An Examination of the Community Participation Interests of Young Adults with Serious Mental Illnesses

  • Elizabeth C. ThomasEmail author
  • Gretchen Snethen
  • Amber O’Shea
  • John Suarez
  • Irene Hurford
  • Mark S. Salzer


Participation in various aspects of community life (e.g., education, employment) plays a critical role in fostering young adult development and health. To support behavioral health services in addressing a broader array of meaningful community participation areas, the current study examined the participation interests of young adults with serious mental illnesses via a literature review and focus groups interviews. Literature review results revealed a range of community participation areas of interest to these individuals, including employment, education, religion and spirituality, social networking (e.g., using social media), volunteering activities, socializing, and civic and artistic participation (e.g., attending a political event, playing music). Focus group participants named many of these same areas, but also mentioned unique areas of participation that have not been the focus of previous research (i.e., playing games, sports, exploration of other communities (e.g., traveling), hanging out, and nature-based participation). Implications for future research and behavioral health practice are discussed.


Funding information

The content of this paper was developed with assistance from grant K08MH116101 from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Arnett JJ. Emerging Adulthood: A Theory of Development from the Late Teens through the Twenties. American Psychologist. 2000;55(5):469-480.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Martel A, Fuchs DC. Transitional Age Youth and Mental Illness – Influences on Young Adult Outcomes. Child and Adolescent Psychiatric Clinics of North America. 2017;26(2):xiii-xvii.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Burns-Lynch B, Brusilovskiy E, Salzer MS. An Empirical Study of the Relationship Between Community Participation, Recovery, and Quality of Life of Individuals with Serious Mental Illnesses. Israel Journal of Psychiatry and Related Sciences. 2016;53(1):46-55.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Berzonsky MD. Identity Style and Well-Being: Does Commitment Matter? Identity: An International Journal of Theory and Research. 2003;3(2):131-142.CrossRefGoogle Scholar
  5. 5.
    Holland D, Lachicotte W. Vygotsky, Mead, and the new sociocultural studies of identity. In: Daniels H, Cole M, Wertsch JV (Eds). Cambridge Companion to Vygotsky. Cambridge: Cambridge University Press, 2007, pp. 101-135.CrossRefGoogle Scholar
  6. 6.
    O'Shea A, Meyer RH. A Qualitative Investigation of the Motivation of College Students with Nonvisible Disabilities to Utilize Disability Services. Journal of Postsecondary Education and Disability. 2016;29(1):5-23.Google Scholar
  7. 7.
    Bandura A, Schunk DH. Cultivating Competence, Self-Efficacy, and Intrinsic Motivation through Proximal Self-Motivation. Journal of Personality and Social Psychology. 1981;41(3):586-598.CrossRefGoogle Scholar
  8. 8.
    Garcia-Poole C, Byrne S, Rodrigo MJ. Youth-Led Activities Associated with Positive Competence Changes in a Community-Based Program for Adolescents. Child & Family Social Work. 2018;23(4):599-608.CrossRefGoogle Scholar
  9. 9.
    Visser PL, Hirsch JK. Health Behaviors among College Students: The Influence of Future Time Perspective and Basic Psychological Need Satisfaction. Health Psychology and Behavioral Medicine. 2014;2(1):88-99.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    de Girolamo G, Dagani J, Purcell R, et al. Age of Onset of Mental Disorders and Use of Mental Health Services: Needs, Opportunities and Obstacles. Epidemiology and Psychiatric Sciences. 2012;21(1):47-57.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Dudley R, Nicholson M, Stott P, et al. Improving Vocational Outcomes of Service Users in an Early Intervention in Psychosis Service. Early Intervention in Psychiatry. 2014;8(1):98-102.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Ramsay CE, Stewart T, Compton MT. Unemployment among Patients with Newly Diagnosed First-Episode Psychosis: Prevalence and Clinical Correlates in a US Sample. Social Psychiatry and Psychiatric Epidemiology. 2012;47(5):797-803.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Embrett MG, Randall GE, Longo CJ, et al. Effectiveness of Health System Services and Programs for Youth to Adult Transitions in Mental Health Care: A Systematic Review of Academic Literature. Administration and Policy in Mental Health and Mental Health Services Research. 2015;43(2):259-269.CrossRefGoogle Scholar
  14. 14.
    Kaplan K, Salzer M, Brusilovskiy E. Community Participation as a Predictor of Recovery-Oriented Outcomes Among Emerging and Mature Adults with Mental Illnesses. Psychiatric Rehabilitation Journal. 2012;35(3):219-229.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Snethen G, Bilger A, Maula EC, et al. Exploring Personal Medicine as Part of Self-Directed Care: Expanding Perspectives on Medical Necessity. Psychiatric Services. 2016;67(8):883-889.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    World Health Organization. ICF: International Classification of Functioning, Disability, and Health. Geneva, Switzerland: World Health Organization, 2001.Google Scholar
  17. 17.
    Furstenberg FF. Becoming Adults: Challenges in the Transition to Adult Roles. American Journal of Orthopsychiatry. 2015;85(5, Suppl):S14-S21.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Penttilä M, Jääskeläinen E, Hirvonen N, et al. Duration of Untreated Psychosis as Predictor of Long-Term Outcome in Schizophrenia: Systematic Review and Meta-Analysis. The British Journal of Psychiatry. 2014;205(2):88-94.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Mueser KT, Penn DL, Addington J, et al. The NAVIGATE Program for First-Episode Psychosis: Rationale, Overview, and Description of Psychosocial Components. Psychiatric Services. 2015;66(7):680-690.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Kane JM, Robinson DG, Schooler NR, et al. Comprehensive versus Usual Community Care for First-Episode Psychosis: 2-Year Outcomes from the NIMH RAISE Early Treatment Program. The American Journal of Psychiatry. 2016;173(4):362-372.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Substance Abuse and Mental Health Services Administration. Guidance for Revision of the FY 2014-2015 MHBG Behavioral Health Assessment and Plan, 2014. Accessed at:
  22. 22.
    Ramsay CE, Broussard B, Goulding SM, et al. Life and Treatment Goals of Individuals Hospitalized for First-Episode Nonaffective Psychosis. Psychiatry Research. 2011;189(3):344-348.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Iyer SN, Mangala R, Anitha J, et al. An Examination of Patient-Identified Goals for Treatment in a First-Episode Programme in Chennai, India., Early Intervention in Psychiatry. 2011;5(4):360-365.PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    Thomas EC, Snethen G, Salzer MS. A Developmental Study of Community Participation of Individuals With Serious Mental Illnesses: Implications for Policy and Practice. American Journal of Orthopsychiatry. 2017;87(5):597-605.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Oxhandler HK, Narendorf SC, Moffatt KM. Religion and Spirituality Among Young Adults With Severe Mental Illness. Spirituality in Clinical Practice. 2018;5(3):188-200.CrossRefGoogle Scholar
  26. 26.
    Gowen K, Deschaine M, Gruttadara D, et al. Young Adults with Mental Health Conditions and Social Networking Websites: Seeking Tools to Build Community. Psychiatric Rehabilitation Journal. 2012;35(3):245-250.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Abdel-Baki A, Lal S, Charron OD, et al. Understanding Access and Use of Technology among Youth with First-Episode Psychosis to Inform the Development of Technology-Enabled Therapeutic Interventions. Early Intervention in Psychiatry. 2017;11(1):72-76.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Jivanjee P, Kruzich J, Gordon LJ. Community Integration of Transition-Age Individuals: Views of Young with Mental Health Disorders. Journal of Behavioral Health Services & Research. 2008;35(4):402-418.CrossRefGoogle Scholar
  29. 29.
    Gürbüz HGA, Demir T, Özcan BG, et al. Use of social network sites among depressed adolescents. Behaviour & Information Technology. 2017;36(5):517-523.CrossRefGoogle Scholar
  30. 30.
    Shimitras L, Fossey E, Harvey C. Time Use of People Living with Schizophrenia in a North London Catchment Area. The British Journal of Occupational Therapy. 2003;66(2):46-54.CrossRefGoogle Scholar
  31. 31.
    Salzer M, Brusilovskiy E, Prvu-Bettger J, et al. Measuring Community Participation of Adults With Psychiatric Disabilities: Reliability of Two Modes of Data Collection. Rehabilitation Psychology. 2014;59(2):211-219.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Segal SP, Silverman C, Temkin T. Measuring Empowerment in Client-Run Self-Help Agencies. Community Mental Health Journal. 1995;31(3):215-227.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Diamond R, Becker M. The Wisconsin Quality of Life Index: A Multidimensional Model for Measuring Quality of Life. Journal of Clinical Psychiatry. 1999;60:29-31.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Wykes T, Sturt E. The Measurement of Social-Behavior in Psychiatric Patients: An Assessment of the Reliability and Validity of the SBS Schedule. British Journal of Psychiatry. 1986;148:1-11.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I): The Development and Validation of a Structured Diagnostic Psychiatric Interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry. 1998;59(Suppl 20):22-33.PubMedPubMedCentralGoogle Scholar
  36. 36.
    Morgan DL. Focus Groups. Annual Review of Sociology. 1996;22(1):129-152.CrossRefGoogle Scholar
  37. 37.
    Bradley EH, Curry LA, Devers KJ. Qualitative Data Analysis for Health Services Research: Developing Taxonomy, Themes, and Theory. Health Services Research. 2007;42(4):1758-1772.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Prior L. Content analysis. In: Leavy P (Ed). The Oxford Handbook of Qualitative Research. New York, NY, US: Oxford University Press, 2014, pp. 359-379.Google Scholar
  39. 39.
    Metcalfe JD, Drake RE, Bond GR. Economic, Labor, and Regulatory Moderators of the Effect of Individual Placement and Support among People with Severe Mental Illness: A Systematic Review and Meta-Analysis. Schizophrenia Bulletin. 2018;44(1):22-31.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Unger KV, Pardee R, Shafer MS. Outcomes of Postsecondary Supported Education Programs for People with Psychiatric Disabilities. Journal of Vocational Rehabilitation. 2000;14(3):195-199.Google Scholar
  41. 41.
    Salzer MS, Baron RC, Menkir S-MA, et al. Community Integration. In: Nemec PB, Furlong-Norman K (Eds). Best Practices in Psychiatric Rehabilitation, 2nd edition. McLean, Virginia: Psychiatric Rehabilitation Association, 2014, pp. 219-236.Google Scholar
  42. 42.
    Becker DR, Drake RE. Individual Placement and Support: A Community Mental Health Center Approach to Vocational Rehabilitation. Community Mental Health Journal. 1994;30(2):193-206.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Dixon LB, Holoshitz Y, Nossel I. Treatment Engagement of Individuals Experiencing Mental Illness: Review and Update. World Psychiatry. 2016;15(1):13-20.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Lucksted A, Essock SM, Stevenson J, et al. Client Views of Engagement in the RAISE Connection Program for Early Psychosis Recovery. Psychiatric Services. 2015;66(7):699-704.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Niendam TA, Tully LM, Iosif A-M, et al. Enhancing Early Psychosis Treatment Using Smartphone Technology: A Longitudinal Feasibility and Validity Study. Journal of Psychiatric Research. 2018;96:239-246.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Olivet J, Haselden M, Piscitelli S, et al. Results from a Pilot Study of a Computer-Based Role-Playing Game for Young People with Psychosis. Early Intervention in Psychiatry. 2018.Google Scholar

Copyright information

© National Council for Behavioral Health 2019

Authors and Affiliations

  1. 1.College of Public HealthTemple UniversityPhiladelphiaUSA
  2. 2.Department of Social and Behavioral Sciences, College of Public HealthTemple UniversityPhiladelphiaUSA
  3. 3.College of EducationPennsylvania State University University ParkState CollegeUSA
  4. 4.Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA

Personalised recommendations