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.     

A Social Ecological Approach to Investigating Relationships Between Housing and Adaptive Functioning for Persons with Serious Mental Illness

This paper seeks to advance mental health—housing research regarding which factors of housing and neighborhood environments are critical for adaptive functioning, health, and recovery for persons with serious mental illness (SMI). Housing and neighborhood environments are particularly important for persons with SMI because of the prevalence of poor housing conditions among this population. Most mental health—housing research has been limited by a focus on problems in environments and functioning. The paper seeks to expand the mental health—housing research agenda to consider protective factors that promote community integration and adaptive functioning. We provide an account of how social ecology theory transformed a research program, from examining individual risk factors to investigating the functioning of persons in the contexts of their housing and neighborhood experiences. The resulting housing environment framework—physical aspects of housing and neighborhoods, social environment of neighborhoods, and interpersonal relationships tied to housing—allows for identification of opportunities for health promotion and facilitation of participation in community-based settings. This program of research draws upon several methods to understand the social experience of persons with SMI living in community settings—survey research, qualitative interviews, Geographic Information Systems, participatory research, and visual ethnography. In this paper, we present how social ecology theory was instrumental in the development of new housing environment measures, the selection of appropriate research methods, and framing research questions that are building a new empirical base of knowledge about promoting adaptive functioning, health, and recovery for persons with SMI living in community settings.     

Homelessness, Mental Illness, and Criminal Activity: Examining Patterns Over Time

This study examined whether street homelessness, sheltered homelessness, and the severity of psychological symptoms predicted non-violent and violent crime among 207 mentally ill participants who were homeless at baseline. Participants were interviewed at 9 time points over 4 years. Hierarchical linear modeling (HLM) was used to examine whether changes in homelessness status and symptom severity predicted changes in criminal activity over time. Results indicated that homelessness both on the streets and in shelters and psychological symptom severity predicted increases in non-violent crime. Sheltered homelessness and symptom severity predicted increases in violent crime, although street homelessness did not. A separate mediational analysis with 181 participants showed that the relationship between diagnosis of a psychotic disorder and both non-violent and violent criminal activity was partially mediated through the severity of psychotic symptoms. Implications for research and intervention are discussed.     

Trauma‐Informed Care for Individuals with Serious Mental Illness: An Avenue for Community Psychology's Involvement in Community Mental Health

Individuals with serious mental illness are at particularly high risk for trauma; however, service environments with which they interact may not always be trauma‐informed. While community mental health and other human services settings are moving toward trauma‐informed care (TIC) service delivery, a variety of TIC frameworks exist without consensus regarding operationalization, thereby leading to challenges in implementation. TIC is principle‐driven and presents substantial overlap with community psychology values and competencies, including ecological frameworks, second‐order change, empowerment, and citizen participation. One way to address barriers to TIC implementation is to draw on the strengths of the field of community psychology. With a particular emphasis on the applicability of TIC to individuals with serious mental illness, this paper identifies key implementation issues and recommends future directions for community psychologists in clarifying the service framework, its adaptation to specific service contexts, and improving delivery through consultation and evaluation. Community psychologists may work with various disciplines involved in the TIC field to together promote a more conscious, actionable shift in service delivery.     

Housing for People with Serious Mental Illness: A Comparison of Values and Research

This article contrasts values associated with the delivery of housing programs for people with serious mental illness with the typical topics pertaining to housing that are studied by researchers. Six values were identified through a search and content analysis of the literature on housing for people with serious mental illness. A second review of the literature was conducted to identify research on housing for this population. A comparison of findings from the two reviews suggested that whereas values concerned with the therapeutic benefits of housing had received considerable research attention, those concerned with a citizenship dimension had received relatively little. The findings are discussed in terms of their implications for the delivery of housing services and for housing research.     

Applying a Time‐Patterned Typology of Homelessness Among Individuals with Mental Illness

Identification of subgroups of the homeless populations, or typologies, has been an important research priority to guide homelessness services and policies. This study builds on previous typological research conducted in the general homeless population by focusing on individuals with mental illness to further delineate typologies within a more homogenous subset of the homeless population. A time‐patterned typology based on episodes of street and shelter homelessness over a four‐year period was applied to a sample of 246 individuals identified through mental health administrative records. Four groups were created based upon patterns of homelessness: 26.8% experienced homelessness for 4 years, 13.4% had one episode of homelessness but were no longer homeless at the end of the follow‐up, 48.4% had at least two episodes of homelessness, and 11.4% had a single episode of homelessness lasting 3 months or less. Findings from a multinomial logistic regression indicated that gender, presence of a psychotic disorder, substance abuse, and year of study enrollment significantly predicted group membership. Residential trajectories upon exit from homelessness and at the end of the four‐year follow‐up were examined. Implications for current policy and future research are discussed.     

Community Psychology and Community Mental Health: A Call for Reengagement

Community psychology is rooted in community mental health research and practice and has made important contributions to this field. Yet, in the decades since its inception, community psychology has reduced its focus on promoting mental health, well‐being, and liberation of individuals with serious mental illnesses. This special issue endeavors to highlight current efforts in community mental health from our field and related disciplines and point to future directions for reengagement in this area. The issue includes 12 articles authored by diverse stakeholder groups. Following a review of the state of community mental health scholarship in the field's two primary journals since 1973, the remaining articles center on four thematic areas: (a) the community experience of individuals with serious mental illness; (b) the utility of a participatory and cross‐cultural lens in our engagement with community mental health; (c) Housing First implementation, evaluation, and dissemination; and (d) emerging or under‐examined topics. In reflection, we conclude with a series of challenges for community psychologists involved in future, transformative, movements in community mental health.     

心理疾病自我污名:心理康复的一个高危因子

心理疾病自我污名是心理疾病患者内化公众的消极刻板印象、偏见和歧视,形成自我偏见和歧视的现象.心理疾病自我污名会给患者带来一系列的负面影响,是心理康复过程中的一个高危因子.自我污名可能是通过引发患者的消极认知、负面情感和自我歧视行为来危及心理康复过程的.对自我污名的干预应针对患者和社会公众分别加以实施.未来可以从理论构建、测量工具和干预措施的改进,以及去污名与心理康复的融合等方面展开自我污名本土化的研究.     

大陆和台湾地区精神疾病患者强制住院医疗之比较研究

精神病患者是社会弱势群体,其权利易遭受他人的侵害,同时其有可能对他人权利造成损害。因此为维护本人和他人权利,有必要对其实施特殊的措施。大陆和台湾地区均规定对严重精神病患者实施强制住院医疗措施,但二者在强制医疗的对象、程序以及人身自由的限制等方面存在重大差异。大陆强制医疗采取的是行政程序,而台湾地区是"准司法程序",其强制医疗决定由第三方作出。台湾地区精神卫生法为精神病患者提供了较为完善的权益保障体系。     

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.     

South African Muslim Psychologists' Perceptions of Mental Illness

This study explored perceptions of mental illness in a sample of 10 female Muslim psychologists in a South African city to determine the influences of religion (and Islam specifically) on their understanding of the aetiology and treatment of mental illness. Participants responded to a semi-structured interview. The data from the interviews were thematically analyzed. Four themes emerged from the analysis: mental illness as maladaptive coping, religion as a resource for wellbeing, influences of personal religiosity on therapy and openness to collaborative treatment     

South African Muslim Faith Healers Perceptions of Mental Illness: Understanding,Aetiology and Treatment

The important role that religious beliefs may have on perceptions of mental illness cannot be ignored. Many religions including Islam advocate witchcraft and spirit possession—all of which are thought to influence the behaviour of a person so as to resemble that of a mentally ill individual. Thus this research explored Muslim Faith Healers perceptions of mental and spiritual illness in terms of their understanding of the distinctions between the two, the aetiologies and the treatments thereof. Six Muslim Healers in the Johannesburg community were interviewed and thematic content analysis was used to analyse the data. From the results it is clear that the faith healers were aware of the distinction between mental and spiritual illnesses. It was also apparent that Islam has a clear taxonomy that distinguishes illness and the causes thereof. Treatments are then advised accordingly. Thus this paper argues that the predominant Western view of the aetiology and understanding of mental illness needs to acknowledge the various culturally inclined taxonomies of mental illness so as to better understand and aid clients.

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.     

Exploring Recovery Perspectives in Individuals Diagnosed with Mental Illness

Using a phenomenological research design with a photovoice method, we aimed to understand the lived experience of eight individuals diagnosed with mental illness and identify factors affecting their recovery. We conducted focus group interviews whereby participants discussed their recovery, shared photographs taken of items symbolizing their recovery, and created personalized photobooks or scrapbooks. Data analysis yielded the following themes: (1) caring relationships, (2) leisure and outings, and (3) relaxation, stress reduction, and coping. Findings revealed factors influencing recovery from mental illness and can be used to develop person-centered and occupation-based interventions to promote recovery in clients with mental health issues.     

Mental Illness Publications in Major Pastoral Care Journals from 1950 to 2003

The issue of mental illness has been of considerable interest to both of us over the past several years. The first author has taught a course on the subject for a decade, and his recent publications on the subject include several articles on John Nash (Capps, 2003b, 2004a,b, 2005b), a book on mental illness for pastoral care professionals (2005a), and an article on whether William James was a patient at McLean Hospital (2007). The second author has had experience with the mentally ill through his pastoral work at Trenton Psychiatrist Hospital in Trenton, New Jersey, a mental hospital with a rather checkered history (see Scull, 2005), and in Scotland and has also written an article on John Nash (Carlin, 2006). This shared interest, together with evidence that serious mental illness in America has been steadily increasing (Torrey &; Miller, 2001, pp. 295–299), caused us to wonder what sort of attention mental illness has received in our major journals of pastoral care from 1950 to the present. Specifically, has this attention kept pace with the increase in mental illness?     

Utilizing Religious Schemas to Cope with Mental Illness

Recent Gallup Polls suggest that 96% of Americans polled believe in God or a universal supreme being (Gallup, 1995). In addition, large percentages of Americans polled report that they pray or believe in miracles. It appears then that religious belief might be a useful coping strategy for those experiencing significant distress or illness. Although much of the research regarding religious coping and illness has focused on physical illness, it seems likely that religious coping would also be useful to those who are experiencing a mental illness. Existing data regarding the use of religious coping and mental illness is discussed, and Daniel McIntosh's theory of religion as a cognitive schema is applied to those suffering severe mental illness.     

Gender Differences in Reactions to Mental Illness Labeling: The Role of Agency and Communion

Numerous individual characteristics influence responses to receiving a mental health diagnosis, including gender. This study sought to determine how gender influences reactions to being labeled as depressed or not depressed, which were categorized as falling into themes of communion or agency. Using the themes developed by Niedzwienska (2003), 168 college students’ responses to depression labels were coded as a part of a laboratory experiment. The results indicate that the expected sex differences do exist, but multivariate analyses indicate that the choice of communal themes was influenced by sex but the use of agency themes was not influenced by sex.     

Creative Activity,Personality, Mental Illness,and Short‐Term Mating Success

It has been argued that creativity evolved, at least in part, through sexual selection to attract mates. Recent research lends support to this view and has also demonstrated a link between certain dimensions of schizotypy, creativity, and short‐term mating. The current study delves deeper into these relationships by focusing on engagement in creative activity and employing an expansive set of personality and mental health measures (Five Factor Model, schizotypy, anxiety, and depression). A general tendency to engage in everyday forms of creative activity was related to number of sexual partners within the past year in males only. Furthermore, schizotypy, anxiety, and Neuroticism were all indirectly related to short‐term mating success, again for males only. The study provides additional support for predictions made by sexual selection theory that men have a higher drive for creative display, and that creativity is linked with higher short‐term mating success. The study also provides support for the contention that certain forms of mental illness may still exist in the gene pool because particular personality traits associated with milder forms of mental illness (i.e., Neuroticism & schizotypy) are also associated directly with creativity and indirectly with short‐term mating success.     

19世纪西方医学对精神疾病诊治的影响

精神疾病是现代困扰人类的主要疾病之一。通过总结19世纪西方医学对精神疾病的认识及主要治疗方法,拟展现这个世纪中治疗方法随观念变化和实践深入而发展的轨迹,旨在说明19世纪是西医精神病学发展史上的重要时期,并揭示其与现代精神疾病治疗的历史传承性。     

心理疾病内隐污名述评

心理疾病内隐污名是个体无法内省或精确识别的与心理疾病有关的痕迹, 它潜在地调节着个体对心理疾病患者的观念和行为。心理疾病内隐污名的主要测量方法包括内隐联想测验、简式内隐联想测验、启动任务和生理心理测量。当前该研究领域集中在内隐污名的成分、公众内隐污名、自我内隐污名、去污名化评估等方面。未来研究可从心理疾病内隐污名的构成与结构、认知神经基础、测量整合和本土化等角度做进一步探讨。