In the last decade, the idea of recovery has been getting more attention in the mental health and substance abuse research and services. A new study by the Centre for Mental Health and Substance Abuse at the University of South-Eastern Norway, researchers Esther Ogundipe, Knut Tore Sælør, Kenneth Dybdahl, Larry Davidson and Stian Biong delves deeper into the role of the community in social recovery. The study is called, ‘Come together: A thematic analysis of experiences with belonging’.
“There are different aspects of recovery," says Esther Ogundipe, the corresponding author of the paper.
Clinical recovery focuses on symptoms, and what we have come to understand as psychiatry. Individual recovery focuses on individual wishes and hopes, explains Ogundipe.
But social recovery goes beyond the individual person and focuses on the contribution of other persons, such as the community and contextual factors, according to the researcher.
Social inclusion—the sense of belonging, the opportunity to participate and experience citizenship within the community, is an important factor in social recovery.
The paper argues that those with co-occurring mental health and substance abuse issues are at a higher risk of social exclusion than others.
Challenges around housing
This is especially true when it comes to housing. One of the attempts to address exclusion has been by assigning supportive housing. However, the challenges around housing for persons experiencing mental health and substance abuse issues remains under-researched.
The study tries to address that challenge by asking two questions:
1. How do persons with co-occurring mental health and substance abuse problems, living in supportive housing experience belonging?
2. How does the residential support staff experience promoting a sense of belonging for the persons with co-occurring mental health and substance abuse problems living in supportive housing?
The 14 participants in the study were staff and residents of a supportive housing site in one of the districts in the capital, Oslo.
Constantly on guard
In their study, the researchers find that their participants who reside in supportive housing did not feel safe because of fellow residents’ behaviour. They felt like always have to be on guard. They were afraid to walk the hallways or take the elevator because they did not know what danger was waiting for them around the corner.
In one of the interviews a resident, who is constantly afraid of the unexpected says, “I am fully dressed, ready to run out or call the police.”
Researcher Ogundipe argues that this insecurity leads to a lack of sense of belonging.
“What we want to highlight here is that we give a home to people living with co-occurring mental health and substance abuse issues, but they themselves don’t feel like they have a home,” she says.
A limited number of choices
The study further explores belonging as an aspect of inclusion, as the researchers focus on choice when it comes to housing. In the Norwegian context, people living with co-occurring mental health and substance abuse issues may not have access to housing, and it is the municipality’s responsibility to find housing.
One of the respondents described choosing a house and a community as a choice between the lesser of two evils.
“They are given a limited number of choices, and have to choose from one or another—and they don’t feel like they have much of a choice,” says Ogundipe, adding, “Just because we have assigned a house, does not make them feel included, or that they have a home.”
Ogundipe argues that the social community has a big role to play in making people living with co-occurring mental health and substance abuse issues feel a sense of belonging.
“One simple thing that the society can do is to make housing more affordable—build different kinds of houses in different areas, make the market more flexible so more people can own their own place in a neighbourhood that meet their preferences,” she says.
Housing is not the only way that the community can contribute to social inclusion, and thus, social recovery.
When Ogundipe and the other researchers asked the residents what can be done to increase their sense of belonging, their reply was, “Everyone needs to come together, as a society, on all levels, and start with being kind to each other.”
One of them said that the act of kindness could mean making an environment where people were willing to engage in small talk in public places, be able to greet and socialize.
“Everyone in society has collective responsibility when it comes to the idea of inclusion. I am calling for a radical change, moving away from individualistic to a collective response,” says Ogundipe.
“We need to start seeing people living with co-occurring mental health and substance abuse issue as one of our own.”