Master of Arts (MA)
Faculty of Science
Within the last few decades there has been a shift from traditional institutional approaches in mental health to community based service delivery systems. Researchers examining the community-based model have focused on improving the quality of community care. Specifically, use of aftercare services has been found to improve the quality of community care (Byers, Cohen, & Harshbarger, 1978; Gittelman 1974; Krauss & Slavinsky 1982; Weinman et al. 1978). Coordination of services has also been shown to improve the quality of community care by increasing the effectiveness of aftercare (Broskowsky, marks, & Burmen 1982; Clark 1976; Krauss & Slavinsky 1982). At the level of the chronically mentally ill, quality of community life is affected by the quality of care. Researchers have shown that psychiatric patients or clients experience poor quality of life in the community (General Accounting Office, 1978; Krauss & Slavinsky, 1982; Lamb, 1982). The present research was designed to examine  service providers’ perceptions of aftercare service coordination in their community,  service receivers’ (i.e. the chronically mentally ill’s) perceptions of their quality of life in the community, and  factors hypothesized to affect co-ordination of services for the chronically mentally ill in the community. Organizational research has demonstrated that co-ordination is affected by relationships  within the agency, and,  between community agencies (Evan, 1967; Etztoni, 1961; marks & Broskowski, 1982). These factors hypothesized to affect co-ordination are referred to as intraorganizational perceptions and interorganizational perceptions respectively. Two communities were studied. One community operated from a community care model where chronic mental patients/clients were treated entirely in the community or on a hospital out-patient basis. The second community operated from an institutional care model using in-hospital, out-patient and community treatment. A comparison was made between the two communities using data provided by service providers. Two scales were constructed for this research. The scale for service providers examined perceptions of co-ordination of services for the chronically mentally ill, interorganizational perceptions, and intraorganizational perceptions. The self-administered instrument was constructed in the form of a multiple-choice and 5-point Likert format scale. The scale for service receivers examined Quality of Life in the community by measuring  life adjustment, based on factors outlined by Krauss & Slavinsky (1982) which were: a need to be taken care of, a need for social interaction, a need for relief from psychiatric symptoms, a need for basic life necessities, and a need for hope, and,  life satisfaction using an adapted version of the Bradburn Satisfaction Scale (Bradburn, 1969). The self-administered service receiver instrument was constructed in the form of a multiple choice and 5-point Likert format scale. It was found that co-ordination of services was moderate in the institutional care model and low in the community care model. There was a significant difference between the two communities in the perceived level of co-ordination of services. Interorganizational perceptions affected co-ordination of services at the local level. Chronically mentally ill persons experience a poor quality of life in the community: Life adjustment was affected by the level of care, relief from psychiatric symptoms, and hope of recovery provided by service providers. This paper concludes with a discussion of the limitations in the research. It is shown that there is no reason to believe that the results were spurious. Recommendations based on the research are provided, and directions for further research are suggested.
Ferris, Lorraine, "An examination of aftercare services for the chronically mentally ill in two communities" (1985). Theses and Dissertations (Comprehensive). 514.