What is Community Integration and How Does It Relate to the Work of Peer Support Specialists?
The term “community integration” has evolved from early efforts to help integrate or reintegrate groups of people into their local community. These groups included
· people with serious mental illness who had been living in psychiatric hospitals.
· military personnel who were returning to civilian status.
· adults who had been incarcerated, returning to the community.
· people who were immigrating to a new country.
From the beginning, the focus has not been on where the person lives, but on whether they are participating in common activities in the community in which they live. Researchers have defined community integration to include an objective element (e.g. is the person participating in employment?) but also a subjective element (e.g. is the person participating in what they value and want to do in terms of employment?). Both are needed. Given the subjective element, “good” community integration will look differently depending on the values and interests and experiences of the person. It should involve functioning in common roles in the community. It should also involve the opportunity to function in common roles, even if the person does not choose that role (e.g. “I can get a job, but I don’t want to do that right now”). These opportunities must be in the community – with the idea that the person is living in the natural local setting. The roles should not be segregated for special populations, such as relying entirely on set-aside jobs specifically targeting people with a mental illness or set-aside social activities like clinical support groups.
There are a number of advantages of thinking of community integration as a useful target we are always working toward in recovery. They include:
· Community integration requires success in prior outcomes including symptom reduction and self-management, improved functioning, participation in formal supports, participation in some informal supports.
· It involves the person connecting with existing natural community-based supports and resources, lowering the need and dependence on professional resources.
· It involves activities that are valued by clients. They want jobs in the community, friendships in the community, etc. The roles include that subjective element of what they want, emphasizing their choice and preferences.
· It changes the community. Recovery is not just about changing the person --- our communities will benefit from the impact of having these individuals actively engaged in local community life.
A group of experts on community reintegration met together in 2012 (Resnik et al., 2012), and concluded that the best way to think about community integration is to focus on whether people function in key adult roles in the community. These roles include:
1. Being a social member of the community: Maintaining core relationships: friends and family members.
2. Being a productive member of the community thru work: Engaging in paid and unpaid employment to contribute to the community.
3. Being a student/learner: Engaging in educational activities.
4. Being a parent: Providing care for and supervising the raising of children.
5. Being an intimate partner: Engaging in a long-term relationship.
6. Spiritual/religious: Engaging in activities and roles that address spiritual needs.
7. Leisure: Engaging in preferred avocational activities.
8. Domestic life: Engaging in activities to maintain the home and live in a noninstitutional residence within the community.
9. Civic: Engaging in activities focused on the betterment of society and the responsibilities of citizens. This would include voting, volunteering in the community, etc.
10. Self-care: Engaging in activities to maintain societal standards of grooming and to maintain health.
11. Economic life: Engaging in simple and complex economic transactions and having command over one’s own economic resources.
Why are Peer Support Specialists perfectly positioned to help clients build healthy community integration?
1. Peer Support Specialists model successful community integration. You have recovered from an illness and are living and working in the community. You may not be active in all of the roles listed above, but to someone who is early in their recovery, your success in at least some these roles will be evidence that they can do this as well.
2. Peer Support Specialists have personal experience with the experience of recovery. That typically involves the recovery of valued roles in the community. Many clinical interventions don’t focus on this part of recovery. That is very unfortunate. It is often challenging to re-establish these roles. Clinical teams and clients will often look to Peer Support Specialists to use their experience to help clients achieve this part of their recovery.
3. Peer Support Specialists often have strong networks of social and other contacts in the community that can help clients better connect with that community. Support groups, activity groups, employers, schools, religious organizations, leisure groups like softball leagues or videogaming groups, etc., are all potential places that a client could reengage in a community. Peer Support Specialists often have better community connections than other team members, and so can support this part of the recovery.
4. Peer Support Specialists often have more flexibility in the type of interventions they provide and where they provide them. Many clinicians work exclusively in a healthcare office. Good community integration often requires that clients go into the community with some trusted member of their clinical team. They may be meeting new people, starting to attend a new support group or religious organization, applying for jobs or signing up for school. The Peer Support Specialist role has the flexibility to help clients do this range of important tasks.
Community integration is a growing focus on clinical work in mental health services. Given that Peer Support Specialists have key advantages to helping in this area, there will be important opportunities for Peer Support Specialists to provide the needed supports for clients to build real lives in their communities.
REFERENCES
Resnik, L., Bradford, D. W., Glynn, S. M., Jette, A. M., Johnson Hernandez, C., & Wills, S. (2012). Issues in defining and measuring veteran community reintegration: proceedings of the Working Group on Community Reintegration, VA Rehabilitation Outcomes Conference, Miami, Florida. Journal of Rehabilitation Research & Development, 49(1).
KEY WORDS: Peer Support Specialist, Community Integration, Peer Bridging, Recovery, Peer Support Training, Peer Support Certification, Peer Support Jobs