Irene Wong Yin-Ling, Stanhope Victoria
School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA 19104-6214, USA.
Soc Sci Med. 2009 Apr;68(8):1376-87. doi: 10.1016/j.socscimed.2009.01.046. Epub 2009 Feb 27.
Housing and services for persons with developmental disabilities (DD) have been shaped by the normalization approach, a commitment to full integration within the general community. In contrast, housing and services for persons with psychiatric disabilities (PD) have had various and sometimes conflicting goals, including provision of custodial care, promotion of therapeutic community, and community integration. This cross-field study compares the neighborhood characteristics of publicly-funded housing for the PD and DD populations in a metropolitan community. The aim of the study was to examine whether the contrasting housing approaches are reflected at an ecological level and to consider how these findings relate to the goal of community integration for people with PD and DD. Administrative databases provided residential addresses of 1932 residents with PD living in 297 locations and 1716 residents with DD living in 749 locations in the city of Philadelphia. The 2000 U.S. Census and city's police department database provided information on neighborhood characteristics. Geographic information system (GIS) methodology generated maps displaying the distribution of housing locations in relation to spatial dispersion, distress, stability, safety, and race/ethnic diversity. Statistical analyses compared neighborhood characteristics of the DD and PD populations. Findings indicated that the DD population in supportive housing was more spatially dispersed, and lived in less distressed, less unstable, more secure, but equally racially/ethnically diverse neighborhoods when compared to the PD population in supportive housing. Greater geographic dispersal among persons with DD may be the result of more emphasis on normalization within policies and programs determining the location of their housing. The higher funding levels for housing and residential support for persons with DD also provided programs with the option of placing people in higher income neighborhoods. Given that community integration has emerged as an organizing principle within mental health services over other models, policymakers in the field of psychiatric disabilities may have much to learn from the normalization movement for people with developmental disabilities.
发育障碍（DD）患者的住房和服务受到正常化方法的影响，该方法致力于在普通社区中实现完全融合。相比之下，精神疾病残疾（PD）患者的住房和服务目标则多种多样，有时甚至相互冲突，包括提供监护护理、促进治疗性社区发展以及社区融合。这项跨领域研究比较了一个大都市社区中为PD和DD人群提供的公共资助住房的邻里特征。该研究的目的是检验这些截然不同的住房方式在生态层面上是否有所体现，并思考这些研究结果与PD和DD患者的社区融合目标有何关联。行政数据库提供了居住在费城297个地点的1932名PD患者和居住在749个地点的1716名DD患者的居住地址。2000年美国人口普查和该市警察局数据库提供了有关邻里特征的信息。地理信息系统（GIS）方法生成了地图，展示了住房位置相对于空间分散、困境、稳定性、安全性以及种族/族裔多样性的分布情况。统计分析比较了DD和PD人群的邻里特征。研究结果表明，与支持性住房中的PD人群相比，支持性住房中的DD人群在空间上分布更为分散，居住在困境较少、稳定性较低、更安全但种族/族裔多样性相同的社区。DD患者之间更大的地理分散可能是由于在决定其住房位置的政策和项目中更加强调正常化。为DD患者提供的更高住房和居住支持资金水平也使项目有选择地将人们安置在高收入社区。鉴于社区融合已成为心理健康服务领域相对于其他模式的组织原则，精神疾病残疾领域的政策制定者可能有很多可以向发育障碍患者的正常化运动学习的地方。
