Neighborhood types and community reaction to the mentally ill: a paradox of intensity.

Neighborhood Types and Community Reaction to the Mentally Ill: A Paradox of Intensity STEVEN P. SEGAL JIM BAUMOHL EDWIN W. MOYLES University of California. Berkeley Journal of Health and Social Behavior 1980, Vol. 21 (December):345-359 Employing data from a statewide study of sheltered-care residents and facilities in California. combined with archival data describing the census tracts in which these facilities are located. the authors analyze the impact of community reaction on sheltered-care residents in diﬁerent types of neighborhoods. Findings suggest that conservative middle-class communities are most likely to exhibit extreme negative reactions that can have a deleterious impact on the social integration of residents in community care. Liberal. nontraditional neighborhoods conform most closely to the ideal accepting community. In liberal. nontraditional neighborhoods and conservative working-class neighborhoods a moderate level of community reaction actually facilitates the social integration of sheltered-care residents. Community reaction to the mentally ill has been an oft discussed and researched phenom- enon during the past ten years. and it has been well established that such reaction affects both the ability of the mentally ill to participate in community life and the willingness of local government to provide or permit the provision of services (Segal and Aviram. I978). In this paper we are concerned with the immediate environment of the community-based sheltered-care facility. a residential setting that is intended to provide supervised living for a handicapped group, in this case. the mentally ill. The oldest fonn of sheltered-care facility is the family-care home. which has traditionally aimed to maintain the chronically mentally ill in local areas (Morrissey. I967). Later. halfway houses with more rehabilitative goals devel- This paper was prepared for the conference New Directions for Research on Stigma Toward the Mentally Ill. sponsored by the National Institute of Mental Health, Bethesda. Md. , January 24 and 25. I980. Thanks to Mark Kaplan for his comments and assistance. This research is supported in part by the National Institute of Mental Health. Center for Epidemiologic Studies. Grant SROI MH254l7-06 ESR. Address communications to: Dr. Steven P. Segal, School of Social Welfare. University of California. Berkeley, CA 94720. __345 oped as an element of sheltered-care (Apte. I968). 'l1Iese have been joined by board-and- care facilities that have assumed all three functions of community-based sheltered-care: long-term care. transitional care. and place- ment of first resort (Segal and Avir-am. I978). in California there ate approximately l,l55 sheltered-care facilities serving nonretarded individuals between I8 and 65 years old who have had some experience in a psychiatric in- patient ‘setting. Family-care homes constitute 26% of these facilities and serve l4% of all sheltered-care residents. Halfway houses, which have received the greatest attention of the mental health professions, account for only 2% of all facilities and serve only 3% of the state's sheltered-care population. Board-and- care homes. which have developed in an un- planned, ad hoc manner, make up 72% of the state's facilities and serve 82% of Califomia‘s sheltered-care residents (Segal and Aviram, 1978). The community sunounding the sheltered- care facility may be a place in which ex-mental patients ﬁnd a comfortable home or an oppres- sive one; a place in which their safety is threatened or in which they can feel free to be about; a place in which they can establish re- lationships or in which others are unavailable to them; a place in which their public depen-