There is strong commitment to social inclusion in UK mental health policy and, more broadly, in European social policy. We need to work together with our colleagues in local authorities, the wider NHS and voluntary organisations to develop outcomes that will promote opportunities and choice for people we work with that are meaningful and lasting.". ... and Mental Health Europe, for their helpful assistance. HOUSING. Each of these implies certain remedies for exclusion or approaches to inclusion, and thereby offers indications for mental healthcare and other agencies tasked with addressing social exclusion. This in turn increases perceived similarity between the two groups and promotes greater liking. Social inclusion is a worthy goal of mental health services, but its attainment requires extensive social change. For the most part, the social integrationist perspective fails to address exclusion in the work place and gives little importance to unpaid work within society, which includes voluntary work, caring for dependants, neighbourhood and political involvement, and other activities associated with the strengthening of communities and the welfare of individuals. A local NHS Trust has reconfirmed it’s commitment to social inclusion for people living in Calderdale, Kirklees and Wakefield who have mental health problems. A coherent theory of social inclusion in mental health could act as a fulcrum, turning policy commitment into systemic change. Remedies might include programmes targeted at specific social groups, for instance work-related training and parenting classes. It became influential in social policy at national and international levels during the 1990s (Reference Dahrendorf, Frank and HaymanDahrendorf et al, 1995; Reference Rodgers, Gore and FigueiredoRodgers et al, 1995; Reference RoomRoom, 1995). And breaking down barriers to employment goes hand in hand with promoting social inclusion’ (Department of Work and Pensions, 2003: p. 3). Date: 5th March 2008. The higher goal of ‘social cohesion’ has been introduced as the justification for actions to reduce social exclusion. evidence linking social inclusion with positive mental health. 5 This unit will focus on mental health promotion, prevention and early intervention and will also examine processes by which individuals and groups are included or excluded in society. In the moral underclass discourse this unfavourable treatment is judged to be the fault of the victim, but in the societal oppression discourse, it is blamed on an unjust, powerful overclass. From this perspective, exclusion limits the interactions that are possible between individuals, families, communities, regions and even nations. The redistributionist discourse: exclusion results from poverty and can be prevented by redistribution of wealth, 2 The life domains of the Social Inclusion Database, • Physical exercise and sports activities. Step-by-step guides to socially inclusive mental health services are available (Department of Health, 2006a Published online by Cambridge University Press:  These factors may be interrelated, such as poverty, poor housing, poor education and poor health. Students will be introduced to social inclusion as a determinant of health, a public health approach to the prevention of mental health problems and the promotion of mental health. Thanks to the community mental health and recovery fields, there has been a shift toward perceiving people with mental health diagnoses as being capable of living meaningful lives in their community. In the face of the rapid changes brought about through economic integration and migration across the continent of Europe, social cohesion has emerged as a major policy objective in the UK as in other European nations (Reference LevitasLevitas, 2005): social exclusion poses a threat of social disintegration and, with it, economic failure. To return to the questions implied at the outset, can social exclusion be remedied, should it be addressed and, if so, what responsibility does the psychiatrist have in this? The database gives examples of what is being done in the name of social inclusion in mental health, but the rationale behind these activities is not explained and, as we have already been pointed out, there is danger in using the term ‘social inclusion’ simplistically to convey general approval. Secker, Jenny This is the understanding of social exclusion that dominates European social policy. e a moral underclass leads to greater exclusion. }. Floyd, Mike Total loading time: 0.469 2 This programme is designed to coordinate government departments and is divided into seven areas, listed in Box 3. From a dynamic perspective, the process whereby a person becomes socially excluded can be intercepted and countered. Slade, Jan Office of the Deputy Prime Minister, 2004, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_074241, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_074579, http://www.dwp.gov.uk/publications/dwp/2003/nap/nap.pdf, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4131059, http://www.rcpsych.ac.uk/pdf/Segregationinclusion.pdf, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4087169, http://www.cabinetoffice.gov.uk/social_exclusion_task_force/context. Responses to multiple disadvantages need to be multifaceted. The European Union set up an observatory on national policies to combat social exclusion in 1991, and continues to reinforce the theme by requiring national governments to submit annual reports on how they are tackling the issue. Query parameters: { For example, one remedy implied by the relativity of social exclusion is to reduce the differences between people with mental health problems and others. "metrics": true, Direct payments may reduce the relative disadvantage but might also entrench the individuals' dependence on benefits, preventing increasing social inclusion when their illness improves or remits. Render date: 2021-01-17T13:58:08.436Z ) showed just how far people with mental health problems fit the definition of the ‘socially excluded’. Prison is an example of social exclusion that is planned and implemented by a system established to protect society and punish deviants. Across Europe, male mortality is 210% higher in the 15–64 age range (White, 2011). Suggested actions from the conference included: removing barriers between services to help achieve real contact with local community services; address obstructions to education and employment; and health promotion programmes to de-stigmatise mental illness. In the UK today, there is a strong consensus that the state has a role in reducing social exclusion; this follows directly from much European economic and social policy and it is also the understanding of the United Nations. This is the most common understanding of social exclusion, and is reflected in the accusations against schools and rail companies cited above. Psychiatrists are clearly expected to play their part: in April 2007 social inclusion was named as a policy priority for mental health services over the next few years (Reference ApplebyAppleby 2007a Not only is this more inclusive, it may also be more effective (Reference Schneider, Carpenter and WooffSchneider et al, 2002; Reference Carpenter, Schneider and McNivenCarpenter et al, 2004). Dickens, Geoffrey L. Rinaldi, Miles A meta-analytic test of intergroup contact theory, Journal of Personality and Social Psychology, Social Inclusion and Recovery: A Model for Mental Health Practice, Direct what? ). This is one factor that keeps the theme live in UK policy circles and it tends to be adopted by interest groups whenever an injustice is perceived or policy priority is sought. These higher goals are formulated in abstract terms: ‘law and order’ or ‘economic prosperity’. Reference Noble and DouglasNoble & Douglas (2004) reported that service users want more involvement in decision-making about their own care, whereas carers want good information and communication with services. Resource 1: Social Inclusion as a determinant of mental health and wellbeing Resource 2: Burden of Disease due to mental illness and mental health problems Resource 3: Ethnic and race-based discrimination as a determinant of mental health and wellbeing Resource 4: Violence against women in Australia as a determinant of mental health and wellbeing One might think that people who cannot afford to take the train are not disadvantaged in any other way, but describing their situation as social exclusion draws attention to the possibility that without this mode of transport they are also at risk of missing out on other entitlements, perhaps education or employment. Promoting the efficiency and effectiveness of charities (RR14) Promoting social inclusion and social protection, promotes the subjective mental health and well-being of people, builds the capacity of communities to manage adversity, and reduces the burden and consequences of mental health problems. Until relatively recently, many were hidden away from the rest of society in institutions. With its focus on individuals and families, this discourse gives little attention to the structural or institutional factors that contribute to exclusion, such as inadequate housing, lack of amenities and labour market forces. Social inclusion in mental health may be described as ‘a discourse in search of a theory’. Each describes a dyadic relationship (criminal justice system–prisoner, owner–slave) that is understood to have goals beyond the immediate interests of the parties directly involved. There is an imbalance of power between service providers and service users or carers. 3 Challenging stigma around mental illness and promoting social inclusion using the performing arts J R Soc Promot Health . Social exclusion is ‘dynamic’, meaning that: a once people have been excluded they remain that way, b exclusion is passed from one generation to the next, d exclusion leads to greater social mobility. 1 Increasing the social inclusion of young people with SMI in particular is a key indicator of Australia’s Fourth National Mental Health Plan (Department of Health, 2009). It may be helpful to consider these responses in relation to alternative ‘discourses’ of social exclusion. Within services, structures, systems and the balance of power between clinician and patient will have to be re-examined. 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