Modeling community-based, self-help mental health rehabilitation reform

Australas Psychiatry. 2007:15 Suppl 1:S99-103. doi: 10.1080/10398560701701296.

Abstract

Objectives: The research used supported collaborative inquiry in participative action research to record the effectiveness of peer support and narrative therapy, in an indigenous-informed community of belonging, or open urban tribe. There were three objectives: (i) to identify the active attributes of consciousness among those living with intellectual disability and/or mental illness, which can be acknowledged, nurtured and developed to strengthen their balanced self-awareness, and assist them in taking more responsibility for their lives; (ii) to identify how these aspects of self awareness can be used to inform improved individual and group empowerment and improved rehabilitation practice, in communities of inter-subjective relationship and belonging, and; (iii) by exploring collaborative engagement with 'the system' which serves these two groups, to identify how they can more effectively be empowered to manage the planning, policies, programs and service delivery which largely determine their quality of life. The research also seeks to clarify how this person-valuing approach can be applied, in a self-help, peer-supported, community-based rehabilitation system.

Findings: People living with mental illness and/or intellectual disability experience improved quality of life and self-determining sense of self when they are included in mixed open urban tribes, or communities of belonging. The predominant way this comes about is through the diverse shared metaphors of being which the participants provide for each other, through their energy of life and testimonies of experience which give each other encouragement and stimulation, generating motivation and strengthened intention for life. It is not the cognitive or social ability to perform particular skills in individual or group exchange that determines the impact of this open urban tribal model; it is more the spirit and essence of the people, and their way of exchanging loving interaction and generous caring, listening and feedback that enhances participants' quality of life experience. Successful psychosocial rehabilitation depends on people's motivation for recovery, growth and development, and this happens best in communities of belonging, not in isolated 'group homes' or patronizing 'professional' service delivery that pathologizes its recipients. Improvement in mental health and supported living services will accelerate and create cheaper bottom line costs, with the provision of equitably facilitated, self-help, peer-supported, open urban tribe models of mutual support and motivation for ongoing life development.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anthropology, Cultural
  • Female
  • Health Care Reform
  • Humans
  • Male
  • Mental Disorders / ethnology
  • Mental Disorders / rehabilitation*
  • Mental Health Services / organization & administration*
  • Models, Theoretical*
  • Native Hawaiian or Other Pacific Islander / psychology*
  • Peer Group
  • Residence Characteristics
  • Self-Help Groups*
  • Urban Population