Exploring the Experience of Community Participation Among Individuals With Serious Mental Illness

Abstract

People with serious mental illness (SMI) encounter restrictions in the quantity of their community participation. Less is known about the quality of their participation. We aimed to explore the relationship between symptoms of SMI and the daily experience (i.e., loneliness and enjoyment) of community participation. We examined daily community participation among people with SMI using ecological momentary assessment surveys. We built multilevel models to examine the associations between symptoms of SMI and loneliness or enjoyment during community participation. Our analysis included 183 people among four participant groups: bipolar disorder (n = 44), major depressive disorder (n = 46), schizophrenia/schizoaffective disorder (n = 40), and control (n = 53). People with schizophrenia engaged in more unstructured activities (e.g., socializing) than people among other groups. Symptom association varied across diagnostic groups. To support tailored intervention development, researchers and practitioners should consider the context of participation and the clinical characteristics of the client.

Plain Language Summary

People with Serious Mental Illness Have Different Patterns and Emotions Related to Community Participation

Why was this study done?

Adults with serious mental illness engage in less community participation—activities done with another person—than their peers. In addition, it is possible that people with serious mental illness do not experience the emotions that we expect during community participation. This study explored the subjective experience of community participation among people with serious mental illness.

What did the researchers do?

Researchers collected information about participants’ mental health symptoms and daily activity participation. Participants completed surveys that were sent to their cell phone multiples times per day. On the survey, participants described the kind of activity they were doing, whether or not they were doing the activity with someone else, and how much loneliness or enjoyment they were experiencing. Researchers looked at which activities were most often done with someone else. Researchers also looked at which mental health symptoms were related to loneliness and enjoyment during community participation.

What did the researchers find?

People with schizophrenia or schizoaffective disorder did less community participation at work or school than the other groups. Mental health symptoms, especially depression, negative symptoms (i.e., lack of pleasure and motivation), and defeatist beliefs, were related to less enjoyment and more loneliness across the groups.

What do the findings mean?

People with schizophrenia or schizoaffective disorder may have less opportunities for community participation. Different symptoms may affect community participation in different ways. Researchers and practitioners should consider these findings when developing intervention plans.