Citizenship and Mental Health, by Michael Rowe, 2015, New York, Oxford University Press, 247 pages, $45, ISBN 978-0-19-935538-9.
Michael Rowe, a medical sociologist, has written an excellent book that can be useful for social workers, social work students, social work educators, and social work clients. Through a discussion of 20 years of projects in Connecticut connecting mental health and citizenship, creating an empirical citizenship scale, clinical vignettes, and results of focus groups, Dr. Rowe details important innovations in practice and evaluation for citizenship and mental health. The book presents multiple perspectives of research, interventions, and community analysis, which makes it helpful for a variety of stakeholders in social work.
Dr. Rowe introduces the book with case examples of clients who have experienced difficulty in the mental health system with outreach, resulting from a lack of inclusion and citizenship in the community. The author goes on to define the importance of citizenship for clients in the mental health system. Traditionally, recovery has been the paradigm for helping people with mental illness without addressing the citizenship needs of this population. The European inclusion model of working with clients fits with the need for citizenship for the mentally ill. The balance of the book is a discussion of efforts to further the citizenship of people with mental illness.
The Citizenship Project developed into a 6-month course to enhance the community skills of clients in the areas of rights and responsibilities, knowledge of disabilities, advocacy, legal issues, speech, jobs and education, and relationships. A 2-year randomized control study of this project showed improvement in the quality of life in the experimental group after twelve months compared to the control group. The next step was the development of a citizenship measure, which was statistically validated. The author discusses this process of evaluation research.
The next stage was a citizen collaborative, which developed citizenship within the context of the mental health system in Connecticut. This phase included developing a manual for citizenship, fostering voter registration, building community at the mental health center, conducting community focus groups, and working on financial planning.
Toward the end of the book, Dr. Rowe presents the opinions of clinicians on the citizenship model. Wendy, a clinician in an acute services department, discusses the barriers to citizenship that occur when clients are struggling to survive on a daily basis.
In the final chapter, the author presents a model of citizenship and mental health in which clients are brought into treatment in an integrated mental health system that has a citizenship orientation, creating inclusion in community life. Dr. Rowe discusses the 5 Rs of citizenship, which are rights, responsibilities, roles, resources, and relationships.
In American society, the mentally ill population has been marginalized by incarceration; high rates of homelessness; not being registered to vote; and being victims of trauma, poverty, and substance abuse. In a compassionate and well-researched book, Michael Rowe presents to students, social work clients, educators, and practitioners a model of inclusion and citizenship for members of the mentally ill population to be members of American society.
Reviewed by Steven Granich, DSW, LCSW, LMFT, MPA, Assistant Professor of Social Work, Lock Haven University.