Citizenship programmes: the experience of students in Scotland and the US

25th October 2017

This article* looks at the contribution of Citizenship programmes in achieving citizenship and recovery – the experience of students in Scotland and the US.

The importance of maintaining human rights and increasing citizenship in supporting people experiencing mental illness is an increasing part of both public policy and service design in both Scotland and the U.S. These policy developments reflect a drive to ensure that all citizens are able to meet their responsibilities, claim their rights and be protected from discriminatory actions that may reduce their legal, civil, political and human rights. Despite this policy context, individuals accessing services often report a reduced sense of citizenship characterised by a sense of community disconnection and a dependence on services for their social networks. It has also been suggested by those experiencing mental illness that community participation can improve both quality of life and recovery.

This article considers the ways in which a Citizenship Programme developed by the Program for Recovery and Community Health (PRCH) at Yale University in the US and replicated by Turning Point Scotland (TPS) adapted for a Scottish context helped to reconnect participants to their communities and to enhance their citizenship overall. These programmes aimed to assist students who have experienced a significant life disruption such as a mental illness to acknowledge their existing skills, develop new skills and to develop valued social roles within their communities as part of their recovery and a bridge towards re-building their citizenship.

Background to the programmes in the US and Scotland

U.S.

The U.S. Citizen’s Project was piloted by PRCH in 2000 and has subsequently expanded and replicated in various locations in Connecticut and internationally. The Citizen’s Project is a six-month programme that runs twice weekly. Students must be currently receiving care/follow-up for mental illness for co-occurring mental health and substance abuse and have had involvement in the criminal justice system (arrest, probation, parole or incarceration) within the past three years. Students are recruited from various service agencies and a large number of referrals are from graduates of the programme. Service providers do not simply refer a potential student; the individual must contact the programme directly. Citizen’s Project participants are referred to as “students” because they are appreciated holistically as human beings who are students of life, not as individuals who are ill, as the word “patient” implies or someone who receives services, as the word “client” implies; reflecting a strengths-based approach.

There are four components to the Project: 1) Citizen’s classes are built upon the five “R’s” of Citizenship: rights, responsibilities, roles, resources, and relationships, as well as a perception of belonging in the community; 2) “What’s Up?”, a student facilitated support group where participants have the opportunity to share what is going on in their lives and receive and give feedback to one another; 3) Valued Role Projects are individual or group projects that are inspired by participants’ knowledge, passion, and life experiences; and, 4) Wrap around peer support is provided by Peer staff who; have had similar life experiences.

The participants explore in the program and “What’s Up?” how to build a community and family. They learned that what they say and how they say it matters and impacts their relationships. They also learn that what they have to offer is of value and that they are important to themselves and to others. Whilst it takes some time through this process, participants learn to trust one another and that they can be trustworthy as well. In the group, there are a diversity of personalities and worldviews, by working together they learn to be more accepting of each other’s differences and therefore accepting of themselves as well. The participants are encouraged to share their good times as well as their challenges so they celebrate themselves and others, the importance of having fun and finding the humorous side of life is also stressed.

Scotland

Connecting Citizens is a program delivered by TPS. The program, which follows the framework of the PRCH ‘Citizens’ project outlined above, has been running since February 2016.  Connecting Citizens is open to individuals who are currently accessing or have recently completed one of TPS’s services. One of the key aims of Connecting Citizens is to empower participants to build an identity away from the issues that brought them into services. As such individuals attend the program as ‘students’ rather than ‘service users’, and participants complete an application form rather than accessing the program through being referred by a key worker or practitioner.

Alongside the core components outlined above, participants are also supported to complete a college course for which they receive a formal qualification. Graduates of the program have the opportunity to take on a volunteer peer mentor role with the next cohort of students.

A recent study** undertaken by the authors with graduates and existing students on both programmes found that participation in the programmes had improved the overall inclusion of participants in their communities, enhancing their citizenship, although challenges remain. The key themes identified were the importance of relationships: recognition, respect and reciprocal trust; participation; access to opportunities; identity; sense of belonging and safety; the importance of goal setting.

Involvement in the local community at a social and practicable level was at the core of considerations of citizenship by students of the programme.  The significance of communicating with and having positive interactions with others, particularly those with shared experiences, was reported. Trusting and respecting each other was deemed necessary to have a meaningful sense of community and citizenship which enabled students to learn from and advocate for one another and to give and receive feedback, something that was practiced in the “What’s Up?” part of the programmes and was considered to prepare participants to engage more effectively with their communities.

There was a clear acknowledgement of the need to ‘put yourself out there’ (Participant 2, Scotland) to engage in your local communities whether they were focused around geography or common interest and that reciprocity was required to ensure that these relationships could flourish and recognition of each other’s’ value could develop. This reciprocal trust was noted as challenging to achieve in some communities, particularly given participants’ experiences of rejection, isolation, discrimination and exclusion, but it was acknowledged that they needed to give in order to receive, (Participant 3 – Scotland) something practiced throughout the programmes:

I want to become a counsellor and give back to the community. Open a sober house or a halfway house for women (Participant 2 – US).

 

Having empathy and compassion for others whilst engaging with your communities was similarly thought to be important to become part of the community and a valued key feature of accepting communities. This was illustrated by one participant (Participant 1 – US) who noted that often exclusionary or discriminatory comments/behaviours could be based on ignorance of others experience and the responsibility to educate and/or challenge in those situations was keenly felt. Participants in Scotland noted the value of social movements and public campaigns to challenge these discriminatory perceptions (e.g. See Me campaign to challenge negative images of mental health in Scotland)

The role of peer-advocacy, knowledge exchange and peer learning in achieving citizenship and full membership in the various communities that participants were members of were also considered important. Both programmes offered these opportunities to participants and this facilitated skill development and an exchange of ideas that promoted risk taking and the development of trust. This was considered to be a key part of the journey towards recovery, reclaiming previous skills and elements of the life lost due to the specific life disruption.

Challenges to achieving citizenship and community involvement, however, remain. The evidence from students in both the US and Scotland suggests that although participants are provided with tools and skills to increase confidence and self-esteem, and skills to engage with their individual communities, communities that do not recognize, value or respect a range of life experiences will still exclude individuals and reduce their citizenship. Services and supports directed at the level of community development and engagement are therefore crucial in promoting inclusion and increasing citizenship for marginalized groups. Challenging community attitudes, stigma and discrimination is also vital. Further development of social and political movements to tackle the exclusion of those individuals experiencing mental illness at a community and broader social level, alongside equipping them for their own recovery journey are essential.

 

*Article contributors: Ailsa Stewart, University of Strathclyde, Karen Black, Turning Point, Scotland (TPS), Patricia Benedict, Programme for Recovery and Community Health (PRCH), Yale University and Victoria Benson, Programme for Recovery and Community Health (PRCH), Yale University.

**A detailed exploration of the methods and findings for this study can be found in the American Journal of Psychiatric Rehabilitation, Vol 20 (3) July-September (2017)