Connectedness and Citizenship: Redefining Social Integration

Columbia University, New York, New York, United States
Psychiatric Services (Impact Factor: 2.41). 05/2007; 58(4):469-74. DOI: 10.1176/
Source: PubMed


Despite decades of deinstitutionalization, individuals with psychiatric disabilities living outside the hospital may be described as in the community, but not of it. To effectively address the persisting problem of social exclusion of persons with psychiatric disabilities, new conceptual tools are needed. To address this need, a new definition of social integration is offered.
The definition is based on data from a qualitative study. Data collection consisted of individual, unstructured interviews with 56 adults who have been psychiatrically disabled (N=78 interviews) as well as ethnographic visits to five service sites working to promote social integration for their users (N=8 visits). An interpretive approach was used to analyze the data.
Social integration is defined as a process, unfolding over time, through which individuals who have been psychiatrically disabled increasingly develop and exercise their capacities for connectedness and citizenship. Connectedness denotes the construction and successful maintenance of reciprocal interpersonal relationships. Social, moral, and emotional competencies are required to sustain connectedness. Citizenship refers to the rights and privileges enjoyed by members of a democratic society and to the responsibilities these rights engender. The definition calls for full rights and responsibilities of citizenship.
The new definition sets an ideal, but not unrealistic, standard for social integration in the context of psychiatric disability. High standards encourage mental health professionals and policy makers to rethink what is possible for mental health services and to raise expectations for connectedness and citizenship among persons once disabled by mental illness.

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Available from: Kim Hopper, Apr 07, 2014
    • "In Dutch, we speak of " vermaatschappelijking " , by which we mean that psychiatric treatment is moved from within the institution towards society, e.g. by means of providing outreach and assertive community treatment initiatives in the clients' natural environment. The goal is inclusive citizenship, an empowering practice, based on full societal contribution of all people and with " belonging " as a core feature (Lister, 2007;Ware et al., 2007).Perron et al. (2010, p.102) have called this the " citizen experience " , which is produced through individual and community participation, choice, inclusion, protection, power, voice, expression and freedom. In August 2011, Villa Voortman opened his doors for the first time, trying to create (literally as well as figuratively) a space for these individuals within a new societal reality, in order to enable them to become " inclusive citizens " . "
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    ABSTRACT: Purpose - Influenced by evolutions in mental health, a meeting house, "Villa Voortman", was recently developed. It is based on an integration of therapeutic community (TC) and psychoanalytical Lacanian thinking. The purpose of this paper is to investigate the position of Villa Voortman in the treatment continuum for dually diagnosed clients. Two research questions are addressed: How does Villa Voortman operate ? and how do clients perceive the Villa? Design/methodology/approach - The first question was tackled by a personal account of the founders of Villa Voortman. The second question was addressed by a qualitative study using video-material of 19 visitors' personal accounts. Findings - The visitors mentioned three themes: social inclusion, personal development and equality. These aspects are further refined into sub-themes including the provision of "asylum"; the instalment of a warm and welcoming atmosphere; the focus on real human encounter; a permissive, supportive and "waiting" environment; a minimal but "good enough" structure; the necessity of a place where persons can develop themselves; the striving for social inclusion and future perspectives; and the support in becoming inclusive citizens again. Originality/value - The value of the paper lies in disclosing the visitors' lived experience. This is an essential part of shedding light on the "active ingredients" of support, In reference to the title, visitors nor treatment staff have "carte blanche" with regard to how support develops, as this is driven by the dialectal course of everything that occurs during the support process.
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    • "The capabilities framework is a powerful construct in disability discourse related to the social and economic isolation experienced by people with mental illness (Ware et al. 2007; Baumgartner & Burns, 2014). Shifting the focus from a position where disability is located in personal functioning to a position where disability is located in the opportunities provided by society for social reintegration and participation, Sen's work provides a basis for conceptualising social integration as 'a process, unfolding over time, through which individuals who have been psychiatrically disabled increasingly develop and exercise their capacities for connectedness and citizenship' (Ware et al. 2007). Similarly, in relation to poverty and (mental) health, the capabilities framework can help shift the focus away from considering economic exclusion a consequence of individual dysfunction; towards an understanding of the structural social, economic and political forces that so often render people vulnerable to both poverty and mental illness. "
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    • "Researchers from various disciplines have tried to define and measure community integration (CI) as well as related concepts such as social inclusion and citizenship (Dorvil et al. 2005; Ware et al. 2007; Wong and Solomon 2002). CI was originally conceptualized as physical presence in a neighborhood and was operationalized as the cumulative frequency of self-initiated participation and use of community resources (Segal et al. 1980). "
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