Enhancing Choice, Capabilities, and Community for Chronically Mentally Ill Persons: The Social Context of a Faith-Based Day Program Open Access

Smith, Sarah Megan (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/d217qq38h?locale=en
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Abstract

In the 21st century, the majority of chronically mentally ill persons live in the wider deinstitutionalized community and are receiving community-based care. In most cases, they lack positive social supports that would allow them to thrive in the community in which they reside. This study focuses on the social world of a faith-based day program, referred to as the Oaks, in the Atlanta metropolitan area that provides opportunities for participants to thrive via enhanced capabilities, maximizing choice, and engagement in the community at the center. Comprised of three original empirical research papers, this qualitative project explores the social community at the Oaks. The first paper is a thematic analysis study that examines the role of the Oaks as a mediating structure that leads to what we refer to as enhanced capabilities. The second paper is a grounded theory study that explores how participants develop meaningful dyadic relationships with each other. The third paper is a thematic analysis that investigates how enhanced capabilities lead to engagement in the religious collectivity. Data were collected beginning in 2012 and ending in 2015. In total, the first author completed over 80 hours of participant observation, conducted 34 semi-structured interviews with program participants and key staff, and reviewed facility records. Through the development of theory and the extension of multiple conceptual frameworks, including mediating structures, the capabilities approach, and the social convoy model, we found that participants reach toward their maximum potential as equal persons in an environment that provides consistent opportunities for social interaction.

Table of Contents

TABLE OF CONTENTS

CHAPTER 1: INTRODUCTION 1

CHAPTER 2: ENHANCING THE CAPABILITIES OF THE

CHRONICALLY MENTALLY ILL THROUGH THE

MEDIATING STRUCTURE OF A FAITH-BASED

DAY PROGRAM 17

Figure 2.1 54

CHAPTER 3: SOCIAL RELATIONSHIPS OF THE

CHRONICALLY MENTALLY ILL IN THE

CONTEXT OF A FAITH-BASED DAY PROGRAM 55

Table 3.1 92

Table 3.2 93

Table 3.3 94

Figure 3.1 95

CHAPTER 4: ENHANCED CAPABILITIES AND

ENGAGEMENT IN THE RELIGIOUS COMMUNITY

AT A FAITH-BASED DAY PROGRAM 96

CHAPTER 5: DISCUSSION 121

APPENDIX A 138

APPENDIX B 170

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