Understanding the experience of place: Expanding methods to conceptualize and measure community integration of persons with serious mental illness

Abstract

Community integration research explores community contexts and factors that encourage or hinder individuals with serious mental illness (SMI) from actively participating in community life. This research agenda can be advanced by using mixed-methods that better document the relationships between contextual factors and individual experience. Two such methods were applied to a mixedmethods study of 40 adults with SMI living in independent housing in the Southeastern United States. Their contextualized experiences of community integration were measured by applying innovative participatory mapping and Geographic Information Systems (GIS) mapping techniques. Use of these methods in conjunction with one another facilitated the creation of activity spaces, which can measure geographic accessibility and help to represent an individual's experience of place and degree of mobility. The utility of these newly applied methods for better understanding community integration for persons with SMI is explored and implications for using these measures in research and practice are discussed. KeywordsPsychiatric disabilities; Community integration; Geographic Information Systems; Participatory Mapping; Activity Space All too often, individuals with serious mental illness experience isolation and lack opportunities to fulfill meaningful roles and activities in their communities. This is unfortunate because there is abundant evidence that participation in community life positively affects health (Antze, 1979;Barrera, 2000;Strauss & Carpenter, 1977). While most research on the experience of serious mental illness (SMI) has focused on individual's functioning, we argue that it is important to understand the role of place in participation in community life, particularly as it relates to health. The emerging body of community integration research has been devoted to studying the community contexts and factors that encourage or hinder individuals with serious mental illness from actively participating in community life (e.g., Aubry & Myner, 1996;Gulcer, Tsemberis, Stefancic, & Greenwood, 2007;Prince & Gerber, 2005;Wong & Solomon, 2002). This research agenda can be advanced by using methods that better document the relationships of contextual factors to individual experience. The overwhelming majority of community integration studies have used survey and self-report data to understand the experience of community life for persons with SMI. Further, few studies have directly assessed the impact of place on community integration, despite suggestions that it may be a critical component in the integration process (Carling, 1995;Yanos, 2007). The authors of this paper aim to contribute to the literature by presenting the methods and findings from a pair of innovative approaches to conceptualizing and measuring community integration. We argue NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscriptthat an expansion of the methods used for community integration research can better ground investigation in...

Understanding perceptions of community participation in persons with severe mental illness: A mixed-methods approach

“…For these participants, small activity spaces reflected social ties within a local geographic area, consistent with results from previous studies where people with smaller activity spaces were shown to experience a stronger sense of community. 5 However, there were contrasting results for two other participants in this activity space size measure (<5 km). Despite occupying a local geographical area, these participants had minimal social ties or meaningful places nearby (ID 19).…”

“…1 Community and community participation (CP) in turn involve social and emotional connections constructed in physical spaces, movement across spaces, and the qualities of spaces. [2][3][4][5][6] These connections are dynamic over time -shifting with considerations such as self-concept, socio-economic context and culture. 7 In mental health literatures, community is framed as a resource (social and otherwise) -a place where recovery most readily occurs; and participating in communities is an often-cited treatment, service and system objective.…”

“…5 One mixed-methods approach in this area combines geographic information systems (GIS) social resource mapping with qualitative inquiry. 5 In literatures of community development, poverty, and welfare reform, combining mapping with qualitative inquiry has been found to be a highly effective way for people to describe their understanding of and participation in communities.…”

“…5 One mixed-methods approach in this area combines geographic information systems (GIS) social resource mapping with qualitative inquiry. 5 In literatures of community development, poverty, and welfare reform, combining mapping with qualitative inquiry has been found to be a highly effective way for people to describe their understanding of and participation in communities. 4,[10][11][12] One example of this type of approach for an SMI population is Townley et al's 5 use of social mapping to examine sense of community and activity in the Southeastern United States.…”

“…This study emphasized the salience of "home" as the most important activity location, and observed that those with a smaller radius of community activity had a stronger sense of community integration, though lower life satisfaction. 5 The current study was designed to examine the perceptions of community and empirical use of space by individuals with SMI in the large urban centre of Downtown Toronto through a mixedmethods approach of participatory mapping and qualitative interviews, thereby addressing the following research question: How does a diverse group of individuals with SMI living in Metro Toronto experience community? This approach closely follows Townley et al's work and attempts to incorporate a closer examination of an ethnically diverse population.…”