Social Integration for Psychiatrically Disabled Adults

描述（由申请人提供）：目前，许多住在医院外的精神残疾患者可以说是在社区，但不是社区。他们都是孤立的，在非常真实的意义上，在社会上是隐形的，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、朋友和休闲相比，精神残疾患者的日常生活可能包括药物就诊、治疗和/或病例管理就诊、前往服务机构领取残疾检查、参加日间项目等。然而，有些人确实设法实现了相当程度的社会融合。他们是怎么做到的？精神卫生服务如何才能最好地支持和帮助他们？这些都是我们在这个全定性研究中要解决的研究问题。这个三州项目的总体目标是为患有或曾经患有精神残疾的人建立一个基于经验的社会融合理论和概念模型，作为实际行动的基础。强调这些人的观点。数据将通过“最低结构”访谈从代表三个群体的个人中收集：(a)积极走向更大社会融合的人，(b)他们的重要他人，以及(c)在波士顿、纽约市和佛蒙特州南部七个服务点工作的精神卫生服务提供者。该研究利用互补的方法和理论框架来描述精神残疾人士的社会融合。类别构建的归纳方法将用于描述这些人与他人建立和维持联系的过程（“连接过程”）。在六个案例研究中，将使用生活图表方法和叙事分析来追踪社会融合的过程。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，将为建议作出改变奠定基础，以更加强调精神卫生服务可能作出的社会融合。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产生知识。该项目是朝着设计和实施一项或多项理论上知情的服务干预措施的长期目标迈出的第一步，这些干预措施旨在促进精神残疾者的社会融合。

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.