Abstract
Aims: The purpose of this study was to verify how integration into the mental health community, a subculture of persons with mental illness, affects the integration into the non-mental health community. Thus, we analyzed the effect of community-based mental health service programs on non-mental health community integration, mediated by mental health community integration. Methods: In total, 190 persons with mental illness (M age = 42.78; SD = 11.3; male, 54.7%; female, 45.3%), living in local communities and using community-based mental health programs, participated in the study. We measured their sociodemographic and clinical variables, the environmental variables of mental health service programs, and the level of integration of the mental health and non-mental health communities. The data collected were analyzed to test the proposed hypotheses using Structural Equation Modeling (SEM). Results: The common significant predictors affecting the two types of community integration were symptoms and resource accessibility: the more accessible the various community resources and the less severe the psychiatric symptoms were, the higher the level of the two types of community integration was. In path analysis, the program’s atmosphere and the participation of people with mental illness (program involvement) significantly predicted the level of integration into the mental health community. This, in turn, had a positive effect on their physical integration, social contact frequency, and psychological integration into the non-mental health community, mediated by the integration of the mental health community. Conclusion: Based on the results, we emphasize the importance of mental health communities and suggest strategies to support the integration of mental health communities.
Highlights
Deinstitutionalization has led mental health treatment facilities to shift from facilities within hospitals to within communities
The inclusion criteria for participants included a diagnosis of schizophrenia or a mood disorder according to DSM-5, living within the community, and using community-based mental health service programs
We identified a significant path by which program atmosphere and involvement among program environmental factors affected physical integration, social contact frequency, and psychological integration, mediated by mental health community integration
Summary
Deinstitutionalization has led mental health treatment facilities to shift from facilities within hospitals to within communities. The purpose of mental health services is to enable people with mental disorders to satisfactorily participate in their communities with equal rights [1]. Both a facilitator and an outcome of the recovery process [2,3]. In their definition of community integration, Wong and Solomon [4] included the individual’s capacity to carry out daily activities in their community (physical integration), to pursue interaction with mentally well members of their community (social integration), and to feel a sense of belonging within their community (psychological integration). A normalization strategy should be pursued that allows people with mental illness to actively interact with non-disabled people, participate in various community activities with equal rights, and build psychological bonds within their community
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