Community Mental Health Journal

, Volume 53, Issue 6, pp 679–687 | Cite as

An Exploratory Analysis of Unhealthy and Abusive Relationships for Adults with Serious Mental Illnesses Living in Supportive Housing

Original Paper
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Abstract

Individuals living with serious mental illness are at high risk of chronic homelessness, victimization, and intimate partner violence. In recent years, supportive housing programs have emerged as one way to prevent homelessness and victimization for this population, while also expanding social interactions and social networks. In concert with a focal supportive housing program, this research conducted two focus groups with 18 individuals who have a serious mental illness diagnosis. The authors sought to answer the research question, “What are perceptions of healthy and unhealthy relationships among formerly homeless people with serious mental illness?” To this end, the eight-item questionnaire was created around dimensions of power and control, as well as relationship equality. Findings from an inductive thematic analysis reveal three broad families of themes (relationship ideals, lived experiences, and risk/resources in supportive housing), around which smaller themes and subthemes are organized. Implications for policy, practice, and future research are also discussed.

Keywords

Serious mental illness Chronic homelessness Intimate partner violence Supportive housing Social networks Healthy relationships Relationship skills 
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References

  1. Bengtsson-Tops, A., Ericsson, U., & Ehliasson, K. (2014). Living in supportive housing for people with serious mental illness: A paradoxical everyday life. International Journal of Mental Health Nursing, 23(5), 409–418.CrossRefPubMedGoogle Scholar
  2. Berg, B. L. (1998). Qualitative research methods for the social sciences (3rd edn.). Boston, MA: Allyn & Bacon.Google Scholar
  3. Black, M. C., Basile, K. C., Breiding, M. J., Smith, S. G., Walters, M. L., Merrick, M. T., ... Stevens, M. R. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 summary report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.Google Scholar
  4. Bonfils, K. A., Firmin, R. L., Salyers, M. P., & Wright, E. R. (2015). Sexuality and intimacy among people living with serious mental illnesses: Factors contributing to sexual activity. Psychiatric Rehabilitation Journal, 38(3), 249–255.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Braun, V., & Clark, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.CrossRefGoogle Scholar
  6. Breiding, M. J., Smith, S. G., Basile, K. C., Walters, M. L., Chen, J., & Merrick, M. T. (2014). Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization-National Intimate Partner and Sexual Violence Survey, United States, 2011. Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
  7. Brunt, D., & Hansson, L. (2002). The social networks of persons with severe mental illness in in patient settings and supported community settings. Journal of Mental Health, 11(6), 611–621.CrossRefGoogle Scholar
  8. Casas, J. G., Usaola, C. P., Aguado, F. G., Gironés, M. L., & Liria, A. F. (2014). Prevalence and characteristics of intimate partner violence against women with severe mental illness: A prevalence study in Spain. Community Mental Health Journal, 50, 841–847. doi: 10.1007/s10597-014-9703-1.CrossRefGoogle Scholar
  9. Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data/.
  10. Chavis, A. Z., & Hill, M. S. (2008). Integrating multiple intersecting identities: A multicultural conceptualization of the power and control wheel. Women & Therapy, 32(1), 121–149. doi: 10.1080/02703140802384552.CrossRefGoogle Scholar
  11. Collins, S. E., Malone, D. K., & Clifasefi, S. L. (2013). Housing retention in single-site housing first for chronically homeless individuals with severe alcohol problems. American Journal of Public Health, 103(S2), S269–S274.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Cramer, E. P., & Plummer, S. (2009). People of color with disabilies: Intersectionality as a framework for analysing intimate partner violence in social, political, and historical contexts. Journal of Maltreatment, & Trauma, 18(2), 162–181. doi: 10.1080/10926770802675635.CrossRefGoogle Scholar
  13. Creswell, J. W., & Miller, D. L. (2000). Determining validity in qualitative inquiry. Theory Into Practice, 39, 124–130.CrossRefGoogle Scholar
  14. Domestic Abuse Intervention Programs. (2013). Equality wheel. Retrieved from: http://www.theduluthmodel.org/pdf/Equality.pdf.
  15. Elkington, K. S., Hackler, D., Walsh, T. A., Latack, J. A., McKinnon, K., Borges, C., Wright, E. R., & Wainberg, M. L. (2012). Perceived mental illness stigma, intimate relationships, and sexual risk behavior in youth with mental illness. Journal of Adolescent Research, 28(3), 378–404.CrossRefGoogle Scholar
  16. Farrokhi, F., & Mahmoudi-Hamidabad, A. (2012). Rethinking convenience sampling: Defining quality criteria. Theory and Practice in Language Studies, 2(4), 784.CrossRefGoogle Scholar
  17. Federal Register. (1993). Rules and regulations: Definitions of adults with a serious mental illness (SAMSHA publication vol. 58, no. 96). Washington, D.C.: U.S. Government Printing Office.Google Scholar
  18. Federal Register. (2015). Rules and regulations: Definition of chronic homelessness (HUD publication vol. 80, no. 233). Washington, D.C.: U.S. Government Printing Office.Google Scholar
  19. Friedman, S. H., Loue, S., Heaphy, E. L. G., & Mendez, N. (2011). Intimate partner violence victimization and perpetration by Puerto Rican women with severe mental illnesses. Community Mental Health Journal, 47(2), 156–163. doi: 10.1007/s10597-009-9270-z.CrossRefPubMedGoogle Scholar
  20. Haskell, R., Graham, K., Bernards, S., Flynn, A., & Wells, S. (2016). Service user and family member perspectives on services for mental health, substance use/addition, and violence: A qualitative study of their goals, experiences, and recommendations. International Journal of Mental Health Symptoms, 10(9), 1–14. doi: 10.1186/s13033-016-0040-3.Google Scholar
  21. Henwood, B. F., Matejkowski, J., Stefancic, A., & Lukens, J. A. (2014). Quality of life after housing first for adults with serious mental illness who have experienced chronic homelessness. Psychiatry Research, 220, 549–555. doi: 10.1016/j.psychres.2014.07.072.CrossRefPubMedGoogle Scholar
  22. Johnson, J. Q., & Miller, B. (2016). When women “snap”: The use of mental illness to contextualize acts of violence in contemporary popular media. Women’s Studies in Communication, 39(2), 211–227. doi: 10.1080/07491409.2016.1172530.CrossRefGoogle Scholar
  23. Khalifeh, H., Moran, P., Borschmann, R., Dean, K., Hart, C., Hogg, J., Osborn, D., Johnson, S., & Howard, L. M. (2014). Domestic and sexual violence against patients with severe mental illness. Psychological Medicine, 45(04), 875–886.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Kilbourne, A. M., McCarthy, J. F., Post, E. P., Welsh, D., & Blow, F. C. (2007). Social support among veterans with serious mental illness. Social Psychiatry and Psychiatric Epidemiology, 42(8), 639–646.CrossRefPubMedGoogle Scholar
  25. Krueger, R. A., & Casey, M. A. (2000). Focus groups: A practical guide for applied research (3rd edn.). Thousand Oaks: Sage.Google Scholar
  26. Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Thousand Oaks, CA: Sage.Google Scholar
  27. McClure, L. (2012). Where is the sex in mental health practice? A discussion of sexuality care needs of mental health clients. Journal of Ethics in Mental Health, 7, 1–6.Google Scholar
  28. Murray, C. E., Horton, G. E., Johnson, C. H., Notestine, L., Garr, B., Pow, A. M. … & Doom, E. (2015). Domestic violence service providers’ perceptions of safety planning: A focus group study. Journal of Family Violence, 30, 192–381. doi: 10.1007/s10896-015-9674-1.CrossRefGoogle Scholar
  29. National Institute of Mental Health. (2016). Serious mental illness among U.S. adults. Retrieved from http://www.nimh.nih.gov/health/statistics/prevalence/serious-mental-illness-smi-among-us-adults.shtml.
  30. Nausland, J. A., Aschbrenner, K. A., & Bartels, S. J. (2016). How people with serious mental illness use smartphones, mobile apps, and social media. Psychiatric Rehabilitation Journal. doi: 10.1037/prj0000207.Google Scholar
  31. Oh, H. Y., & DeVylder, J. E. (2014). Mental health correlates of past homelessness in Latinos and Asians. Community Mental Health Journal, 50(8), 953–959.CrossRefPubMedGoogle Scholar
  32. Östman, M. (2014). Low satisfaction with sex life among people with severe mental illness living in a community. Psychiatry Research, 216(3), 340–345. doi: 10.1016/j.psychres.2014.02.009.CrossRefPubMedGoogle Scholar
  33. Padgett, D. K., Henwood, B. T., Drake, R. E., & Abrams, C. (2008). Social relationships among people who have experienced serious mental illness, substance abuse, and homelessness: Implications for recovery. American Journal of Orthopsychiatry, 78(3), 333–339. doi: 10.1037/a0014155.CrossRefPubMedGoogle Scholar
  34. Padgett, D. K., Smith, B. T., Henwood, B. F., & Tiderington, E. (2012). Life course adversity in the lives of formerly homeless persons with serious mental illness: Context and meaning. American Journal of Orthopsychiatry, 82(3), 421–430.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Patterson, M. L., Currie, L., Rezansoff, S., & Somers, J. M. (2015). Exiting homelessness: Perceived changes, barriers, and facilitators among formerly homeless adults with mental disorders. Psychiatric Rehabilitation Journal, 38, 81–87. doi: 10.1037/t18597-000.CrossRefPubMedGoogle Scholar
  36. Pence, E., & Paymar, M. (1993). Education groups for men who batter: The Duluth Model. New York: Springer.Google Scholar
  37. Perese, E., & Wolf, M. (2005). Combating loneliness among persons with severe mental illness: Social network interventions’ characteristics, effectiveness, and applicability. Issues in Mental Health Nursing, 26, 591–609.CrossRefPubMedGoogle Scholar
  38. Pernice-Duca, F. M. (2008). The structure and quality of social network support among mental health consumers of clubhouse programs. Journal of Community Psychology, 36(7), 929–946.CrossRefGoogle Scholar
  39. Reid, R. J., Garcia-Reid, P., Forenza, B., Eckert, C., Carrier, M., & Drag, S. (2014). Let our voices be heard: Urban minority adolescents share their perspectives regarding substance abuse and HIV/AIDS prevention messages. American Journal of Health Promotion, 29(2), 107–114.CrossRefPubMedGoogle Scholar
  40. Roy, L., Crocker, A. G., Nicholls, T. L., Latimer, E. A., & Ayllon, A. R. (2014). Criminal behavior and victimization among homeless individuals with severe mental illness: A systematic review. Psychiatric Services, 65(6), 739–750.CrossRefPubMedGoogle Scholar
  41. Slade, M., Amering, M., Farkas, M., Hamilton, B., O’Hagan, M., Panther, G., Perkins, R., Shepherd, G., Tse, S., & Whitley, R. (2014). Uses and abuses of recovery: Implementing recovery-oriented practices in mental health systems. World Psychiatry, 13(1), 12–20.CrossRefPubMedPubMedCentralGoogle Scholar
  42. State of New York, Office of Mental Health. (2015). Supported housing guidelines. Retrieved from https://www.omh.ny.gov/omhweb/adults/SupportedHousing/supported_housing_guidelines.pdf.
  43. Temple University Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities. (2011). Community inclusion: definition and background. Retrieved September 2011, from http://tucollaborative.org/comm_inclusion/community_integ_intro.html.
  44. Townsend, L., Zippay, A., Caler, K., & Forenza, B. (2016). Technology and opportunity: People with serious mental illness and social connection. Journal of the Society for Social Work and Research, 7(2), 371–393.CrossRefGoogle Scholar
  45. U.S. Department of Housing and Urban Development, Office of Community Planning and Development. (2011). The 2010 annual homeless assessment report to congress. Retrieved January 16, 2016, from https://www.hudexchange.info/resources/documents/2010HomelessAssessmentReport.pdf, see more at https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers#sthash.h4bGvkg5.dpuf.
  46. Viron, M., Bello, I., Freudenreich, O., & Shtasel, D. (2014). Characteristics of homeless adults with serious mental illness served by a state mental health transitional shelter. Community Mental Health Journal, 50(5), 560–565.CrossRefPubMedGoogle Scholar
  47. Walters, M. L., Chen, J., & Breiding, M. J. (2013). The National Intimate Partner and Sexual Violence Survey: 2010 findings on victimization by sexual orientation. Retrieved March 7, 2016, from http://www.cdc.gov/violenceprevention/pdf/nisvs_sofindings.pdf.
  48. Wong, Y., & Solomon, P. (2002). Community integration of persons with psychiatric disabilities in supportive housing: A conceptual model and methodological considerations. Mental Health Services Research, 4, 13–28.CrossRefGoogle Scholar
  49. Wright, P. A., & Kloos, B. (2007). Housing environment and mental health outcomes: A levels of analysis perspective. Journal of Environmental Psychology, 27, 79–89.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Yanos, P., Barrow, S. M., & Tsemberis, S. (2004). Community integration in the early phase of housing among homeless persons diagnosed with severe mental illness: Success and challenges. Community Mental Health Journal, 40, 133–150.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Center for Child Advocacy and PolicyMontclair State UniversityMontclairUSA
  2. 2.Family StudiesMontclair State UniversityMontclairUSA

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