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Community identification of discharged mental patients residing in Vancouver city boarding homes : a preliminary study Adrian, Peter Gerhard

Abstract

This study was designed to assess the community identification of discharged mental patients in community boarding homes-specifically, those patients discharged from the Riverview Mental Hospital and placed directly into Vancouver City boarding homes as part of a cooperative programme between the Social Service Department of the Riverview Hospital and the Medical Section of the City Social Service Department. Community identification was defined in terms of three factors: physical presence in a geographic area; quality and quantity of social participation; and, relative opportunity for decision-making and independent functioning. Quantitative measurement of the latter two factors was attained through administering the Chapin Leisure Participation and Enjoyment Scale and the Vine-land Social Maturity Scale respectively. A qualitative measurement was attained by administering two questionnaires designed by the researchers--one to the boarding home operators, the other to the patients in the boarding homes The design of the study was initially that of a retrospective nature, comparing current data to data of previous performance obtained from hospital files. As this latter source proved inadequate, a longitudinal design was proposed, and a pretest of the research instruments was implemented with a boarding home sample and a comparative hospital sample. The findings of the study thus pertain to the qualitative responses of the former patients in community boarding homes, and to qualitative comparisons of the responses of the community and hospital samples. The qualitative responses were generally of a positive nature indicating a satisfaction with community placement and an enjoyment of community life. The quantitative responses indicated a decrease of social participation, occupational activity and socialization skills following placement into the community boarding homes, but an increase in the skill of self-direction and competency of locomotion. A comparison of the interviewers' ratings and the patients' ratings of significant impediments to social functioning indicated that the latter perceived this in financial terms while the former perceived it in psychological terms. Conclusions of this study, necessarily limited because of its preliminary nature, relate primarily to the concept of community identification and to the difficulty of defining this concept in concrete terms. As the findings indicated that autonomy and independent decision-making were most closely related to subjective feelings of community identity, and that this increase in autonomy was related to increased feelings of dignity and self-worth, it was suggested that greater autonomy was the principal factor in the community identification of this population, and that this indicated a positive evaluation of the boarding home placement programme in that it led to the enhancement of the patients' feelings of dignity and self-worth. Recommendations for improvement of the programme include psychiatrically trained staff to supervise the patients, new regulations concerning finances, and provision of more activities and facilities designed to enhance the patients' feelings of self-worth.

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