Portland Street Response (PSR) is an alternative first response program located in Portland, Oregon. The program assists individuals experiencing mental health crises by providing an unarmed first response in non-violent situations that ordinarily would be responded to by armed police officers. In order for such programs to thrive, collaboration with other organizations is crucial. Service-providing organizations are uniquely prepared to collaborate with programs such as PSR due to their proximity to vulnerable communities. Currently, there is a lack of information about the perspectives of service providers concerning alternative first response programs, particularly regarding their motivations for collaboration. The current study utilizes qualitative interviewing methods to examine motivation to collaborate. Qualitative interviews were conducted with 16 participants and then analyzed to uncover key themes. The current study resulted in themes pertaining to motivations for collaboration, including the importance of building relationships, establishing and maintaining trust, and themes pertaining to shared values, such as a commitment to equity. The current study also revealed the importance of concrete program features in relation to collaboration, specifically access to resources and mobility. This research has implications for other alternative first response programs collaborating with local service providers in communities across the US.

Latino immigrant workers have been an exploited community within many dangerous workforces, but especially within the agricultural industry. They are a crucial population for the labor and economy of the U.S., yet Latino farmworkers report feeling expendable, discriminated against, and exposed to hazardous working conditions. Due to these experiences, it is essential to explore the resources that farmworkers find valuable in improving their working conditions. This study draws upon qualitative interviews conducted with 41 Latino farmworkers in Oregon. Themes pertaining to work and nonwork resources were uncovered through thematic analysis, illustrating that farmworkers receive support from their proximal communities and feel empowered by them, but lack support from their distal communities and need basic work necessities, fair wages, supportive supervisors, legislative labor protection, and a pathway to citizenship. Findings make clear that employers and elected officials must do more to advocate for Latino immigrant farmworkers and provide resources to protect their well-being. We demonstrate the need for future research related to changes in farmworkers' resources over time, their reporting of workplace violations, the impact of labor legislation on their health, and how information sharing or unionization occurs among farmworkers.

Police are often called to address concerns about people experiencing homelessness and mental health crises. These interactions often lead to arrests, which lead to fines that many are unable to pay, loss of personal belongings, and additional barriers to housing and employment. Based on concerns about the over-policing of people experiencing homelessness, communities have become increasingly interested in alternatives to police response to calls involving people experiencing mental health distress and homelessness. Portland Street Response (PSR) is one such alternative that was developed and implemented in Portland, Oregon. Although specifically focused on mental and behavioral health crises, a large portion of PSR's calls respond to individuals experiencing homelessness. For this reason, it is critical to assess unhoused community members' knowledge of PSR and their experiences with and attitudes toward the program. 719 surveys of unhoused community members and 29 follow-up qualitative interviews were conducted across four evaluation timepoints. Knowledge of PSR was low at the beginning of the program but increased significantly over the evaluation period. Unhoused community members, particularly those who were Black, Indigenous, and other People of Color (BIPOC), reported feeling unsafe calling 911 to request service from PSR, though their trust increased over time. While only a small percentage of unhoused community members we spoke with reported direct experience interacting with PSR, those who did expressed high levels of satisfaction, appreciating the compassionate, person-centered care they received in the community; the connection to housing, health services, and other resources; and the collaborative manner in which PSR staff engaged with them. As cities across the country implement alternative first responder programs, our findings help identify important areas to consider to ensure that unhoused community members are aware of how to access the programs, and, importantly, that they trust the programs will help them rather than harm them.

Portland Street Response (PSR) was implemented in Portland, Oregon to provide an alternative to police response for individuals in crisis related to mental illness, substance use, or homelessness in public space. PSR is dispatched through 911. Most calls resulting in a PSR dispatch are made by housed community members, making it important to assess community members' knowledge of PSR, their thoughts about accessing PSR through 911, and their experiences using PSR. 440 community members were surveyed over four evaluation timepoints. Sixty of these participants were qualitatively interviewed about their direct experience with PSR. Knowledge of PSR was lower among BIPOC than White community members, but increased considerably over the evaluation period. Community members were ambivalent about using 911 to call PSR due to fear of police response or anticipated slow response, though their confidence in reaching PSR increased over time. Community members were satisfied with PSR's work in the field, describing the team's kindness, de-escalation skills, and ability to connect with clients and the larger community. These findings are useful to other cities as they consider implementing alternative first responder programs, and the consistent positive feedback on PSR's work in the field demonstrates the value of these programs.

As researchers, advocates, and policymakers continue to emphasize community participation for people with serious mental illness (SMI), it is important to understand and strengthen the natural ties that these individuals have in the community. This study investigated how the social support provided by natural supports (i.e., relationships that occur in everyday life, such as friends, family members, co-workers, and neighbors) relates to community participation. It was hypothesized that natural supports would be positively associated with community participation. Forty-eight participants completed a survey, and 15 of these participants completed a semi-structured qualitative interview. Family, friends, and neighbors were the most frequently identified supports. However, spouses, religious leaders, and pets provided higher levels of emotional support. Average total support was significantly related to community participation. Themes included families spending time together, mental health challenges as barriers to participation, and the desire to do activities with others. These findings provide insight about the role of natural supports in promoting community participation and inform interventions aimed at increasing social support and community participation.

The provision of residential and community-based services for individuals with serious mental illness (SMI) has become increasingly important following the deinstitutionalization movement. Much of the existing research on supportive housing focuses on housing outcomes rather than exploring how the program helps its residents thrive in the broader community. This study draws upon data collected from 176 people with SMI residing in 16 supportive housing locations in Portland, Oregon. Analyses explore how housing staff support relates to residents' loneliness (interpersonal level), residential satisfaction (housing and neighborhood level), and sense of community (community level). Staff support was found to be related to lower levels of loneliness, higher residential satisfaction, and a higher sense of community. Self-determination was considered as a moderator to understand the role of residents' agency in the relationships between staff support and resident experiences. Self-determination moderated the relationship between staff support and residential satisfaction for those with moderate to low self-determination, but not for individuals with high self-determination. In contrast, staff support was associated with decreased loneliness and increased sense of community regardless of self-determination. This study has implications for policymakers, researchers, and interventionists, expanding upon the limited body of research on staff support and the experiences of residents in a supportive housing environment.

Purpose This study explores the relationship between different modes of transportation and community participation among individuals with serious mental illnesses. Methods This study reports on data from 283 individuals with serious mental illnesses recruited from community mental health centers in 15 states. Participants responded to self-report items about the types of transportation used and participation in the community. Data were analyzed using Classification and Regression Trees to determine which modes of transportation were predictive of community participation. Results Individuals with serious mental illnesses reported walking as the most frequently used form of transportation followed by using public transportation. Biking and driving one's own car, were the strongest predictors of amount and breadth of community participation. Walking was the only predictor of community participation sufficiency. Conclusions Lack of transportation is an often-cited barrier to community participation for individuals with mental illnesses. Independent modes of transportation (Biking, driving one's own car, and walking) appear to facilitate participation. Future research should develop and test interventions that aim to promote transportation access and usage in order to facilitate diverse participation in the community.

Women account for over one-third of the unhoused population in the U.S. (United States Department of Housing and Urban Development, 2023) and oftentimes experience barriers when seeking to manage their fertility while unhoused (Begun et al., 2019; Kennedy et al., 2014). Previous research examining contraceptive experiences while homeless has, for the most part, failed to account for the experiences of individuals who report less engagement with homeless services, such as those living in encampments and other unsheltered environments. Therefore, the present study sought to document the contraceptive experiences of unsheltered individuals capable of pregnancy. Qualitative interviews were conducted with 15 individuals capable of pregnancy residing in unsheltered locations to identify meaning ascribed to contraceptive access and use and linkages between reproductive health practices and feelings of empowerment. Findings offer novel contributions to the literature and have implications for future research and service delivery with individuals experiencing unsheltered homelessness.

While some international qualitative research has interviewed people with serious mental illnesses (SMI) about their experiences in the initial months of the COVID-19 pandemic, few US studies have explored their experiences and perspectives as the pandemic has continued. Drawing from disability studies perspectives, this qualitative study conducted in 2022 explored the experiences of people with SMI seeking services at community mental health centers during the COVID-19 pandemic. Fifteen clients who identified as living with an SMI and were clients during March 2020 were interviewed. Using narrative analysis, we identified an overarching tenor of client experiences: feeling left behind by institutions and society. This feeling of being left behind was conceptualized as three themes. As the literature around the COVID-19 pandemic grows and we attempt to integrate it into community mental health policy and practice, it is essential to include the experiences and perspectives of clients with lived experience of SMI.

There is a high prevalence of loneliness among adults with serious mental illness (SMI) with most research focusing on stable contributing factors. This study sought to identify the role of dispositional loneliness and internalized stigma, as well as the momentary feelings of acceptance on experiential loneliness among adults with SMI. Data were collected using ecological momentary assessment via smart phones, and 89 adults with a SMI were included. Hierarchical linear modeling was used to identify the role of dispositional and experience factors in experiential loneliness. Findings indicated that (a) dispositional internalized stigma, (b) being at home, (c) being alone and, (d) a cross-level interaction between dispositional loneliness and feelings of acceptance best fit the data. The relationship of acceptance to experiential loneliness was strongest among the most lonely. Supporting people with SMI to develop social connections contributing to their relational value may enhance feelings of acceptance and reduce loneliness.

Objective: Severe loneliness infrequently occurs in the general population but has very significant impacts on health and quality of life. This study examined the extent to which severe loneliness is experienced by adults with serious mental illnesses (SMIs) relative to adults in the general population and its possible implications for psychiatric rehabilitation services. Method: Data were gathered from samples of individuals with SMI (N = 231) and a general community sample of adults (N = 300) using the University of California, Los Angeles Loneliness Scale. Results: The results indicate that loneliness was much greater among those with SMI than the general adult population sample (Cohen's d = 1.220) and approximately 41% of the participants with SMI were "severely lonely" versus 7.3% of the non-SMI adult sample. Conclusions and Implications for Practice: Severe loneliness is extremely common among individuals with SMI. Psychiatric rehabilitation services that focus on socialization and mattering are needed to address this significant public health issue. Impact and Implications The present study found that disproportionately many people with serious mental illnesses reported severe levels of loneliness. Loneliness should be considered as an intervention target in psychiatric rehabilitation services. To accomplish that, funders and policy makers should prioritize addressing loneliness as a critical outcome of mental health services.

BACKGROUND:People with serious mental illnesses (SMI) have higher levels of loneliness than the general population. Furthermore, people with SMI tend to be less satisfied with their housing and tend to move more frequently.AIM:This study aims to examine relationships between housing variables (whom they live with, duration of residence, and satisfaction) and loneliness among individuals with SMI.METHODS:Data were collected from 188 adults with SMI in greater Philadelphia area. Classification and Regression Trees (CART) were used to examine whether whom they live with, duration of residence, and housing satisfaction were associated with loneliness.RESULTS:Housing satisfaction was found to be the most prominent predictor of loneliness. Those who were unsatisfied with their overall housing conditions always had the highest level of loneliness, regardless of other factors. Even if they were satisfied with their housing conditions, their loneliness was higher if they had just moved to the new residence. Participants had lower loneliness the longer they lived in a residence and had the lowest loneliness levels after about three years.CONCLUSION:Housing is associated with loneliness among people with SMI. Psychiatric service providers should increase support to factors contributing to housing satisfaction and duration of residence, including active engagement in the community.

The Kenton Women's Village is the first city-sponsored pod village for people experiencing homelessness in Portland, Oregon. The village features individual sleeping pods and shared common facilities, and is managed by a local nonprofit organization. Villages have historically been self-governed communities borne of grassroots activism but have become increasingly of interest to nonprofits and municipalities seeking to address homelessness. As the village model proliferates throughout the United States, significant research that centers villager experience to inform the design, operations, and governance structures of future villages is needed. These interviews with the residents of Kenton Women's Village revealed several themes around villagers' experiences and perceptions of their pods, life in the village, and the surrounding community. This initial exploration contributes to our understanding of the managed pod village model and may inform the design of future villages as well as research with other pod villages across the Portland metro area.

Police are often called to address concerns about people experiencing homelessness, with arrests often resulting from low-level, nonviolent crimes, and violations of minor nuisance ordinances. In Portland, Oregon, advocates lobbied for a new model of emergency response for 911 calls involving unhoused community members and people experiencing behavioral health crises. To ensure the program reflected the needs and perspectives of people experiencing homelessness, teams of researchers, community volunteers, and people with lived experience interviewed 184 people in camps, shelters, and parks. Teams asked unhoused people how the program should be designed, including who the first responders should be, how they should approach individuals in crisis, what resources they should provide, and how they should be trained. This article describes the methods, findings, and recommendations from our collaborative survey process aimed at ensuring that the voices of people experiencing homelessness informed the development of the Portland Street Response pilot program.

Mental health services and interventions have increasingly focused on the importance of community participation and mobility for people with serious mental illnesses (SMI). This study examined the role that visits to community mental health centers (CMHCs) may play in increasing community mobility of people with SMI. Eighty-nine adults with SMI receiving services at three CMHCS were tracked with GPS-enabled phones over a 13-day period. Findings revealed that participants visited more destinations on days they went to a CMHC compared to days they did not. They also spent more time out of the home and traveled greater distances. Results suggest that the benefits of visiting a mental health center appear to go beyond treatment outcomes, but also point to the possibility that obligations, whether to a clinic appointment or possibly vocational, educational, leisure, faith, or social commitments, may be an important stepping stone to more mobility and intentional, sustained community participation.

This review examines the reproductive health experiences of unhoused women and youth. Guided by the reproductive justice framework, this review examines barriers to accessing contraception, medical abortion, and prenatal care while homeless. Twenty-one articles were identified through keyword searches in Google Scholar, Ebscohost Academic Search Premier, and PsycINFO. In included articles, barriers were identified at the individual, relational, and contextual levels. Findings from this scoping review illustrate the need to examine multiple levels of analysis when seeking to improve access to family planning services for individuals experiencing homelessness. Included literature suggests an overabundance of research documenting barriers to contraceptive care relative to the literature examining abortion and prenatal care experiences and a scarcity of research examining barriers to reproductive justice among unhoused individuals who do not identify as women.

[Correction Notice: An Erratum for this article was reported online in Psychiatric Rehabilitation Journal on May 20 2021 (see record 2021-48272-001). In the original article, the following acknowledgments were missing from the author note: : "The contents of this article were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR; Grant 901F0065-02-00; Mark S. Salzer, principal investigator). However, the contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and endorsement by the federal government should not be assumed. The authors are grateful to Kevin Frech, Stephany Wilson, Alison Weigl, Jared Pryor, David Glogoza and Katie Pizziketti for their assistance with data collection and analysis and to Alex Fechner for providing his implementation of the ST-DBSCAN algorithm in RapidMiner." All versions of the original article have been corrected.] Objective: The purpose of this study was to determine if environmental novelty was associated with neurocognitive function among adults with serious mental illness. Method: Participants were recruited from community mental health centers (n = 117), and received a Global Positioning System (GPS) enabled cellular phone for 13 days. Data were also collected on cognitive function and recent participation in community-based activities. Independent samples t-tests were conducted to identify differences in neurocognitive function between participants who predominantly stayed in their homes ("homebodies") versus those who ventured more often from their homes ("venturers"). Analyses were also undertaken to identify if the nature of community participation activities mediated the relationship of neurocognitive function to group membership. Results: Overall, 74% of GPS signals were from participants' home residence. Homebodies demonstrated significantly poorer cognitive function than venturers, and this relationship was not mediated by a number of unique destinations or breadth of community participation activities. Conclusions and Implications for Practice: This study identified a subset of adults with serious mental illnesses who left their homes infrequently and who demonstrate significantly poorer cognitive function than those who left their homes more frequently. Spending extensive amounts of time in an unchanging environment may be a contributing factor to poor cognitive function, and a potential area for intervention. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Adults with autism spectrum disorder (ASD) demonstrate low levels of community participation, though no studies have examined the perceived value and satisfaction when assessing community participation among young adults with ASD. Using the Temple University Community Participation measure, young adults with and without ASD were compared on the frequency, perceived importance, and satisfaction of community participation. Adults with ASD participated less frequently in participation areas and identified fewer important participation areas. Importantly, no differences were reported in satisfaction with participation between the two groups despite adults with ASD participating less frequently in the community. Results suggest a need for further exploration of predictors of poor community participation in adults with ASD, as well as effective interventions targeting community participation in this population.