Geoffrey Nelson

Nothing about me, without me: participatory action research with self-help/mutual aid organizations for psychiatric consumer/survivors.

Participatory action research with self-help/mutual aid organizations for psychiatric consumer/survivors is reviewed. We begin by tracing the origins of and defining both participatory action research and self-help/mutual aid. In so doing, the degree of correspondence between the assumptions/values of participatory action research and those of self-help/mutual aid for psychiatric consumer/survivors is examined. We argue that participatory action research and self-help/mutual aid share four values in common: (a) empowerment, (b) supportive relationships, (c) social change, and (d) learning as an ongoing process. Next, selected examples of participatory action research with psychiatric consumer/survivor-controlled self-help/mutual aid organizations which illustrate these shared values are provided. We conclude with recommendations of how the key values can be promoted in both the methodological and substantive aspects of future participatory action research with self-help/mutual aid organizations for psychiatric consumer/survivors.

Social network transactions of psychiatric patients

In this research we examine self-reported social network transactions of former psychiatric inpatients residing in different types of housing in the community. Unlike earlier research, we found considerable reciprocity in network transactions with family and friends. Only professionals provided more support than they received from patients. Providing emotional support to others was positively correlated with positive affect, community integration, and mastery. Respondents reported more supportive than unsupportive transactions with network members and more supportive transactions with friends than with family or professionals. Finally, residents of supportive apartments and group homes provided and received support more frequently than residents of board-and-care homes. We discuss the results in terms of their implications for policy and future research.

The Relationship Between Housing Characteristics, Emotional Well-Being and the Personal Empowerment of Psychiatric Consumer/Survivors

In this research, we examine the relationshipsbetween the housing characteristics and dimensions ofcommunity adaptation for 107 psychiatricconsumer/survivors. Hypotheses about which housingcharacteristics best predict which dimensions of adaptationwere made based on previous research and theory. Usinga longitudinal research design, we found, aftercontrolling for demographic variables and prioradaptation, that the number of living companions, housingconcerns, and having a private room all significantlypredicted different dimensions of community adaptation.The findings partially support our theoretical expectations and illuminate the relationshipbetween physical, social and organizational aspects ofcommunity-based housing and the adaptation ofpsychiatric consumer/survivors. We discuss theimplications of the results for policy and practice inproviding housing for this population.

The relationship between long-term psychiatric clients' psychological well-being and their perceptions of housing and social support

This research tested hypotheses derived from motivation-hygiene theory that housing and social support would be differentially related to long-term psychiatric clients Positive Affect and Negative Affect. The participants were 89 people between the ages of 18 and 65, who had been hospitalized for psychiatric problems at least twice and who had been diagnosed as schizophrenic, chronic depressive, or manic-depressive. Results indicated that the number of Housing Concerns was positively correlated with Negative Affect but not Positive Affect. Support Satisfaction was negatively correlated with Negative Affect, and Frequency of Support was positively correlated with Positive Affect. Interactions between the housing variable and Network Size were found for both Positive Affect and Negative Affect, thus supporting the stress-buffering hypothesis. The findings provided mixed support for motivation-hygiene theory.

A comparative evaluation of supportive apartments, group homes, and board-and-care homes for psychiatric consumer/survivors

In this research, we examined the processes and outcomes of supportive housing for psychiatric consumer/survivors. To determine the relative effectiveness of supportive apartments (SA) and group homes (GH) operated by non-profit mental health agencies, we used a longitudinal design with a non-equivalent comparison group of people residing in private, for-profit board-and-care homes (BCH). A total of 107 psychiatric consumer/survivors completed an initial interview and a follow-up interview one year later. Both quantitative and qualitative data were collected in the interviews. In terms of housing and social support processes, the residents of SA and GH were more likely to have their own room, to spend less of their income on rent, and to have more control in decision-making in the residences than people living in BCH. Residents of group facilities (GH and BCH) had more staff support, more emotional and problem-solving support, and less emotional abuse than residents of SA. The outcome analyses showed that residents in all three types of housing increased their involvement in instrumental roles (e.g., work, education) over time, and residents of SA and GH reported more changes in terms of personal growth and increased community involvement and showed increases in independent functioning, as rated by staff, than residents of BCH. However, none of the groups showed improvement over time on measures of perceived control, resident-rated independent functioning, meaningful activity, positive and negative affect, and life satisfaction. The results are discussed in terms of previous literature and implications for future research.

Housing for psychiatric survivors: values, policy and research.

Geoffrey Nelson, Ph.D., and Richard WalshBowers, Ph.D., are with the Department of Psychology, Wilfrid Laurier University, Ontario. G. Brent Hall, Ph.D., is with the School of Urban and Regional Planning, University of Waterloo, Ontario. The authors are grateful to the National Health Research Development Program of Canada, the Ontario Ministry of Health, Community Mental Health Branch, Wilfrid Laurier University, and the University of Waterloo for funding their research, and the Ontario Mental Health Foundation for supporting the principal investigator with a Senior Research Fellowship. The authors also thank the residents and staff of the different types of housing for their participation in the research and the following persons for their research assistance: Donna Cameron, Gary Edwards, Lorie Fioze, Judy Gould, Karen Hayward, Janice McCarthy, Cari Patterson, Leslea Peirson, Kelly Peters, Ruth Slater, Denise Squire, Colleen Wiltshire, as well as Isaac Prilleltensky for his helpful comments. Address for correspondence: Geoffrey Nelson, Ph.D., Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada, N2L 3C5. high; and abuse and neglect of patients was widespread in these settings (Rappaport, 1977). To address these problems, various community alternatives to institutionalizadon were developed. These programs emphasized treatment-rehabilitation of people with serious mental health problems in the community, with the prevention of rehospitalization and the development of life skills as goals. While community alternatives have been effective in achieving these goals (e.g., Stein & Test, 1985), several problems have been noted (Nelson & Walsh-Bowers, 1994). First, the expert role of mental health professionals, with insufficient attention to the preferences and experiential knowledge of people with serious mental health problems and their family members, maintains the power imbalances between professionals and service-users. Second, the focus on deficits and professional treatment can contribute to stigma and encourage dependence on professionals. Third, locating problems within service-users ignores the social conditions (e.g., poverty, poor quality housing, unemployment), that such individuals face.

Social network interactions among mentally ill persons in community housing: research issues and agenda

This paper discusses social network interactions among individuals who have been hospitalized with mental illness and who currently reside in different types of community housing programmes. First, a conceptualisation of social networks that focuses on network interactions, both supportive and non-supportive, between network interactions may be more important influences on successful or unsuccessful adaptation of current and former psychiatric patients to community life than the structural dimensions of social networks more commonly analysed in the literature. The design of a current longitudinal study of social network interactions is presented. The results of two pilot studies that examine social network interactions is presented. The results of two pilot studies that examine social network interactions with data from several community housing programmes in southern Ontario, Canada are reviewed and an agenda is stated for further data collection and analysis.