Beyond “Landscapes of Despair”: The need for new research on the urban environment, sprawl, and the community integration of persons with severe mental illness

Abstract

The purpose of this commentary is to discuss important trends in the housing of people with severe mental illness in the past 20 years that require the attention of mental health geographers and other experts on the effects of place on mental health. Issues that are worthy of consideration in new research include: assessing the impact of place effects on community integration, the impact of sprawl, and the emergence of the independent scatter-site housing model. Possible implications of these trends for the effects of place on people with severe mental illness are discussed.

Investigating the Relationship Between Neighborhood Experiences and Psychiatric Distress for Individuals with Serious Mental Illness

“…Perceptions of neighborhood social climate (i.e., believing that one belongs and is accepted in the neighborhood) were significantly related to self-reported psychiatric distress. These findings support the value of understanding the community-based experience of persons with SMI to promote their adaptive functioning, recovery, and participation in community life (Yanos 2007). As hypothesized, results indicate that there was a significant positive relationship between each of the neighborhood experience factors and neighborhood social climate.…”

“…With its emphasis on housing being part of community settings and separate from services (Rog 2004), supported housing presents a challenge to research approaches that have focused on physical aspects of housing or programmatic aspects of housing services. Understanding the experience of community-based living in supported housing requires the development of new approaches for conceptualizing and measuring housing experiences embedded in community settings but apart from services (Yanos 2007). This study draws upon social ecology theory to conceptualize housing experiences related to structural, interpersonal, and community levels of analysis that, taken together, form a multi-dimensional construct of housing environment.…”

“…Applying this framework to supported housing research, housing environments can be conceptualized as having three broad domains: (a) the physical environment of housing such as apartments and neighborhood buildings; (b) the social environment of housing such as the neighborhood social climate and perceptions of safety; and (c) interpersonal relationships tied to housing such as those with neighbors and landlords (Kloos and Shah 2009;Moos 1974Moos , 1976. Although these relationships have received little attention in mental health research, policy makers and service providers have consistently emphasized the importance of quality housing and good relationships with landlords and neighbors for housing stability (Carling 1995;Wong and Solomon 2002;Yanos 2007). …”

“…An empirical understanding of factors that can buffer psychiatric distress and enhance adaptive functioning for persons with SMI living in community settings is emerging as a top priority of the community mental health research agenda (Yanos 2007;). Research has demonstrated that a supportive social climate is closely related to overall psychological well-being for individuals with SMI (Prince and Gerber 2005), whereas mental health related stigmatization (i.e., isolation, segregation, lack of belonging) increases depressive-anxiety symptoms and negatively influences social outcomes (Segal et al 1980;Markowitz 1998).…”

“…Assessing the impact of neighborhood social climate on psychiatric distress is particularly important for individuals with SMI who live in supported housing because they often live alone-in some instances, for the first time in their lives . A national evaluation of supported housing found isolation to be a substantial problem facing many mental health consumers, especially since mental health agencies were not yet effective in countering the problem of loneliness (Carling 1993;Yanos 2007). Therefore, it would be helpful for program development and policy decisions to understand how the experience of neighborhoods can influence a supportive social climate for people with SMI, as well as their potential effects on psychological well-being.…”