Connectedness: The Core of Human Experience and Essential Component to Mental Health Recovery

Natalie Aga, Ghent University
Sara Rowaert, Ghent University
Freya Vander Laenen, Ghent University
Stijin Vandevelde, Ghent University
Tom Vander Beken,Ghent University
Kurt Audenaert, Ghent University

Objective: Connectedness is placed at the heart of the recovery process in mental health care. However, in regard to persons labeled not criminally responsible (NCR), considerations of recovery and connectedness remain in the background. The aim of this study is to understand and explore how individuals labeled not criminally responsible experience connectedness. Research method: Sixty-seven in-depth interviews were examined and thematically analyzed. Results: Interviews revealed emotional, functional and personal connectedness as categories of connectedness, each with different qualitative determinants. Conclusion: This study shows that connectedness should be considered as an essential ingredient of the recovery process by practitioners as well as policy makers. We recommend a shift from an individualistic, punitive approach toward a recovery-supportive rhetoric and more ‘shared decision making’ between service users and providers at all levels.

Connectedness, recovery, not criminally responsible, qualitative research

“Studies show an overrepresentation of persons with a mental illness in the criminal justice system…with an additional concern that prevalence rates are rising…numerous scholars have repeatedly pointed at the particular mental health and criminal rehabilitation needs of this population…Despite the growing interest in strengths-based research that promotes integrated and holistic approaches in the context of offender rehabilitation…studies have paid little attention to offenders’ well-being, aspirations and lived experiences…In order to empirically substantiate our understanding and support of this marginalized group, this study aims to understand and explore how persons labeled not criminally responsible feel connected and how this is embedded in their lived experiences…Furthermore, this study investigates what study participants aspire to in relation to connectedness…” (p.303-305).

“Participants (N=67) were purposively recruited across services for persons NCR in Flanders (Belgium)…and included settings with different security levels (low – medium – high). Persons of whom the measure had been abrogated were also contacted…Based on in-depth interviews…the results of the study revealed a myriad of barriers which jeopardize connectedness. In addition to these obstacles, we identified three categories of connectedness, defined as “(the ability) to experience relatedness”: emotional, functional and personal connectedness…A common aspect in the categories of connectedness we encountered is the emphasis the respondents put on the quality of connectedness…the participants need the quality of these connections to be of such a level that it enables them to really mean something in a social context…” (p.310).

“Regarding the first category…”belonging” is seen as a central characteristic and is, in turn, multidimensional. The respondents experienced belonging as feeling at home, feeling safe when others are around…and being attached to places…and objects…Belonging is closely linked to, but not the same as, social inclusion, a second key characteristic of emotional connectedness…The narratives revealed “connectivity” as a third central characteristic of and inseparable from emotional connectedness. Connectivity emphasizes the need for a much closer focus on the significance of processes of ‘enabling,’ facilitating the capability of being relationally connected…” (p.310).

“The second category of belonging, functioning connectedness, refers to functional abilities, and is predominately associated with behavioral and material aspects…The respondents drew much attention to the importance of respecting periods of disengagement to endorse sustained connectedness. This is provoked by their desire not to lose their social achievements and to achieve a full engagement in their relational roles…Finally, the respondents’ narratives revealed the importance of a third category, namely personal connectedness. Being introspective, having a sense of self and physical appearance play a crucial role for the respondents to be able to feel connected. Overcoming obstacles in this area was prominently featured in the interviews, which uncovered that the intrinsic barriers to these self-regulatory processes were gradually built during the participants’ lives, thus nourishing pathways to offending…The narratives also frequently demonstrated how negative friendships build obstacles, and thus activate a subset of counter-reactions to determine who will genuinely ‘be let in’ by the participants…” (p.311).

“Connectedness and its three dimensions…are imperative to shape personal recovery, but challenged by various externally imposed motives. A key role for professionals lies in enabling a genuine feeling of connectedness by providing meaningful encounters and environments to prevent socially [un]desirable elements from predominating the respondents’ needs. Having uncovered external barriers, this study reveals a pivotal need to discuss these barriers from a multidisciplinary perspective (legal, clinical, criminological, and orthopedagogical) without ‘overformalizing’ the concept, keeping the individuals’ lived experiences and needs as guiding principles. The Good Lives Model (GLM) of offender rehabilitation could offer promising pathways in this respect (Maruna et al., 2004). The GLM is a strengths-based approach that supports persons who offended to develop internal and external resources to build a fulfilling and prosocial life…” (p.312-313).

“…Another way to further delineate the concept of connectedness and learn how to put ‘enabling’ into practice is to involve persons with lived experiences in protocol and policy development, since our findings underpin the importance of individuals’ voices and subjective interpretations of this concept. Only relying on objective and quantitative measures and developing fixed standards may undermine the value of genuine lived experiences, for example for policy objectives…connectedness should be considered as an essential ingredient of the recovery process by practitioners as well as policy makers…A cultural transformation in favor of the recovery paradigm embedded in lived experiences is championed and requires a shift from an individualistic, punitive approach toward a rhetoric of shared responsibility on a relational, organizational, and policy level” (p. 313).

“Within the Belgian legislation, persons with severe mental illness who were unable at the time of the offense to appreciate the nature and quality of their actions can be judged not criminally responsible (NCR) and become subject to an ‘internment measure…’ This measure has a three-fold goal: 1) the protection of society; 2) care provision that is proportionate to their needs, and 3) a clear focus on re-integration…The CPS [Chamber for Protection of Society] can assign the interned person to different types of treatment and support, based on diagnosis, risk and security level. The Chamber is also responsible for the implementation of security measures and decides whether and when a person will be (un)conditionally released…” (p.303)

“…An experienced barrier to connectivity is relational discontinuity in care and support, exemplifying the discrepancy between service-based continuity of care and its relational counterpart…Our findings show the respondents’ preference to have on-going, informal contact with professionals, irrespective of their official role. The participants identified a continuous bond with “persons” as primordial, instead of linking continuity to “treatment and services.” This may be due to a past pattern of disruptive and insecure attachments and the presence of a punitive and regulative environment…” (p.310-311).

As always, please join the discussion below if you have thoughts or comments to add!