Ekosistem Yaklaşımı Perspektifinden Ağır Ruhsal Hastalığa Sahip Bireylerin Sosyal İşlevselliğinin Karma Yöntem Tasarımı İle İncelenmesi

Abstract

In this study, the social functioning of individuals with severe mental illness (SMI) was addressed with the use of ecosystem approach of social work emphasizing the interaction points between the individual and the society they live in and investigating the nature of the interaction and it was attempted to examine the relations between the variables in this direction. SMI individuals in general and social functioning of SMI individuals in particular was not examined in various studies conducted specific to social work in the field of health. However, the concept of social functioning is at the center of social service applications as a key concept separating social work from other humanitarian professions. At present, this situation is the starting point of the study. Therefore, the general aim of the research is to examine the sociodemographic characteristics, the disease process, the process of taking service from Community Mental Health Centers (CMHC), the stigmatization experiences, the level of social support they perceive of individuals with SMI who received service from CMHCs in the sample of Ankara and these variables are related to their social functioning. In the study, a mixed design method, in which quantitative and qualitative methods used together, was preferred. For the quantitative step, 138 individuals with SMI from CMHCs in Ankara participated in the present study while for the qualitative step, 12 individuals with SMI were interviewed. As data collection instruments, a question form prepared by the researcher, Functioning Assessment Short Test Stigma Scale for Receiving Psychological Help and Multi-Dimensional Perceived Social Support Scale were used. All the data were collected between the dates 15 May 2017 and 15 August 2017. As quantitative data were processed through SPSS (Statistics Program for Social Sciences), qualitative data were analyzed via Nvivo 11, qualitative analysis program. Most of the participants were middle-aged, never married individuals with SMI who didn’t work, lived with their families and had a middle socioeconomic status. Individuals with SMI got social support at a good level in addition to the fact that they got support from their families and a special person for them at the highest level. On the other hand, individuals with SMI had the perception that they were labelled with their illness by the society. A significant correlation was found among the genders, educational backgrounds, income status, employment status, lifestyles, voting status, duration of the diagnosis of the disease, transportation ways to CMHCs and social functioning. There was a weak negative correlation between the levels of satisfaction of individuals with SMI with CMHC services and functioning in interpersonal relationships. The status of participants’ getting labelled by the society was weakly and positively correlated with cognitive functioning, financial issues, interpersonal relationships and general functioning. Also, there was a weak negative correlation between the social functioning of individuals with SMI and their perception of social support. According to the results of the present study, in order to provide individuals with SMI with social functioning, it was important to enable them to have a lifestyle in which they can maintain their own lives and fulfill their potentials.