Social Integration for Psychiatrically Disabled Adults

描述(申请人提供)：目前，许多居住在医院外的精神残疾人士可以说是在社区里，但不是在社区里。他们都是孤立的，而且在非常真实的意义上，他们在社会上是看不见的，既缺乏与非残疾人的有意义的个人接触，也缺乏基本的、合法的人格标志。与构成我们大部分生活的日常工作、家庭和/或家庭生活、朋友和休闲形成对比的是，精神障碍患者的日常生活可能包括药物治疗、治疗和/或病例管理访问、前往服务机构领取残疾检查、参加日间方案等。他们是怎么做到的？以及：精神健康服务如何才能最好地支持和帮助他们？这些是我们在这项全定性研究中要解决的研究问题。这一三州项目的总体目标是为精神残障人士建立一个以经验为基础的社会融合理论和概念模型，作为实际行动的基础。强调代表这些人的观点。数据将通过“最低限度的结构化”访谈收集，这些个人代表三个群体：(A)积极致力于更大程度的社会融合的人，(B)他们的重要其他人，以及(C)在波士顿、纽约市和佛蒙特州南部的七个服务地点工作的精神健康服务提供者。这项研究借鉴了互补的方法和理论框架来描述精神残疾人的社会融合。范畴建构的归纳方法将被用来描述这些人通过其与他人建立和维持联系的过程(“连接过程”)。将使用生命图法和六个案例研究中的叙事分析来追踪随着时间的推移社会融合的过程。对特定的服务提供者和组织如何促进人类能力发展的审查，将为建议改变心理健康服务可能做出的更多强调社会融合的做法奠定基础。虽然这个项目的目标是建立理论，但我们的目的不是为了知识本身而生产知识。该项目是朝着设计和实施一个或多个理论上知情的服务干预措施的长期目标迈出的第一步，目的是促进精神残疾人的社会融合。

DESCRIPTION (provided by applicant): Presently, many individuals with psychiatric disabilities who are living outside the hospital may be said to be in the community, but not of it. They are both isolated and in a very real sense, socially invisible, lacking both meaningful personal contact with non-disabled persons and basic, legitimizing markers of personhood. In contrast to the daily rounds of work, home and/or family life, friends, and leisure that make up most of our lives, the routines of persons with psychiatric disabilities are likely to consist of medication visits, therapy and/or case management visits, trips to service facilities to pick up disability checks, attendance at day programs, etc. Some individuals, however, do manage to achieve a substantial measure of social integration. How do they do it? And: How can mental health services best support and assist them? These are the research questions we address in this all-qualitative study. The overall aim of this three-state project is to build an empirically based theory and conceptual model of social integration for persons who are or have been psychiatrically disabled as the basis for practical action. Representation of the perspectives of these persons is emphasized. Data will be collected through "minimally structured" interviews from individuals representing three constituencies: (a) persons actively moving toward greater social integration, (b) their significant others, and (c) mental health services providers working at seven service sites in Boston, New York City, and southern Vermont. The research draws upon complementary methodologies and theoretical frameworks to depict social integration for psychiatrically disabled persons. Inductive methods of category construction will be used to characterize processes through which these persons create and sustain ties with others ("connecting processes "). Life chart methods and narrative analysis in six case studies will be used to trace courses of social integration over time. An examination of how particular service providers and organizations foster the development of human capabilities will lay the groundwork for recommending changes toward greater emphasis on social integration that mental health services might make. Though the goal of this project is to build theory, our intent is not to produce knowledge for its own sake. This project is an initial step toward the longer-term goal of designing and implementing one or more theoretically informed services interventions aimed at promoting social integration for persons with psychiatric disabilities.