The impact of psychosis on social inclusion and associated factors

Abstract

Background:People with mental health problems are known to be socially excluded but the contribution of pre-morbid characteristics, symptoms and needs, and the impact on quality of life is unknown.Aims:To investigate change in social inclusion after the development of a psychotic Illness and factors associated with this.Methods:A cross-sectional community survey of people with psychosis was carried out in three areas of London. Five domains of social inclusion (social integration, consumption, access to services, productivity, political engagement) were assessed prior to the onset of illness and currently using the Social Inclusion Questionnaire User Experience. Quality of life, symptoms and needs were also assessed using standardized measures. Factors associated with change in social inclusion were investigated using multiple regression.Results:Productivity and social integration among the 67 participants reduced after the onset of psychosis. Older age at onset and longer duration of illness were associated with greater reduction in productivity. Less reduction in social integration was associated with greater quality of life. Participants reported barriers to social inclusion that were directly related to symptoms of their illness, low confidence and poor self-esteem.Conclusions:A greater focus on interventions that can facilitate the occupation and the social networks of people with psychosis is required. Interventions that tackle ‘self-stigma’ may also prove useful in mitigating the social exclusion experienced by people with psychosis.

Stigma and discrimination in mentally disordered offender patients – a comparison with a non-forensic population

“…One explanation for this may be that individuals with severe mental illness lower their expectations in terms of what they might participate in or achieve, as they age. Moreover, this could suggest that experienced stigma results in a progressive narrowing of aspirations, expectations and social participation over time (Corrigan & Watson, 2002;Killaspy et al, 2014).…”

A review of social participation interventions for people with mental health problems

“…Reasons for this are related both to negative symptoms of the disorder: anhedonia, emotional dullness and low energy, which impairs the motivation and ability to establish and maintain social relationships [8]; low confidence and poor self-esteem [9, 10]; as well as marked social disadvantages such as unemployment [10] and a higher likelihood of living alone [11] with fewer opportunities to utilise social skills. It is unclear whether these are a consequence of the illness or whether they predate it [12].…”

From the rhetoric to the real: A critical review of how the concepts of recovery and social inclusion may inform mental health nurse advanced level curricula — The eMenthe project

“…In order to promote socially inclusive outcomes, various skills can been identified from the literature: e.g. mapping community services (Stickley, 2005); counteracting social isolation (Tooth et al, 2003;Borg and Davidson, 2008;Dorer et al, 2009;Bradstreet and McBrierty, 2012;Edgley et al, 2012;Fieldhouse, 2012b;Tew et al, 2012;Killaspy et al, 2014); strategies for overcoming stigma within communities as well as amongst professionals (Martyn, 2002;Bertram and Stickley, 2005;Felton et al, 2009;Mezey et al, 2010;Quinn et al, 2011;Evans-Lacko et al, 2014;Killaspy et al, 2014).…”