Silver School of Social Work, New York University, 1 Washington Square N., New York, NY, 10003, USA.
School of Social Work, University of Maryland, Baltimore, MD, USA.
Adm Policy Ment Health. 2021 Jan;48(1):143-154. doi: 10.1007/s10488-020-01055-w.
While recent work on community integration for individuals with serious mental illnesses (SMIs) has focused on the multi-dimensionality of community integration, it has not been fully rooted in how consumers define and experience communities for themselves. Guided by symbolic interactionism theory, the goal of the present study is to explore definitions of community as provided by individuals with SMIs, and to incorporate those definitions into a theoretical framework of community to inform community integration efforts in the context of mental health services and recovery. Semi-structured interviews were conducted between November 2017 and September 2018 with 90 racially/ethnically diverse participants who were 18 years and older with an SMI and receiving community mental health services. Interviews were audio-recorded, transcribed, and analyzed using ResearchTalk's "Sort and Sift, Think and Shift" methodology. Themes derived from participants' definitions of community included a structural aspect of people and places; a functional aspect of socializing, helping and receiving resources; and an experiential aspect of shared struggles and experiences, finding safety, and identifying with others. To this end, we propose a Structural, Functional and Experiential (SFE) model of community. The SFE model of community provides a conceptual framework and guidance for clinicians, researchers, policy makers and service stakeholders regarding the complexity and variability of community for their consumers, which is essential to their recovery. Application of the SFE framework for assessment and intervention is discussed.
虽然最近针对严重精神疾病（SMI）患者的社区融合工作集中在社区融合的多维性上，但它并没有完全扎根于消费者如何为自己定义和体验社区。本研究以符号互动主义理论为指导，旨在探讨 SMI 患者提供的社区定义，并将这些定义纳入社区的理论框架中，为心理健康服务和康复背景下的社区融合工作提供信息。2017 年 11 月至 2018 年 9 月，对 90 名不同种族/族裔的参与者进行了半结构式访谈，他们年龄在 18 岁及以上，患有 SMI 并接受社区心理健康服务。访谈进行了录音、转录，并使用 ResearchTalk 的“Sort and Sift, Think and Shift”方法进行了分析。参与者对社区的定义中包括了社区的结构性方面（人和地方）、功能性方面（社交、帮助和获取资源）以及体验性方面（共同的挣扎和经历、寻找安全和与他人认同）。为此，我们提出了社区的结构、功能和体验（SFE）模型。社区的 SFE 模型为临床医生、研究人员、政策制定者和服务利益相关者提供了一个概念框架和指导，了解他们的消费者的社区的复杂性和可变性，这对他们的康复至关重要。讨论了 SFE 框架在评估和干预中的应用。
