Quality of Life Research

, Volume 14, Issue 1, pp 161–169 | Cite as

Subjective well-being and community integration among clients of assertive community treatment

  • Pamela N. Prince
  • Gary J. Gerber


Three aspects of community integration (i.e., physical, social, and psychological integration) were examined in relation to subjective well-being (SWB) in a sample of 92 persons with psychiatric disabilities receiving services from assertive community treatment (ACT) teams. Although two of the integration variables, namely physical and psychological integration, were related to SWB at the bivariate level, these relationships were not maintained following sequential multiple regression analysis. Findings support previously established relationships between SWB and psychiatric symptoms and between SWB and self-esteem. Results also emphasize the importance of client perceptions of social support that may be attributable, in part, to ACT services.


Psychiatric illness Subjective well-being Community integration 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Mechanic, D, Rochefort, DA 1990Deinstitutionalization: An appraisal of reform.Annu Rev Sociol16301327CrossRefGoogle Scholar
  2. Flynn, R, Aubry, T. 1999Integration of persons with developmental or psychiatric disabilities: Conceptualization and measurement.Flynn, RJLemay, R eds. A Quarter Century of Normalization and Social Role Valorization: Evolution and ImpactUniversity of Ottawa PressOttawa, Ontario271303Google Scholar
  3. Baker, F, Intagliata, J 1982Quality of life in the evaluation of community support systems.Eval Program Plan56979CrossRefGoogle Scholar
  4. Lehman, AF 1983The well-being of chronic mental outpatients.Arch Gen Psychiatry40369373PubMedGoogle Scholar
  5. Sartorius, N 1992Rehabilitation and quality of life.Hosp Community Psychiatry4311801181PubMedGoogle Scholar
  6. Prince, PN, Prince, CR 2001Subjective quality of life in the evaluation of programs for people with serious and persistent mental illness.Clin Psychol Rev2110051036CrossRefPubMedGoogle Scholar
  7. Prince, PN, Gerber, GJ 2001Measuring subjective quality of life in people with serious mental illness using the SEIQoL-DW.Quality of Life Research10117122CrossRefPubMedGoogle Scholar
  8. Cohen, S, Wills, T. 1985Stress, social support, and the buffering hypothesisPsychol Bull98310357CrossRefPubMedGoogle Scholar
  9. Lazarus, RS, Folkman, S 1984Stress, Appraisal, and Coping.SpringerNew YorkGoogle Scholar
  10. Bradburn, NM 1969The Structure of Psychological Well-beingAldineChicago, Ill.Google Scholar
  11. Campbell, A, Converse, PE, Rodgers, WL 1976The Quality of American life: Perceptions, Evaluations, and Satisfactions.SageNew YorkGoogle Scholar
  12. Diener, E, Emmons, RA, Larsen, RJ,  et al. 1985The satisfaction with life scale.J Pers Assess497175Google Scholar
  13. Diener, E 2000Subjective well-being: The science of happiness and a proposal for a national index.Am Psychol553443CrossRefPubMedGoogle Scholar
  14. Myers, D, Diener, E 1995Who is a happy?Psychol Sci61019Google Scholar
  15. Corrigan, PW, Buican, B 1995The construct validity of subjective quality of life for the severely mentally ill.J Nerv Ment Dis183281285PubMedGoogle Scholar
  16. Holloway, F, Carson, J 1999Subjective quality of life, psychopathology, satisfaction with care and insight: An exploratory study.Int J Soc Psychiatry45259267PubMedGoogle Scholar
  17. Packer, S, Husted, J, Cohen, S, Tomlinson, G 1997Psychopathology and quality of life in schizophrenia.J Psychiatry Neurosci22231234PubMedGoogle Scholar
  18. Sullivan, G, Wells, KB, Leake, B 1992Clinical factors associated with better quality of life in a seriously mentally ill population.Hosp Community Psychiatry43794798PubMedGoogle Scholar
  19. Lehman, AF 1988A quality of life interview for the chronically mentally ill.Eval Program Plann115162CrossRefGoogle Scholar
  20. Skantze, K, Malm, U, Dencker, SJ, May, PRA, Corrigan, P 1992Comparison of Quality of life with standard of living in schizophrenic out-patients.Br J Psychiatry161797801PubMedGoogle Scholar
  21. Corten, P, Mercier, C, Pelc, I 1994Subjective quality of life: Clinical model for assessment of rehabilitation treatment in psychiatry.Soc Psychiatry Psychiatr Epidemiol29178183PubMedGoogle Scholar
  22. Gibbons, JS, Butler, JP 1987Quality of life for ‘new’ long-stay psychiatric in-patients: The effects of moving to a hostel.Br J Psychiatry151347354PubMedGoogle Scholar
  23. Leff, J, Dayson, D, Gooch, C, Thornicroft, G, Wills, W 1996Quality of life of long-stay patients discharged from two psychiatric institutions.Psychiatr Serv476267PubMedGoogle Scholar
  24. MacGilp, D 1991A quality of life study of discharged long-term psychiatric patients.J Adv Nurs1612061215PubMedGoogle Scholar
  25. Lehman, AF, Possidente, S, Hawker, F 1986The well-being of chronic mental patients in a state hospital and in community residences.Hosp Community Psychiatry37901907PubMedGoogle Scholar
  26. Aubry, T, Myner, J 1996Community integration: A comparison of persons with psychiatric disabilities in housing programs and community residents who are neighbours.Can J Commun Ment Health15520PubMedGoogle Scholar
  27. Kruzich, JM 1985Community integration of the mentally ill in residential facilities.Am J Community Psychol13553564CrossRefPubMedGoogle Scholar
  28. Mowbray, CT, Greenfield, A, Freddolino, PP 1992An analysis of treatment services provided in group home for adults labelled mentally ill.J Nerv Ment Dis180551559PubMedGoogle Scholar
  29. Nelson, G, Smith Fowler,  H 1987Housing for the chronically mentally disabled: Part II - Process and outcome.Can J Commun Ment Health62991Google Scholar
  30. Segal, S, Aviram, V 1978The Mentally Ill in Community-Based Sheltered Care and Social Integration.WileyNew YorkGoogle Scholar
  31. Carling, P 1990Major mental illness, housing, and supports: The promise of community integration.Am Psychol45969975CrossRefPubMedGoogle Scholar
  32. Crisp, R 1996Community integration, self-esteem, and vocational identity among persons with disabilities.Aust Psychol31133137Google Scholar
  33. Nagy, MP, Fisher, GA, Tessler, RC 1988Effects of facility characteristics on the social adjustment of mentally ill residents of board-and-care homes.Hosp Community Psychiatry3912811286PubMedGoogle Scholar
  34. Nikkonen, M 1996Life after the mental hospital: The way of life of deinstitutionalized psychiatric patients.J Psychiatr Ment Health Nurs3373383PubMedGoogle Scholar
  35. Mallik, K, Reeves, RJ, Dellario, DJ 1998Barriers to community integration for people with severe and persistent psychiatric disabilities.Psychiatr Rehabil J22175180Google Scholar
  36. Prince, PN, Prince, CR 2002Perceived stigma and community integration among clients of assertive community treatment teams.Psychiatr Rehabil J25323331PubMedGoogle Scholar
  37. Brown, C, Cosgrove, N, DeSelm, T 1997Barriers interfering with life satisfaction for individuals with severe mental illness.Psychiatr Rehabil J206771Google Scholar
  38. Nelson, G, Hall, GB, Walsh-Bowers, R 1997A comparative evaluation of supportive apartments, group homes, and board-and-care homes for psychiatric consumer/survivors.J Community Psychol25167188CrossRefGoogle Scholar
  39. Stein, LI, Test, MA 1980Alternatives to mental hospital treatment: I. Conceptual model, treatment program, and clinical evaluation.Arch Gen Psychiatry37392397PubMedGoogle Scholar
  40. Krupa T, Eastabrook S, Gerber GJ. Variations on Assertive Community Treatment: A Study of Approaches and Client Outcomes of Four Teams in South Eastern Ontario. Grant from the Ontario Ministry of Health and Long-Term Care in collaboration with the Ontario Mental Health Foundation, the Canadian Mental Health Association-Ontario and the Centre for Addictions and Mental Health, 1997. Google Scholar
  41. Surles, RC, McGurrin, MC 1987Increased use of psychiatric emergency services by young chronic mentally ill patients.Hosp Community Psychiatry38401405PubMedGoogle Scholar
  42. Baronet, AM, Gerber, GJ 1998Psychiatric rehabilitation: Efficacy of four models.Clin Psychol Rev18189228CrossRefPubMedGoogle Scholar
  43. Burns, BJ, Santos, AB 1995Assertive community treatment: An update of randomized trials.Psychiatr Serv46669675PubMedGoogle Scholar
  44. McGrew, JH, Bond, GR, Dietzen, L, McKasson, M, Miller, LD 1995A multisite study of client outcomes in assertive community treatment.Psychiatr Serv46696701PubMedGoogle Scholar
  45. Perkins, DD, Florin, P, Rich, RC, Wandersman, A, Chavis, DM 1990Participation in the social and physical environment of residential blocks: Crime and community context.Am J Community Psychol1838115CrossRefGoogle Scholar
  46. Lehman, AF 1995Toolkit for evaluating quality of life for persons with severe mental illness.Center of Mental Health Services Research, University of Maryland School of MedicineBaltimoreGoogle Scholar
  47. Overall, JE, Gorham, DR 1962The brief psychiatric rating scale.Psychol Rep10799812Google Scholar
  48. Arnold R. Methodology. In: Description of Baseline Data from the Older Cohort Communities Kingston. Better Beginnings, Better Futures Research Coordination Unit. Kingston, Ontario: Queen’s University, 1995: 5–14.Google Scholar
  49. Rosenberg, M 1965The measurement of self-esteemRosenberg, M eds. Society and the Adolescent Self-ImagePrinceton University PressPrinceton, NJ1636Google Scholar
  50. Statistical Package for the Social Sciences (SPSS). SPSS Base System, Release 10.0. Chicago: SPSS Inc., 2000. Google Scholar
  51. Tabachnick, BG, Fidell, LS 1996Using Multivariate Statistics3Harper Collins College PublishersNew YorkGoogle Scholar
  52. Postrado, LT, Lehman, AF 1995Quality of life and clinical predictors of rehospitalization of persons with severe mental illness.Psychiatr Serv4611611165PubMedGoogle Scholar
  53. Aubry, T, Tefft, B, Currie, R 1995Predicting intentions of community residents toward neighbours with psychiatric disabilities.Psychosocial Rehabil J185166Google Scholar
  54. Fellin, P 1993Reformulation of the context of community-based care.J Sociol Soc Welf205767Google Scholar
  55. Sullivan, G, Wells, KB, Morgenstern, H, Leake, B 1995Identifying modifiable risk factors for rehospitalization: A case-control study of seriously mentally ill persons in Mississippi.Am J Psychiatry15217491756PubMedGoogle Scholar
  56. Gerber, GJ, Prince, PN, de Souza, H, Lafave, HG 1997A consortium of agencies serving people with serious mental illness: Promises made and broken.Psychiatr Rehabil J208083Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  1. 1.Brockville Psychiatric Hospital, (A Division of the Royal Ottawa Health Care Group), Institute for Mental Health Research, Carleton UniversityBrockville
  2. 2.West Park Healthcare Centre, University of OttawaToronto, OttawaCanada

Personalised recommendations