Boston University College of Health & Rehabilitation Sciences:
Sargent College

Boston University College of Health & Rehabilitation Sciences: Sargent College

Enhancing the Community Living and Participation of Individuals with Psychiatric Disabilities

An exploration of barriers to community participation and the development and testing of a community participation intervention

Description

Full community participation is arguably the most essential of rehabilitation goals and is a gauge of one’s quality of life. Community participation emerged as important when it became clear that simply living outside of institutional walls was insufficient to insure that individuals lived full and integrated lives (Bazelon Center for Mental Health Law, 2009). Community participation is a way to overcome the isolation and loneliness that are often reported as part of the experience of individuals with psychiatric disabilities and has been associated with a host of positive outcomes such as greater self-confidence, hope, self-determination and well-being (Bond, Salyers, Rollins, Rapp, & Zipple, 2004; Prince & Gerber, 2005; Townley, Kloos, & Wright, 2009). But, despite general agreement about the importance of community participation as a component of recovery, there has been little consensus on the dimensions comprising it (Heineman, 2010), or interventions to promote it, particularly for individuals with psychiatric disabilities.

In recent policy statement, both the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) and the Substance Abuse and Mental Health Services Administration (SAMHSA) re-affirmed the importance of community living and participation. As noted by NIDILRR, individuals with disabilities are entitled to participate fully in “mainstream American society” and enjoy the independence, self-determination, opportunities, and contributions of other full citizens. Our proposed DRRP is designed to address these issues, mindful of both the personal and environmental barriers and facilitators to community participation (World Health Organization, ICF, 2002). In keeping with NIDILRR’s objectives, we proposed and conducted a range of rigorous research studies using a community-based participatory approach, with input from individuals with psychiatric disabilities and other important stakeholders.

To achieve the goals of this project, we conducted an exploratory study to develop an in-depth understanding of community living for adults with psychiatric disabilities. We developed, refined and tested a new measure of community participation for individuals with psychiatric disabilities focusing on both objective and subjective aspects of community participation. We manualized, refined and pilot-tested a peer-led intervention titled “Bridging Community Gaps Photovoice (BCGP)” which integrates group and individual peer support with photovoice and community asset mapping methodologies. Finally, we conducted a randomized clinical trial in multiple mental health programs to evaluate the efficacy of the peer-led “Bridging Community Gaps Photovoice” intervention.

The research and dissemination activities are intended to contribute to ongoing efforts to increase community participation and quality of life for individuals with psychiatric disabilities.

Documents:

Millner, U.C., Woods, T., Furlong-Norman, K., Rogers, E.S., Rice, D.,& Russinova Z. (2019). Socially Valued Roles, Self-Determination, and Community Participation among individuals living with Serious Mental Illnesses.(2019).  American Journal of Community Psychology, 63, 32-45. doi: 10.1002/ajcp.12301. Epub 2019 Feb 6.

Rogers, E.S., Millner, U. C., Russinova, Z., Ludlow, L., & Lord, E. M. (in press). Development of an Inventory of Community Participation for individuals with psychiatric conditions. Psychiatric Rehabilitation Journal.