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Social exclusion and mental health - how people with mental health problems are disadvantaged: an overview
- Author:
- BOARDMAN Jed
- Journal article citation:
- Mental Health and Social Inclusion, 15(3), 2011, pp.112-121.
- Publisher:
- Emerald
Social exclusion is a major problem in the UK. Evidence shows that those with mental health problems or learning disabilities are excluded from participation in many areas of society. This article provides an overview of aspects of social exclusion, and the way in which certain groups are excluded from mainstream society. It summarises the main findings of the work of the Royal College of Psychiatrists Scoping Group on Social Exclusion and Mental Health. The article suggests that a person is socially excluded if they do not participate in key activities of the society in which he or she lives. People with mental health problems, particularly those with long-term psychoses, are among the most excluded groups. They may be excluded from material resources and living in relative poverty, excluded from socially valued productive activity, excluded from social relations and neighbourhoods, and also excluded from civic participation and health and health services.
Social exclusion and mental health: review of literature and existing surveys
- Author:
- PAYNE Sarah
- Publisher:
- Poverty and Social Exclusion in the UK: the 2011 survey
- Publication year:
- 2011
- Pagination:
- 12p., bibliog.
- Place of publication:
- Bristol
Poverty and Social Exclusion (PSE) project aims to advance the theory and practice of poverty and social exclusion measurement. This research has three main objectives: to improve the measurement of poverty, deprivation, social exclusion and standard of living; to assess changes in poverty and social exclusion in the UK; and to conduct policy-relevant analyses of poverty and social exclusion. This report presents the rationale for the inclusion in the PSE survey of questions relating to the relationship between social exclusion and mental health problems. Poverty and social exclusion are likely to lead to an increased risk of mental health difficulties, as a result of stress or managing on a low income, living circumstances, local environment, discrimination and decreased opportunities for positive self-esteem. The mental health domain in the PSE covers questions which aim to establish the presence of mental health problems. In this survey the primary approach will be to use a well-validated instrument, the General Health Questionnaire 12 to indicate presence or absence of symptoms of common mental health problems.
Homelessness and mental health: adding clinical mental health interventions to existing social ones can greatly enhance positive outcomes
- Author:
- COCKERSELL Peter
- Journal article citation:
- Journal of Public Mental Health, 10(2), 2011, pp.88-98.
- Publisher:
- Emerald
This study investigated the association between homelessness and poor mental and physical health. A pilot project run by St Mungo's suggests that adding clinical mental health interventions makes existing social care interventions several times more effective. The aim of the project was essentially to test the hypothesis that if chronically excluded adults were excluded because of their psychological disorders could a psychotherapeutic intervention reduce their exclusion? Two hundred and seventy four people were invited to attended therapy, of which 70% participated. Of those who did attend assessment, 80% went on to attend four or more sessions; most clients attended either two to four sessions, or more than 12. Attendance overall was 76%, and non-attendances were noted on 11% of occasions. Many homeless people become caught in the trap of hostels, prison, hospitals and the streets, often for many years. This study suggests that this form of homelessness affects people because of their mental health, and that social solutions alone are not sufficient. The authors concluded that offering clinical interventions alongside social ones could begin to transform this situation.
Turning the Tide: a Vision Paper for multiple needs and exclusions
- Author:
- PAGE Anna
- Journal article citation:
- Advances in Dual Diagnosis, 4(4), 2011, pp.173-179.
- Publisher:
- Emerald
This article summarises the 2011 publication, “Turning the Tide: A Vision Paper for multiple needs and exclusions” by Revolving Doors and Making Every Adult Matter, and addresses the financial and social costs of society's failure to support adults facing multiple needs and exclusions in England. The report showed that people with multiple needs and exclusions experience several problems simultaneously and have ineffective contact with services. The article sets out the vision that in every local area people facing multiple needs are supported by effective coordinated services. It argues that to achieve this, a new approach is needed, and five key areas to achieving this are examined. The article shows how politicians, local leaders, and commissioners can act to make coordinated services for people facing multiple needs and exclusions the norm, and is of relevance to service providers to tackle multiple needs by building partnerships, taking proposals to commissioners, and supporting members to develop new approaches to care.
Tackling homelessness and exclusion: understanding complex lives
- Author:
- MCDONAGH Theresa
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2011
- Pagination:
- 15p.
- Place of publication:
- York
Homelessness is often something that is inextricably linked with complex and chaotic life experiences. Mental health problems, drug and alcohol dependencies, street culture activities and institutional experiences are often closely linked with the more extreme experiences of homelessness. This paper explores evidence collected as part of the Multiple Exclusion Homelessness (MEH) Research Programme. The programme provides a statistically robust account of MEH in seven UK cities, alongside evidence from the life histories and accounts of people with first-hand experience of MEH and reflections from front-line workers, managers and commissioners. The paper looks at services for people with complex needs and suggests ways that policy and practice can more effectively tackle homelessness. Key points show that most complex needs were experienced by homeless men aged between 20 and 49, and especially by those in their 30s. Where homelessness and housing support agencies take on primary responsibility for supporting people with multiple and complex needs, workers can often feel isolated and out of their depth. It has been suggested that housing support workers are now filling the gap left by the retreat of social workers from direct work with adults. The paper concludes that there needs to be an integrated response across health, housing and social care.
Turning the tide: a vision paper for multiple needs and exclusions
- Authors:
- PAGE Anna, HILBERY Oliver
- Publisher:
- Making Every Adult Matter
- Publication year:
- 2011
- Pagination:
- 23p.
- Place of publication:
- London
This publication calls for a vision, that, in every local area, people experiencing multiple needs are supported by effective, coordinated services and empowered to tackle their problems, reach their full potential and contribute to their communities. The publication suggests that, despite some good progress, it is clear that local services cannot achieve this vision alone. Too often offering coordinated services means going against policy and battling for political and strategic engagement. A new approach is needed from national government to create an environment in which it becomes the norm for leaders in local areas to put in place the coordinated services that have been shown to work for this group. The Vision Paper is aimed at government ministers, Members of Parliament and key local decision makers. It sets out five building blocks for the new approach with recommended actions for each. Each of these is covered by a two-page spread setting out the problem thoughts on the solutions. Areas addressed include: communicating a clear message that tackling multiple needs and exclusions is a government priority; defining and identifying people experiencing multiple needs and exclusions; creating accountability, leadership and transparency; making outcomes and commissioning work for this group; and getting the finances right in local areas.
Addressing the impact of social exclusion on mental health in Gypsy, Roma, and Traveller communities
- Authors:
- LAU Annie Yin-Har, RIDGE Michael
- Journal article citation:
- Mental Health and Social Inclusion, 15(3), 2011, pp.129-137.
- Publisher:
- Emerald
This article reviews the impact of social exclusion on mental health in Gypsy, Roma, and Traveller (GRT) communities. It also presents suggestions for services to address it. Areas considered include accommodation, education, employment, health, gender, poverty and discrimination, which together show that members of these communities suffer significant inequalities in all health and social spheres. While examples of good current provision are outlined, a case study demonstrates the problematic social context in relations between traditional GRTs and the settled community. The article aims to contribute to raising public awareness in supporting members of the community in participation in policy and decision making. In conclusion, gaps in commissioning arrangements and poor support for health and social care needs of the GRT communities are discussed.
Staff and ex-service user co-working: a counselling service's enhanced response to multiple exclusion homelessness
- Authors:
- CONOLLY John, ASHTON Paul
- Journal article citation:
- Housing Care and Support, 14(4), 2011, pp.134-141.
- Publisher:
- Emerald
This article presents a novel collaboration between a worker and a former service user in developing two support groups – an art group and an alcoholics anonymous group at a central London hostel for the homeless. It begins with an overview of policy frameworks and research that promote and advocate inclusion practice; then gives an account of the origins and development of the collaboration initiative. The main challenge for professionals lies in the need for reflective practice and to challenge their own personal investments in the maintenance of their professional role and status. For ex-service users, the challenge is to overcome low self-confidence, the safety of the service user role, and to realise that, despite real obstacles, a useful contribution can be made to society. This can therefore be seen as a journey for both parties. The article provides unique learning into the development and running of support groups, resulting from the collaboration between workers and former service users.
Paul's journey
- Author:
- ASHTON Paul
- Journal article citation:
- Housing Care and Support, 14(4), 2011, pp.142-144.
- Publisher:
- Emerald
This article presents a personal account of one of the authors of “Staff and ex-service user co-working: a counselling service's enhanced response to multiple exclusion homelessness” (Housing, Care and Support, 14(4), pp. 134-141), which presents a novel collaboration between a worker and a former service user in developing two support groups – an art group and an alcoholics anonymous group at a central London hostel for the homeless. It is published to appear alongside the account of the authors’ joint experience of co-working, as part of the series on personal perspectives on development work. It aims to give an account of the author’s journey into homelessness and mental health problems in the context of multiple exclusion and homelessness.
Observations on alcohol-related mental illness in the North West of England: better use of service data can help tackle health inequalities and improve commissioning
- Authors:
- TOCQUE Karen, et al
- Journal article citation:
- Advances in Dual Diagnosis, 4(3), 2011, pp.125-134.
- Publisher:
- Emerald
The North of England characteristically has higher levels of alcohol-related harm and higher levels of mental illness compared with the South. Observations from several different NHS datasets are presented in an attempt to better understand how inequalities in dual diagnosis (DD) with alcohol–related mental illness affect the general population and the delivery of health services. The study found that there are high levels of DD of alcohol and mental health in the North West with significantly higher rates in the more socially deprived areas and gaps in access to services. It is noted that these health inequalities in relation to DD can only be demonstrated robustly for hospital inpatient admissions because other datasets currently provide intelligence only for larger geographical areas. The authors suggest that these data could be better used to inform joint commissioning. They also suggest that further work extending their initial evaluation of the cost of DD services is required so that commissioners can purchase services in relation to outcomes and/or proven cost-effective treatments or interventions.