Social Work’s Contribution to Community Integration for Individuals with Serious Mental Illness: Lessons Learned and Future Directions

Despite decades of examination and emphasis in mental health policy, individuals with psychiatric illness still endorse a fairly low to moderate level of community integration.  With an estimated 26.2% of Americans ages 18 and older suffering from a diagnosable mental illness (MI) and trends toward briefer hospital stays in a post-deinstitutionalization era, it is critical to understand how those individuals exiting institutions are integrating into the community.  Community integration can be understood as enabling individuals to transcend the roles and structures linked to psychiatric illness (i.e. segregated housing, work enclaves, etc.) while facilitating progress toward greater independence, illness self-management and normal role fulfillment in non-mental health communities.  The mental health field traditionally defined community integration as a unidimensional concept consisting of physical integration which essentially focused on use of resources and engagement in activities in the shared place.  As a consequence of this narrow conceptualization, the evidence-based practices and programs that have been developed predominantly address and promote physical integration.  These community-based programs should be praised and credited for helping individuals to control symptoms, maintain employment or housing and increase community tenure via reduced rates of hospitalization. However, while physical integration may be viewed as a necessary step in moving toward community membership, a multidimensional perspective of community integration would argue that a critical element of integration, namely social integration, has been understudied and relatively neglected.  Social workers have been at the forefront of focusing on practices and policies that improve both the physical and social integration of individuals living with MI.  Community Integration is an important topic given the focus of this year’s conference on understanding the benefits and costs of social problems and possible solutions in the face of budgetary constraints and the need for new emphases on cost effective practices.  Community Integration offers low cost, sustainable outcomes that benefit individuals with MI through greater participation and social interactions with community members.

This proposed roundtable will present the current state of knowledge on community integration across several domains.  Presenters will focus on the research and practices used in the mental health field to improve community membership and citizenry while reinforcing the contribution of social work in advancing this knowledge.  Participants will gain an understanding of the theoretical approaches to integration, the current research trends in capturing integration, and a presentation of emerging and empirically supported practices that promote community integration. This roundtable will be chaired by two speakers whose research focuses on community integration for individuals with SMI.  They will present on the latest findings in social integration, and will offer evidence on the effectiveness of community integration.  The second set of speakers will discuss their expertise in housing first approaches to improve physical integration. The third set of speakers will present their expertise on psychosocial and vocational rehabilitation as part of the community integration process.  Our goal is to stimulate conversation that promotes understanding of the contributions and challenges of research on these topics, ways to further integration across arenas, and emerging areas of scholarship and practice.