Citizenship is a multidimensional construct encompassing the degree to which individuals with different life experiences perceive inclusion or involvement across a variety of activities and concepts.
This study assessed the effectiveness of an intervention based on a theoretical framework of citizenship on reducing psychiatric symptoms, alcohol use, and drug use, and increasing quality of life for persons with serious mental illness (SMI) and criminal justice involvement. One-hundred fourteen adults with SMI and a history of criminal justice involvement participated in a 2 × 3 longitudinal randomized controlled trial of a four-month citizenship intervention versus usual services. Linear mixed model analyses were used to assess the intervention's impact on quality of life, symptoms, and substance use. After controlling for baseline covariates, participants in the experimental condition reported significantly increased quality of life, greater satisfaction with and amount of activity, higher satisfaction with work, and reduced alcohol and drug use over time. However, individuals in the experimental condition also reported increased anxiety/depression and agitation at 6 months (but not 12 months) and significantly increased negative symptoms at 12 months. Findings suggest that community-oriented, citizenship interventions for persons with SMI and criminal justice histories may facilitate improved clinical and community outcomes in some domains, but some negative clinical findings suggest the need for post-intervention support for intervention participants. Implications for practice and future research are discussed.
Of the outcomes, only decreased alcohol use was attributable to the experimental intervention. Although this may be a chance finding, peer- and community-oriented group support and learning may facilitate decreased alcohol use over time.
Declaration of Interest:The views in this publication are solely the responsibility of the authors. The Commission is not responsible for any use that may be made of the information it contains.
FUNDINGThis project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 690954.Correspondence related to this manuscript can be sent to Chyrell D. Bellamy, chyrell.bellamy@yale.edu Rowe: relationships, rights, resources, roles, and rights, and a sense of belonging. While a measure has its utility in clinical settings, in order to address time constraints and other administrative burdens expressed by providers in their day-to-day practice, a Citizens tool was developed as a practical way that providers can enhance dialogue between providers and clients on citizenship for clients served in mental health and criminal justice reentry settings. This paper describes the development of the tool, testing of the tool's utility with case managers, and implications for practice.
Declaration of Interest:The views in this publication are solely the responsibility of the authors. The Commission is not responsible for any use that may be made of the information it contains.
FUNDINGThis project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 690954.Correspondence related to this manuscript should be sent to Ailsa Stewart: ailsa.e.stewart@strath.ac.uk
Abstract:This paper explores the usefulness of recognition theory, recovery and citizenship in explaining constructions of community by adults who have experienced life disruptions participating in similar Citizenship programs in the US and Scotland. A content analysis of secondary data was undertaken and focus groups held with recent graduates of both programs. The findings indicate that constructions of community aligned significantly with aspects of identity and common experience rather than location. Moving towards an identity framed by assets rather than deficits, was further identified, which reflects the need for recognition to be extended by communities that are well informed and non-discriminatory in their attitudes towards those with life disruptions to promote inclusion and connectedness.Interventions at the level of community development and engagement are therefore crucial in promoting inclusion and increasing citizenship for marginalized groups; alongside the role of social movements and public policy in tackling stigma and discriminatory attitudes.Uniquely, within this project, a theoretical framework that combined elements of recognition theory, recovery and citizenship emerged that best explained the experience of those with life disruptions and provided direction for a future focus on community development as well as recovery and citizenship oriented practice.
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