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Community integration is a model that blends psychiatric care and psychosocial rehabilitation. It is rooted in the belief that many people diagnosed as suffering from psychiatric symptoms do not need to live apart from their community, whether in residential programs or hospital settings.

People whose lives are disrupted by psychiatric symptoms often experience traumatic social losses – of family and friends, work, school and social identity. They can also suffer from stigma and lose confidence in their own ability to create a purposeful life in the real world. Care delivered in settings outside the community can reinforce these social losses.

Community integration programs are an effective community-based alternative that achieve excellent outcomes.

These programs deliver psychiatric treatment and psychosocial rehabilitation to clients living with various degrees of independence in the community. While receiving psychiatric care, clients are intensively supported in maintaining or building meaningful connections to family and social networks; in reclaiming their social role; and in moving purposefully toward a future – in believing in their own future.

While A4CIP’s member programs have individual differences, we share core values. We believe – and we have all seen firsthand – that many people with psychiatric symptoms do best when living a normal life in the community, where they can form nurturing social ties and rebuild a sense of purpose. There is mounting evidence that these are key ingredients in psychiatric recovery.

Client Empowerment and Voice

Community integration programs seek to re-empower clients, helping them regain a voice and control in their lives. From the start of the therapeutic relationship, the client’s voice is the central guide in treatment. As the client sets the course of their recovery, clinicians partner with them, without directing their lives.

If you are interested in learning more about the community integration philosophy, approach, and related topics, see our Resources page.

What is the meaning of “evidence-based”?

The term means that there is reliable and valid evidence, based on a body of research and a set of criteria, that a program or practice works. Evidence-based mental health treatment practices have demonstrated positive outcomes in multiple research studies.

 

What makes the community integration treatment model “evidence-based”?

Research over the past decades into the most effective mental health treatment, much of it conducted by the federal Substance and Mental Health Services Administration (SAMHSA), has identified approaches that consistently deliver good results. Deemed “evidence-based,” these approaches are characteristics of the community integration model of care.

Based on repeated objective evidence of successful outcomes, the following are considered the six features of evidence-based practice in mental health treatment. * Features five and six constitute the definition of a community integration program. The community integration programs in this association implement all six practices to varying degrees and in different ways.

  1.  Primary focus on recovery
  2.  Facilitating empowerment and choice
  3.  The recognized role of relationship, i.e., social connections
  4.  The importance of delivering services in the client’s natural setting, i.e., in clients’ homes, places of work, school or neighborhood.
  5.  Utilization of the environment as a resource, i.e., the person’s community
  6.  Primary focus on teamwork and integration of therapies and support

* From The Evidence-Based Mental Health Practice Textbook, 2004 edition by Drake, Merrens and Lynde, page 193 of the chapter  “What are the Common Features of Evidence-Based Practices?” by authors Charles Rapp and Richard Goscha.

 

What makes a community integration program different from a fully residential program?

A good residential program can provide a person with a sense of connection to others and a community of people who share the experience of having been diagnosed with a mental illness.  But there is also a downside to residential care. Clients live separated from their community to varying degrees. They may interact with the community, but contact is typically limited and controlled; most of their time is spent within the walls of the residence. They live physically, as well as psychologically and emotionally, apart.

For many people experiencing psychiatric symptoms, living apart from the world can bring with it a cluster of losses, called psychosocial injury. They can suffer from the effects of stigma, loss of a social identity and social ties, loss of an educational or employment track, and loss of movement toward a future and hope for their future.

By contrast, clients in a community integration program benefit from living in the real world to varying degrees, where they encounter and learn to cope successfully with real-world stresses and challenges; from being able to build genuine social connections; from having a social identity and role; and from having a sense of purpose.

While an important aspect of residential treatment is the “milieu,” or setting, in which clients continually interact with one another, community integration programs place clients in the milieu of the broader community, with far greater emphasis on their interactions with the world.

 

What kinds of diagnoses do community integration programs work with?

Most community integration programs can work with any diagnostic issues.

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