The Tornado of Mental Illness

Cheryl Forchuk, RN, PhD, Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada, Catherine Ward-Griffin, RN, PhD, School of Nursing, University of Western Ontario, London, ON, Canada, Rick Csiernik, MSW, RSW, PhD, School of Social Work, Kings College, London, ON, Canada, and Katherine Turner, BA, LLB, CED, (dip), Margaret's Haven Non-Profit Housing, London, ON, Canada.

Problem: De-institutionalization, health system restructuring, and movement toward supported community living for persons with severe mental illness have created the necessity for a comprehensive understanding of needs, gaps and barriers to acquiring and maintaining housing.

Method/Design: An inductive qualitative study resulting in a model of a tornado to describe experience. Open-ended questions were explored with each of nine focus groups. Focus groups were audio-taped and transcribed verbatim. Two note-takers were present to record field notes. Transcripts were reviewed and analyzed for themes. An ethnographic method of analysis was used. An analogy of a tornado was used to describe the upheaval and loss encountered by many psychiatric survivors.

Population, Sample, Setting: Focus groups were conducted in urban and rural areas in South-Western Ontario over a two month time-period during the summer of 2002. Each group was comprised of eight to ten participants, five groups being of mixed gender and four single gender groups. All participants were psychiatric consumer/survivors.

Findings: Analysis revealed three tiers: 1.Struggling to survive, 2.Surviving, 3.Beginning to rebuild. People move between each of the tiers. Like a tornado, columns are not straight, but twist and turn with different widths at different points. Various sub-themes emerged within the tiers and included: loss, destruction, addressing basic needs, obtaining rights, living in fear, identifying supports, seeking services, trying to hold/create relationships, control by external forces, finding personal space/place, and stability of housing/tenancy.

Conclusions/Implications: Persons with severe mental illness are at risk of losing their housing tenure, living in substandard housing or being placed in inappropriate housing. Nursing and other professionals will benefit from understanding such issues, and may apply this knowledge in working toward improved outcomes for this population.

Learning Objective #1: Promote awareness and understandings among nursing and other professionals regarding specific challenges faced by psychiatric consumers/survivors
Learning Objective #2: Promote movement toward improved outcomes for psychiatric consumers/survivors