First Advisor

Greg Townley

Term of Graduation

Spring 2023

Date of Publication


Document Type


Degree Name

Doctor of Philosophy (Ph.D.) in Applied Psychology






community mental health, COVID-19 pandemic, mental health services, serious mental illness



Physical Description

1 online resource (v, 254 pages)


Community mental health centers (CMHCs) have been underfunded and overburdened since Reagan-era disinvestment and the United States' move toward neoliberalism. Rates of mental illness have been rising consistently, particularly in Oregon, as CMHCs face continuing financial pressures and staff retention issues. This was before the COVID-19 pandemic. Today, we are still trying to understand the ongoing pandemic's impact on people with serious mental illnesses (SMI). Most of the studies in this area thus far are quantitative, and first-hand accounts of the pandemic from people with SMI are largely absent. Additionally, research in this area fails to draw on critical alternative models for mental illness found in social movements and disciplines such as the consumer/survivor/ex-patient movement, Mad Studies, and Disability Studies.

In this study, I used a narrative inquiry approach to qualitatively interview 15 CMHC clients with SMI. I also interviewed five staff members and six members of leadership to contextualize the impact of the pandemic on clients. Drawing on thematic narrative analysis and other approaches, I generated richly detailed themes, paying special attention to recurring ideas and metaphors, how the interviews unfolded, and the emotional significance of the themes.

Client themes included feeling left behind as a person with disabilities; the impact of staff turnover; difficulty accessing resources; negative experiences including racism, exhaustion, depression, and isolation; the pandemic as a time for self-work; the potential of the pandemic to create empathy for people with SMI; and a critique of the pandemic as a "great equalizer" Staff themes included burnout and struggle at work; perceptions of clients' independence and coping skills; and whether CMHCs would be able to return to their pre-pandemic functioning. Leadership themes included team cohesion; tensions with staff; and organizational changes that were prompted by the pandemic.

This study adds new perspectives to the growing literature on the COVID-19 pandemic and encourages further investigation into changes in policy and practice that were implemented during the pandemic. It also highlights potential avenues for improvement at CMHCs. Additionally, these CMHC clients offer counternarratives to dominant narratives in the literature and among CMHC staff and leadership about how people with SMI have experienced the pandemic. Reading these narratives may challenge the way CMHC staff and leadership think about people with SMI, and allowing their stories to relate to our own lives may create empathy for people with SMI.


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Persistent Identifier

Available for download on Thursday, May 16, 2024

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