Neighbourhood Response to Community Mental Health Facility Locations

Abstract

<p>The focus of this thesis is upon aggregate neighbourhood response to community mental health facilities. The mentally ill are increasingly being moved out of large institutional treatment settings to receive care from a range of small-scale facilities in the community. Opposition to facility locations has impaired the effectiveness of the community mental health movement and had important ramifications for the social and spatial structure of modern urban areas. Opposition represents a form of neighbourhood response to the perceived externality impacts of facilities exercised as communities act to protect their investment in the neighbourhood environment by territorially excluding the mentally ill. A thorough understanding of this aggregate group-based response is of critical importance to the continued operation of the community mental health movement as well as to our understanding of modern urban sociospatial structure.</p> <p>This thesis develops and tests an operational model of nieghbourhood response. This model specifies a multi-stage process of facility impact and externality field perception which serves to determine neighbourhood response and ultimately, adjustments to the urban landscape. This process is related to a number of contextual variables representing the population surface of a host neighbourhood, the externality surface generated by a facility, and individual stake in the conflict issue. This model was tested using a sample of residents from Toronto, Ontario.</p> <p>The findings indicate that community mental health facilities are perceived as having little impact upon residential neighbourhoods; some concern is apparent, however, over the effect of facilities upon residential property values. Perceived facility desirability tends to decrease with proximity to facilities, indicating the existence of an externality field conforming to a distance-decay relationship; the intensity and extent of this field is nonetheless highly constrained. The externality fields serve to arouse only a limited degree of opposition to facility locations. The propensity for response is related to perceived facility desirability, and increases with advanced proximity to the facility. No significant relationships between the perception and response processes and the analysis variables could be detected.</p>