Exploring the Role of Social Support in Promoting Community Integration: An Integrated Literature Review

Community integration has emerged as a priority area among mental health advocates, policy makers, and researchers (Townley, Miller, & Kloos, 2013; Ware, Hopper, Tugenberg, Dickey, & Fisher, 2007). Past research suggests that social support influences community integration for individuals with serious mental illnesses (Davidson, Haglund, Stayner, Rakfeldt, Chinman, & Tebes, 2001; Davidson, Stayner, Nickou, Styron, Rowe, & Chinman, 2001; Wong & Solomon, 2002), but there has not yet been a systematic review on this topic. Therefore, the purpose of this paper was to explore the influence of social support on community integration through a review of the existing literature. An extensive literature search was conducted, resulting in 32 articles that met the search criteria. These articles were organized into three categories: defining community integration, supportive relationships, and mental health services. The search results are analyzed according to the types of support being provided. Article strengths, limitations, implications, and future directions are also addressed. Overall, the findings of this review suggest that social support, which may be provided by a variety of individuals and services, plays an important role in promoting community integration for individuals with serious mental illnesses. Therefore, as community mental health research and practice continues to promote community integration for individuals with serious mental illnesses, the mental health field should emphasize the importance of social support as a key factor influencing community integration.     

Community-Based Theater and Adults with Psychiatric Disabilities: Social Activism,Performance and Community Engagement

The present study is an in‐depth qualitative inquiry with an established theater troupe composed of adults living with psychiatric disabilities known as The Stars of Light. A grounded theory methodology is used to describe dimensions of social activism and characteristics of theater as a medium of engagement at the individual, setting/troupe, and community levels of analysis. Analysis of a broad scope of interview data, performance content, community contacts, and historical data from the troupe’s 19‐year history led to the identification of eight emergent theoretical concepts formulated from 17 supporting associated themes. The theoretical concepts characterize the impacts of community‐based theater in the lives of participants, and theater troupe processes that contribute to community education and positive social change for adults living with psychiatric disabilities. Advantages, limitations, and future directions for research and action in community‐based theater settings are discussed within the context of present research findings.     

Occupational Choices for People with Psychiatric Disabilities: Comparing Attendees and Non-Attendees at Community-Based Day Centers

Research has shown that people with psychiatric disabilities who attend a day center rate their satisfaction with daily occupations equally in comparison with non-attendees. The current study investigates which occupations the target group performs and also differences in occupational choices between attendees and non-attendees. Reported occupations were analyzed with content analysis. Day center attendees reported more productive occupations, while non-attendees reported more recreational occupations and a greater breadth of occupations. This implies that non-attendees might compensate a lack of work-like occupations at a day center with satisfying recreational occupations. The results can guide development of psychiatric occupational-based rehabilitation.     

Highlighting the Way Forward: A Review of Community Mental Health Research and Practice Published in AJCP and JCP

Articles published in the two most prominent journals of community psychology in North America, the American Journal of Community Psychology (AJCP) and Journal of Community Psychology (JCP), provide a clear indicator of trends in community research and practice. An examination of community psychology's history and scholarship suggests that the field has reduced its emphasis on promoting mental health, well‐being, and liberation of individuals with serious mental illnesses over the past several decades. To further investigate this claim, the current review presents an analysis of articles relevant to community mental health (N = 307) published in the American Journal of Community Psychology (AJCP) and Journal of Community Psychology (JCP) from 1973 to 2015. The review focuses on article characteristics (e.g., type of article and methods employed), author characteristics, topic areas, and theoretical frameworks. Results document a downward trend in published articles from the mid‐1980s to mid‐2000s, with a substantial increase in published work between 2006 and 2015. A majority of articles were empirical and employed quantitative methods. The most frequent topic area was community mental health centers and services (n = 49), but the past three decades demonstrate a clear shift away from mental health service provision to address pressing social issues that impact community mental health, particularly homelessness (n = 42) and community integration of adults with serious mental illnesses (n = 40). Findings reflect both the past and present state of community psychology and suggest promising directions for re‐engaging with community mental health and fostering well‐being, inclusion, and liberation of adults experiencing serious mental health challenges.     

应对方式、社会支持和心理压力对中学生心理健康的影响研究

该研究采用中学生应激源量表、中学生应对方式量表、领悟社会支持量表和症状自评量表(SCL-90)对852名初一至高三的学生进行了调查。通过单因变量多维交互效应的方差分析,结果表明：消极应对方式对中学生的心理健康影响较大;积极应对方式与心理健康的相关不显著;社会支持对心理健康的影响同时具有主效应和缓冲效应;心理压力与心理健康之间存在着显著相关;应对方式和社会支持在心理压力与心理健康的关系中彼此独立起作用,两者之间的交互作用不明显。     

学习不良儿童心理健康的特点研究

考察学习不良儿童心理健康（学习、自我、人际关系、社会生活适应）的特点。被试为小学3～5年级83名儿童。结果发现：学习不良儿童与一般儿童的心理健康存在显著差异;学习不良儿童的学习、自我、社会生活适应等方面显著低于一般儿童。在学习各维度上,学习不良儿童与一般儿童的自我满足感、体脑协调性、学习习惯之间存在显著差异;在自我各维度上,学习不良儿童与一般儿童的社会自我、学术自我、自我认同之间存在显著差异;在社会生活适应各维度上,学习不良儿童与一般儿童的亲社会行为、居家能力存在显著差异。     

Using Geospatial Research Methods to Examine Resource Accessibility and Availability as it Relates to Community Participation of Individuals with Serious Mental Illnesses

Greater community participation among individuals with serious mental illnesses is associated with better psychosocial and health outcomes. Typically, studies examining community participation have utilized self‐report measures and been conducted in limited settings. The introduction of methodological advances to examining community participation of individuals with serious mental illnesses has the potential to advance the science of community mental health research and invigorate the work of community psychologists in this area. This study employed an innovative geospatial approach to examine the relationship between community participation and resource accessibility (i.e., proximity) and availability (i.e., concentration) among 294 individuals utilizing community mental health services throughout the United States. Findings suggest small but significant associations between community participation and the accessibility and availability of resources needed for participation. Furthermore, findings demonstrate the importance of car access for individuals residing in both urban and non‐urban settings. The methods and results presented in this study have implications for community mental health research and services and provide an illustration of ways that geospatial methodologies can be used to investigate environmental factors that impact community inclusion and participation of individuals with serious mental illnesses.     

Poverty and Serious Mental Illness: Toward Action on a Seemingly Intractable Problem

This paper examines the issue of poverty among people with serious mental illness (SMI), positioning it as a key issue to be confronted by community mental health systems and practitioners. The paper reviews three perspectives on poverty, considering how each sheds light on poverty among people with SMI, and their implications for action: (a) monetary resources, (b) basic needs, and (c) capabilities. The paper argues that community mental health programs and systems are currently unable to address poverty as they are overly focused on individual‐level interventions that, on their own, cannot raise people out of poverty. The paper calls for a social justice value, informed by the concept of citizenship, as a necessary complement to the recovery concept that has informed community mental health practice for almost 25 years. Finally, the paper argues that community psychologists, with their concepts, methods, and values, are well positioned to contribute to this important issue. However, it also contends that addressing poverty requires collaboration from community psychologists with researchers and practitioners from other fields and domains of expertise to begin to make progress.     

中国丧亲个体社会支持体验的质性研究

本研究通过对28位丧亲者进行深度访谈,使用解释现象学分析法对质性数据进行分析,探索中国丧亲个体的社会支持体验。结果显示,丧亲社会支持的内容包括后事处理、情感支持、生活恢复帮助,经济与物资支持等。支持来源除家人和朋友之外,还包括同事、相同经历者,以及相关机构等。社会支持通过调节情绪、改变认知等方式促进个体对丧亲的适应。本研究结果为最新丧亲社会支持模型提供了支持,同时也反映出中国社会对丧亲人群的社会支持特色。     

社会支持对慢性病患者身心健康的影响

慢性疾病已经成为威胁现代人健康的头号问题。社会支持作为影响人们身心健康的重要因素,在减轻疾病压力、帮助人们应对压力以及减少心理不适、增进身体健康等方面发挥着重要的作用。从社会网络理论的视角,考察社会支持对慢性病患者身心健康的影响,提出相应的社会支持对策。     

The Citizenship Project Part II: Impact of a Citizenship Intervention on Clinical and Community Outcomes for Persons with Mental Illness and Criminal Justice Involvement

This study assessed the effectiveness of an intervention based on a theoretical framework of citizenship on reducing psychiatric symptoms, alcohol use, and drug use, and increasing quality of life for persons with serious mental illness (SMI) and criminal justice involvement. One-hundred fourteen adults with SMI and a history of criminal justice involvement participated in a 2 × 3 longitudinal randomized controlled trial of a four-month citizenship intervention versus usual services. Linear mixed model analyses were used to assess the intervention’s impact on quality of life, symptoms, and substance use. After controlling for baseline covariates, participants in the experimental condition reported significantly increased quality of life, greater satisfaction with and amount of activity, higher satisfaction with work, and reduced alcohol and drug use over time. However, individuals in the experimental condition also reported increased anxiety/depression and agitation at 6 months (but not 12 months) and significantly increased negative symptoms at 12 months. Findings suggest that community-oriented, citizenship interventions for persons with SMI and criminal justice histories may facilitate improved clinical and community outcomes in some domains, but some negative clinical findings suggest the need for post-intervention support for intervention participants. Implications for practice and future research are discussed.     

Consumer Preference Programs for Individuals Who Are Homeless and Have Psychiatric Disabilities: A Drop-In Center and a Supported Housing Program

We illustrate Fairweather's approach to Experimental Social Innovation and Dissemination with two experimental studies of programs to reduce homelessness for 168 and 225 people with mental illness and often substance abuse. Literally homeless participants were randomly assigned to programs that emphasized consumer choice or to the usual continuum of care, in which housing and services are contingent on sobriety and progress in treatment. A drop-in center that eliminated barriers to access to services was more successful than control programs in reducing homelessness, but after 24 months only 38% of participants had moved to community housing. A subsequent apartment program, in which individuals in the experimental condition moved to subsidized apartments directly from the street, with services under their control, had 79% in stable housing (compared to 27% in the control group) at the end of 6 months. Groups in this study did not differ on substance abuse or psychosocial outcomes.     

家庭及社会支持对城乡老年人心理健康影响的研究——以河北省城乡老年人调查为例

探究家庭及社会支持对老年人心理健康的影响,选取河北省6 173名60岁及以上城乡老年人,采用社会支持和心理健康症状自评量表进行问卷调查。城乡老年人心理健康评测结果显示,有心理症状者占22.9%;社会支持以低中度水平为主,占77.4%;家庭功能以一般及以下为主,占86.3%;经常与子女交流者占53.7%;得到社区帮助者占84.7%;社会支持、家庭功能、与子女交流情况、得到基层社区卫生服务情况均与城乡老年人的心理健康显著相关。统计结果揭示,我国应加大家庭及社会对老年人的支持力度,改善其心理健康状况。     

The School and Community Study: Characteristics of Students Who Have Emotional and Behavioral Disabilities Served in Restructuring Public Schools

We present selected initial results from a study investigating the effects of school restructuring and reform activities on outcomes for students who are identified as having serious emotional and behavioral disabilities. A review of the literature revealed six key areas of reform for investigation: accountability, governance, parent involvement, includedness, curriculum and instruction, and pro-social discipline. Ten schools (five elementary, two K-8, one middle, and two high schools) actively engaged in school restructuring and reform efforts were selected to participate in the study, and their status related to these six areas is presented. Characteristics of the students identified as having emotional and behavioral disabilities and served in these schools in special education settings (N = 116) are described. Results from the administration of standardized assessments revealed that these students have significant levels of emotional and behavioral disabilities that impair their functioning at school and at home. Further, school staff are providing the majority of counseling services to these students during the school day, with non-school professionals providing services to 25% of the students.     

社会支持网络对城市贫困人口身心状况的影响

摘 要 通过对天津贫困人口的随机样本的分析,探讨了社会支持的数量、质量和社会支持网的网络结构对贫困人口的身心状况的影响。研究发现,社会支持的数量对城市贫困人口的身心状况没有影响。社会支持的质量则对贫困人口的身心状况有正向的影响。社会支持网的异质性越高,趋同性越低,生活满意度越高。这些指标对身体健康则没有影响。但网络中高于中心成员收入水平的越多,身心状况越差。     

Like a Fish Out of Water: Reconsidering Disaster Recovery and the Role of Place and Social Capital in Community Disaster Resilience

In this paper we draw on the findings of a critical, multi-sited ethnographic study of two rural communities affected by a wildfire in British Columbia, Canada to examine the salience of place, identity, and social capital to the disaster recovery process and community disaster resilience. We argue that a reconfiguration of disaster recovery is required that more meaningfully considers the role of place in the disaster recovery process and opens up the space for a more reflective and intentional consideration of the disorientation and disruption associated with disasters and our organized response to that disorientation. We describe a social-psychological process, reorientation, in which affected individuals and communities navigate the psychological, social and emotional responses to the symbolic and material changes to social and geographic place that result from the fire's destruction. The reorientation process emphasizes the critical importance of place not only as an orienting framework in recovery but also as the ground upon which social capital and community disaster resilience are built. This approach to understanding and responding to the disorientation of disasters has implications for community psychologists and other service providers engaged in supporting disaster survivors. This includes the need to consider the complex dynamic of contextual and cultural factors that influence the disaster recovery process.     

The Siblings of Individuals with Mental Retardation: A Quantitative Integration of the Literature

The sibling relationship has recently become the focus of much research in developmental psychology. The family system perspective implies the presence of a sibling with mental retardation will impact on the psychological development and functioning of their typically developing siblings. Past reviews of the literature have found this impact to be negative but there is the suggestion of positive consequences to having a sibling with mental retardation. The present meta-analysis sought to quantitatively integrate 25 studies and 79 effect sizes from the literature on the siblings of individuals with mental retardation. A small negative effect for having a sibling with mental retardation was discovered that could not be attributed to a publication bias or some other artifact. This negative effect was greatest for direct observation measures, measures of psychological functioning, especially depression, and for children. Limitations to this meta-analysis and directions for future research are discussed.     

Direct and Indirect Effects of Caregiver Social Support on Adolescent Psychological Outcomes in Two South African AIDS-Affected Communities

Caregiver social support has been shown to be protective for caregiver mental health, parenting and child psychosocial outcomes. This is the first known analysis to quantitatively investigate the relationship between caregiver social support and adolescent psychosocial outcomes in HIV‐endemic, resource–scarce Southern African communities. A cross‐sectional household survey was conducted over 2009–2010 with 2,477 South African adolescents aged 10–17 and their adult caregivers (18 years or older) in one urban and one rural community in South Africa’s KwaZulu‐Natal province. Adolescent adjustment was assessed using adult caregiver reports of the Strengths and Difficulties questionnaire (SDQ), which measures peer problems, hyperactivity, conduct problems, emotional symptoms and child prosocial behavior. Hierarchical linear regressions and multiple mediation analyses, using bootstrapping procedures, were conducted to assess for: (a) direct effects of more caregiver social support on better adolescent psychosocial wellbeing; and (b) indirect effects mediated by better parenting and caregiver mental health. Direct associations (p < .001), and indirect associations mediated through better parenting, were found for all adolescent outcomes. Findings reinforce the importance of social support components within parenting interventions but also point to scope for positive intervention on adolescent psychosocial wellbeing through the broader family social network.     

亲子关系对中学生心理健康的影响:社会支持和心理素质的链式中介作用

为探究亲子关系、社会支持和心理素质对中学生心理健康的影响,本研究采用问卷调查的方式,对全国23个省（市）共10190名初一至高三年级的中学生展开调查。结果表明：（1）父子关系、母子关系、社会支持和心理素质两两之间呈显著正相关,且均与心理健康问题呈显著负相关;（2）相比于母子关系,父子关系对中学生心理健康的影响更大;（3）亲子关系通过三条中介路径对中学生心理健康产生影响：①是社会支持和心理素质的单独中介作用;②社会支持和心理素质的链式中介作用。本研究进一步明确了亲子关系和中学生心理健康之间的内在心理机制,同时能帮助教育工作者预防和干预中学生的心理健康问题。     

社交网站中的自我呈现对生活满意度的影响:积极情绪和社会支持的作用

采用社交网站中的积极自我呈现和真实自我呈现问卷、积极情绪量表、领悟社会支持量表和生活满意度问卷对武汉某高校645名在校大学生进行调查,探讨了社交网站中的积极自我呈现、真实自我呈现对个体生活满意的影响以及积极情绪和社会支持在其中的中介作用,结果发现:(1)社交网站中的积极自我呈现和真实自我呈现与积极情绪、社会支持和生活满意度都呈显著正相关;(2)真实和积极自我呈现对生活满意度都有显著的直接预测作用;此外,真实自我呈现还可以通过社会支持的中介作用对生活满意度产生影响,而积极自我呈现不仅可以通过积极情绪的单独中介作用对生活满意度产生影响,还能通过积极情绪-社会支持的链式中介作用对生活满意度产生影响。