Our objective is to identify links between physical health and community participation among individuals with schizophrenia or a psychosis mental illness. Semi-structured qualitative and quantitative interviews and community tours were conducted over 10 months (N = 30). Interviews were transcribed and analyzed using a grounded theory coding strategy. Physical health played an important role in community participation both as a cause and consequence. Key processes included mobility issues impeding physical community involvement; a multi-directional relationship between social relationships, community involvement, and physical health; identity as a mechanism linking physical health problems and community engagement; and the potential for community-based mental health programs.