Objective: Although behavioral health disciplines offer various interpretations of the concept of community, mental health research has focused on involvement in locality-based entities, typically defined as the neighborhood of the person's residence. Using a mixed-method approach, this study examines the notion of community from mental health consumers' perspectives and delineates patterns of group and organizational involvement.

Methods: This study involves two samples drawn from consumers of mental health services in a large metropolitan area. A probability sample of 252 adults with serious mental illness, selected from 26 supported housing programs, were interviewed as part of an NIMH-funded protocol on community integration. The interviews provided quantitative data on the patterns of group and organizational membership, including types of groups/organizations involved, length and intensity of involvement, geographic distance of groups/organizations from participants' residence, and whether or not the group/organization is comprised of all or mostly individuals with mental health needs. Building on the results of the quantitative analyses, a purposive sample of 62 mental health consumers was recruited to provide qualitative data to explore the meaning and definition of community from consumers' experiences and perspectives. A total of seven focus groups were conducted. Each focus group was comprised of a different mental health consumer group, including Latino and Asian immigrants, persons who identified themselves as LGBT, and residents in group and independent living settings. Focus group transcripts were analyzed using grounded theory methods.

Results: Both focus group and interview data found “relational” communities based on common interests and shared characteristics to be pertinent to mental health consumers' involvement. These include treatment communities (mental and physical health), faith-based communities, and identity communities associated with ethnicity, sexual orientation and gender identity. While a significant portion (48%) was involved in “mainstream” organizations in which the majority of membership was not mental health consumers, very few (<5%) participated in groups organized to address local neighborhood issues. Focus group participants identified “acceptance,” “togetherness,” and “reciprocity” as characteristics core to their sense of belonging. Although participants found community involvement mostly positive, experiences of stigma, discrimination and estrangement were mentioned, especially among LGBT consumers, as impediments. These consumers attributed their negative experiences to rejection based on their sexual orientation/gender identity, as well as mental illness.

Implications: This study highlights the importance for social work practitioners and researchers to enhance their awareness of mental health consumers' multiple communities and consumers' differing levels of comfort with them. It shows that limiting the scope of community to the residential context leads to an incomplete understanding of consumers' social connectedness, as well as narrows social work intervention efforts for empowering consumers on the individual, group/organizational and community levels to fulfill significant social roles. A mixed-method approach of combining qualitative and quantitative findings enables social work researchers to attain a fuller understanding of community integration that is sensitive to different cultural interpretations and relevant to various living environments.