participation have been examined as a central tenet of the recovery paradigm. We undertook this study to test a new multimodal, peer-led intervention, which we have developed with the aim of fostering the self-efficacy of individuals with psychiatric disabilities to pursue involvement in community activities of their choice. Method: We evaluated the effectiveness of the 6-month manualized peer-delivered "Bridging Community Gaps Photovoice (BCGP)" program with a multisite randomized trial (N = 185), with recipients of services at five community mental health programs. Mixed-effects regression models were used to examine the impact of the program on community participation, loneliness, personal stigma, psychosocial functioning, and personal growth and recovery when compared to services as usual. Individuals who were randomized to the BCGP intervention were also invited to participate in exit focus groups, exploring the program's perceived active ingredients of mechanisms of impact. Results: Participation in the BCGP program facilitated ongoing involvement in community activities and contributed to a decreased sense of alienation from other members of the community due to internalized stigma of mental illness. In addition, greater attendance of group BCGP sessions had a significant impact on participants' sense of self-efficacy in pursuing desired community activities. Conclusions and Implications for Practice: This study provided initial evidence about the promise of the BCGP program in enhancing community participation. Its implementation in community mental health agencies can further expand the recovery-oriented services provided to people with psychiatric disabilities.
Impact and ImplicationsThis study provided initial evidence about the promise of the peer-delivered "Bridging Community Gaps Photovoice (BCGP)" program in enhancing the community involvement of people with psychiatric disabilities and decreasing their sense of alienation from other community members due to concerns about prejudice and discrimination. The BCGP program has the potential to contribute to the portfolio of recovery-oriented services as it has the potential to foster individuals' self-determination to pursue a broad spectrum of desired activities as equal community members.
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