Abstract
This study tests components of Wong and Solomon’s (2002, Mental Health Services Research, 4(2), 13–28) model of community integration, identifying both the dimensions and predictors of integration. It evaluates community integration among adults with psychiatric disabilities assigned randomly to receive either independent scatter-site apartments with the Housing First approach (experimental) or services as usual (control). Factor analysis supported a definition of community integration that includes psychological, physical, and social domains, but also suggested the existence of another factor, independence/self-actualization. Regression analysis suggested that choice and independent scatter-site housing were predictors of psychological and social integration respectively. Psychiatric hospitalization, symptomatology and participation in substance use treatment were also found to influence aspects of integration. We discuss several issues that future studies should explore including the possibility that the same factor can differentially influence discrete aspects of integration, the role of person–environment fit, integration that is not based in the neighborhood, and, finally, conceptions of community integration from the perspective of consumers themselves.
Similar content being viewed by others
References
Aubry T., Myner J. (1996). Community integration and quality of life: A comparisons of persons with psychiatric disabilities in housing programs and community residents who are neighbors. Canadian Journal of Community Mental Health 15(1): 5–20
Aubry T. D., Teft B., Currie R. F. (1995). Public attitudes and intentions regarding tenants of community mental health residences who are neighbors. Community Mental Health Journal 31(1): 39–52
Barrera M. Jr. (1981). Social support in the adjustment of pregnant adolescents: Assessment issues In B. H. Gottlied (Ed.), Social networks and social support (pp. 69–96). Beverly Hills: Sage
Becker M., Diamond R., Sainfort F. (1993). A new patient focused index for measuring quality of life in persons with severe and persistent mental illness. Quality of Life Research 2(4): 239–251
Bruckner J. C. (1988). The development of an instrument to measure neighborhood cohesion. American Journal of Community Psychology 16: 771–791
Caplan R. D., Harrison R. V. (1993). Person-environment fit theory: Some history, recent developments, and future directions. Journal of Social Issues 49: 253–276
Ciarolo J. A., Edwards D. W., Kiresuk T. J., Newman F. L., Brown T. R. (1981). Colorado symptom index Washington, DC: National Institute of Mental Health
Gerber G. J., Prince P. N., Duffy S., McDougall L., Cooper J., Dowler S. (2003). Adjustment, integration, and quality of life among forensic patients receiving community outreach services. International Journal of Forensic Mental Health 2(2): 129–136
Greenwood R., Schaefer-McDaniel N., Winkel G., Tsemberis S. (2005). Decreasing psychiatric symptoms by increasing choice in services for adults with histories of homelessness. American Journal of Community Psychology 36(3/4): 223–238
Gulcur L., Stefancic A., Shinn M., Tsemberis S., Fischer S. (2003). Housing, hospitalization and cost outcomes for homeless individuals with psychiatric disabilities participating in continuum of care and housing first programmes. Journal of Community and Applied Social Psychology 13: 171–186
Hull J. T., Thompson J. C. (1981). Factors which contribute to normalization in residential facilities for the mentally ill. Community Mental Health Journal 17(2): 107–113
Kennedy C. (1989). Community integration and well-being: Toward the goals of community care. Journal of Social Issues 45(3): 65–77
Kruzich J. M. (1985). Community integration of the mentally ill in residential facilities. American Journal of Community Psychology 13(5): 553–563
Lehman L. F. (1988). A quality of life interview for the chronically mentally ill Evaluation and Program Planning 11: 51–62
Link B. G. (1987). Understanding labeling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. American Sociological Review 52(1): 96–112
Maslow A. (1971). The farther reaches of human nature. Oxford: Viking
McLellan A. T., Alterman A. I., Woody G. E., et al. (1992). Treatment services review. Philadelphia, PA: University of Pennsylvania
McMillan D. W., Chavis D. M. (1986). Sense of community: A definition and theory. Journal of Community Psychology 14: 6–23
Moos R. H., Lemke S. (1996). Evaluating residential facilities: The multiphasic environmental assessment procedure. Thousand Oaks, CA: Sage
Nagy M. P., Fisher G. A., Tessler R. C. (1988). Effects of facility characteristics on the social adjustment of mentally ill residents in board-and-care homes. Hospital and Community Psychiatry 39(12): 1281–1286
Nelson G., Hall G. B., Squire D., Walsh-Bowers R. T. (1992). Social network transactions of psychiatric patients. Social Science and Medicine 34(4): 433–445
Perkins D. D., Florin P., Rich R. C., Wandersman A., Chavis D. M. (1990). Participation and the social and physical environment of residential blocks: Crime and community context. American Journal of Community Psychology 18(1): 83–115
Prince P. N., Prince C. R. (2002). Perceived stigma and community integration among clients of assertive community treatment teams. Psychiatric Rehabilitation Journal 25: 323–331
Rosenblatt A., Mayer J. (1974). Recidivism of mental patients: A review of past studies. American Journal of Orthopsychiatry 44: 697–706
Segal S. P., Aviram U. (1978). The mentally ill in community-based sheltered care: A study of community care and social integration. New York Wiley
Segal S. P., Everett-Dille L. (1980). Coping styles and factors in male/female social integration. Acta Psychiatrica Scandinavica 61(1): 8–20
Segal S. P., Silverman C., Baumohl J. (1989). Seeking person-environment fit in community care placement. Journal of Social Issues 45(3): 49–64
Sherman S. R., Frenkel E. R., Newman E. S. (1986). Community participation of mentally ill adults in foster family care. Journal of Community Psychology 14: 120–133
Srebnik D., Livingston J., Gordon L., et al. (1995). Housing choice and community success for individuals with serious and persistent mental illness. Community Mental Health Journal 31: 139–152
Timko C., Moos R. H. (1998). Outcomes of the treatment climate in psychiatric and substance abuse treatment programs. Journal of Clinical Psychology 54(8): 1137–1150
Tsemberis S., Asmussen S. (1999). From streets to homes: Pathways to Housing consumer preference supported housing model. Alcoholism Treatment Quarterly 17: 113–131
Tsemberis S., Gulcur L., Nakae M. (2004). Housing first, consumer choice, and harm reduction for individuals who are homeless with dual diagnoses: A 24 month clinical trial American Journal of Public Health 94(4): 651–656
Unger D. G., Wandersman A. (1985). The importance of neighbors: The social, cognitive, and affective components of neighboring. American Journal of Community Psychology 13: 139–163
Van Wel T., Felling A., Persoon J. (2003). The effect of psychiatric rehabilitation on the activity and participation level of clients with long-term psychiatric disabilities. Community Mental Health Journal 39(6): 535–546
Wong Y. I., Solomon P. L. (2002). Community integration of persons with psychiatric disabilities in supportive independent housing: A conceptual model and methodological considerations. Mental Health Services Research 4(2): 13–28
Author information
Authors and Affiliations
Corresponding author
Additional information
Leyla Gulcur is affiliated with New York University, New York, USA. Sam Tsemberis is affiliated with Pathways to Housing, Inc., New York, USA. Ana Stefancic is affiliated with Columbia University, New York, USA. Ronni M. Greenwood is affiliated with University of Dundee, Dundee, Scotland, UK.
Address correspondence to Leya Gulcar, Ph. D., 48 Greenwich Avenue, #5C, New York, NY 10011, USA; email: leyla.gulcur@nyu.edu
Rights and permissions
About this article
Cite this article
Gulcur, L., Tsemberis, S., Stefancic, A. et al. Community Integration of Adults with Psychiatric Disabilities and Histories of Homelessness. Community Ment Health J 43, 211–228 (2007). https://doi.org/10.1007/s10597-006-9073-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-006-9073-4