Tyler Frederick

Locating community among people with schizophrenia living in a diverse urban environment

ABSTRACT Increasing the community participation of people with severe mental illness is a primary goal of recovery-oriented services. Despite this emphasis, the construct of community remains understudied and poorly articulated. This study provides an in-depth examination of the experiences, beliefs, behaviors, and spaces that constitute community participation for a highly diverse group of people with schizophrenia who are urban dwellers. An in-depth, longitudinal qualitative design was employed with 30 individuals with schizophrenia residing in inner-city neighborhoods in Canada’s largest city. For these individuals, community participation is a dynamic process, shaped by illness and non-illness-associated social relationships and spaces, self-concept, and the resources accessible to the person. The complexity of factors that are associated with “community” for people with schizophrenia, with overlays of culture, poverty, victimization, and discrimination, calls for a critical examination of the community rhetoric employed in practice and policy contexts.

Brief report: Youth pathways out of homelessness - Preliminary findings

While there exists an extensive body of knowledge regarding the risks associated with youth homelessness, very little work has addressed the process of exiting street contexts. This paper reports baseline findings from an ongoing longitudinal study assessing factors associated with a successful transition out of homelessness. Fifty-one formerly homeless youth who obtained stable housing in the past 2 months to 2 years participated in this study which took place in two Canadian urban centres. Findings include poorer functioning across all domains for youth residing in housing contexts without supports, a lack of relationship between psychological and behavioural aspects of community integration, and the central role of self-concept in mental health and quality of life. These findings suggest the need for ongoing support for youth exiting street spaces and social contexts, with attention to the importance of self-concept and psychological aspects of community integration.

Diversity at the Margins: The Interconnections Between Homelessness, Sex Work, Mental Health, and Substance Use in the Lives of Sexual Minority Homeless Young People

The unique challenges facing homeless sexual minority young people have received increasing attention in recent years. This chapter reviews the research surrounding LGBTQ young people on the street with a particular focus on the interconnections between homelessness, sex work, drug use, and mental health problems. Homeless sexual minority young people are consistently found to have higher rates of mental health problems, drug use, sexual health risk, and victimization than their heterosexual counterparts—findings that highlight the particular vulnerability of this group of young people. However, there is research that cautions against focusing on a single story by underscoring the resilience and creativity of homeless LGBTQ young people, the diversity of experience, and the opportunities that street life holds for finding acceptance and belonging. This chapter aims to capture the complexity of street life for homeless sexual minority young people and concludes with suggestions for avenues of future research and policy.

Community participation within the context of recovery: multiple perspectives on South Asians with schizophrenia

ABSTRACT Community participation is a key component of recovery for people with schizophrenia however, little is known about this process for persons of South Asian origin. This study explores the community participation and recovery amongst South Asians with schizophrenia living in Toronto, Canada. Seven people of South Asian origin with a diagnosis of psychosis or schizophrenia participated in a longitudinal qualitative study, with interviews taking place at three time points over 10 months. Nineteen service providers and community members were also interviewed in an effort to capture multi-level perspectives of persons of South Asian origin. Using a grounded theory approach we identified five major themes: (i) forces of collectivist community; (ii) religious and supernatural conceptualizations of schizophrenia; (iii) cultivating identity and belonging; (iv) points of exclusion; and (v) points of inclusion. The multi-level analysis provided insight into the many systems and structures that influence the recovery process, impacting identity, self-concept, and use of social space. Provider efforts to encourage community participation and recovery for persons of South Asian origin with schizophrenia should take into account individual identity and community of origin factors. Social and identity capital theories provide a mechanism to promote the social inclusion of individuals with schizophrenia.

Physical health, community participation and schizophrenia

Our objective is to identify links between physical health and community participation among individuals with schizophrenia or a psychosis mental illness. Semi-structured qualitative and quantitative interviews and community tours were conducted over 10 months (N = 30). Interviews were transcribed and analyzed using a grounded theory coding strategy. Physical health played an important role in community participation both as a cause and consequence. Key processes included mobility issues impeding physical community involvement; a multi-directional relationship between social relationships, community involvement, and physical health; identity as a mechanism linking physical health problems and community engagement; and the potential for community-based mental health programs.

Methodological reflections on research with street youth

Summary This paper examines both the epistemological and practical limitations and challenges of data collection by reflecting on the experiences of a team of both junior and senior researchers engaged in such a longitudinal study. Findings This paper argues that longitudinal research with street youth challenges the boundaries and limits of the formal constructs of research and ethics that typically guide qualitative research by grappling with field issues such as navigating reciprocity, risk and authenticity within relationships with a vulnerable group. Application This paper calls for an explicit acknowledgement of the challenges researching populations such as street youth over time in our research ethics guidelines and encourages researchers to engage in dialogue leading to more reflective, transparent and accountable framing of how we collect data in the field with vulnerable youth populations.

A Qualitative Description of Community Service, Business and Organization Perspectives on Mental Illness and Inclusion

ABSTRACT Although stigma associated with mental illness is pervasive, less is known about community stakeholder perspectives on inclusion and exclusion. This study provides a qualitative analysis of the mental illness–related experiences and perspectives of individuals who form much of the fabric of “community” for individuals with severe mental illness. In-depth interviews were conducted with a diverse group of 94 key community stakeholders in five neighborhoods in a large Canadian urban center. Qualitative analysis revealed a range of strategies that were used to foster inclusive spaces, the dilemmas that attended more severe forms of mental illness, and the importance of the meanings ascribed to mental illness in determining responses. Differences in response as a function of stakeholder group were also explored. There exist very promising resources and diverse perspectives on inclusion in urban communities that warrant further investigation given the intensive emphasis upon ‘community’ in policy and practice dialogues.

Fragmented inclusion: Community participation and lesbian, gay, bisexual, trans, and queer people with diagnoses of schizophrenia and bipolar disorder.

Community participation is often cited as a crucial component of wellness for people with mental health diagnoses. Few studies explore community participation from the perspective of lesbian, gay, bisexual, trans, and queer (LGBTQ) people with diagnoses of schizophrenia and bipolar disorder. This article describes an in-depth qualitative study with 16 LGBTQ people; 18 social service workers; and 2 key informants in Toronto, Ontario that examined access to communities for LGBTQ people with mental health diagnoses. Results indicate that community participation is particularly relevant to this group given the functions of communities for marginalized people as a source of support and resistance. However, the participants faced barriers to accessing support and creating social networks due to the lack of intersectional inclusion in various contexts, including LGBTQ communities and mental health/mad communities.