Structural Barriers to Citizenship: A Mental Health Provider Perspective

This study employed a citizenship measure to explore mental health providers’ views of citizenship to support the societal participation of people with mental illnesses, with citizenship defined as a person’s (or people’s) strong connection to the 5Rs of rights, responsibilities, roles, resources and relationships and a sense of belonging that is validated by others. Providers identified key structural barriers to full citizenship for clients. Their comments reflect openness to citizenship as a framework for understanding their clients and the need for greater access to normative community life, but also skepticism regarding providers’ and public mental health centers’ abilities to incorporate citizenship approaches in current care models. Findings suggest there are challenges to implementing “citizenship-oriented care” in public mental health settings, but efforts to address these challenges can support the goal of “a life in the community.”