정신장애인의 자립생활(Self-Determined Living) 적응 경험에 관한 국내ㆍ국외 비교를 위한 메타에스노그래피 분석: 한국ㆍ미국ㆍ영국을 중심으로 = A Meta‑Ethnographic Analysis Comparing Domestic and International Adaptation Experiences of People with Psychiatric Disabilities in Self‑Determined Living: Focusing on Korea, the United States, and the United Kingdom

다국어 초록 (Multilingual Abstract)

This study conducted a meta‑ethnographic synthesis of 21 qualitative investigations published between January 2000 and December 2024 in Korea, the United States, and the United Kingdom that explored self‑determined living among people with mental illness. Applying Noblit and Hare’s seven‑step meta‑ethnography, we reciprocally translated participant narratives and re‑assembled themes, concepts, and metaphors. The synthesis identified five interlocking pillars that must operate simultaneously for long‑term maintenance of self‑determined living: housing and economic stability, multilayered social support, iterative self‑determination experiences, stigma reduction, and 24‑hour crisis response. Although these pillars emerged across all three countries, their strength and interaction varied by socio‑institutional context. In Korea, short‑term supportive housing, low‑wage employment, and family protectionism constrained early self‑determination. In the United States, choice‑driven services were well established, yet county‑level fiscal disparities widened regional gaps. In the United Kingdom, Direct Payment institutionalized autonomy, but repeated welfare cuts threatened service continuity. These findings highlight the need for a densely woven, context‑sensitive multi‑pillar ecosystem in national deinstitutionalization policies. For Korea in particular, priorities include expanding long‑term supportive housing, scaling decision‑making training through Independent‑Living Centers, and legislating a digital–mobile hybrid crisis‑safety network.