Factors contributing to the subjective quality of life of the chronic mentally ill.
Although the deinstitutionalization of the seriously mentally ill has been severely criticized, the success of some model community programs shows that community care can enhance patients' quality of life. We lack specific knowledge, however, about the components that make these programs effective, and why. A theoretical framework for identifying these critical components is proposed. Services can enhance life satisfaction by increasing individuals' actual power through economic resources or status, thus enhancing their perceptions of mastery. An internal evaluation of a model program provides support for this hypothesis. One hundred and fifty-seven patients were interviewed about services, quality of life, and perceptions of mastery. Results show that services providing economic resources and an empowerment approach to service delivery are significantly related to overall quality of life. Furthermore, perceptions of mastery account for the impact of these components on life satisfaction. These findings suggest interventions that can be adopted by a wide range of mental health programs for the improvement of the quality of life of the chronic mentally ill.
Rosenfield
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Institute for Health, Health Care Policy, and Aging Research, Rutgers University, Brunswick, NJ 08903.
D000328:Adult; D000368:Aged; D003156:Community Mental Health Services / Q000458:organization & administration / Q000592:standards*; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D008875:Middle Aged; D008960:Models, Psychological; D009515:New Jersey / Q000453:epidemiology; D010549:Personal Satisfaction; D011209:Power, Psychological; D011788:Quality of Life; D012307:Risk Factors