‘Modelling social exclusion in a diagnostically-mixed sample of people with severe mental illness’

Abstract

Background: Social inclusion is an important indicator of recovery in individuals with severe mental illness. The Social Inclusion Questionnaire User Experience (SInQUE) is a new measure of social inclusion for mental health service users which assesses five domains (consumption, production, access to services, social integration and civil engagement). It has good psychometric properties and is acceptable to service users and mental health professionals. It is not clear whether individuals with different diagnostic conditions experience a similar reduction in social inclusion. Aims: (1) Investigate whether current social inclusion differs between diagnostic groups (people with schizophrenia/other psychotic disorders, common mental disorder or personality disorder); (2) Identify factors associated with lower social inclusion; (3) Examine associations between social inclusion and stigma, quality of life and loneliness. Method: Mental health service users with psychotic disorder, personality disorder or common mental disorder, living in the community, completed the SInQUE, alongside other validated outcome measures. Multiple regression investigated associations. Results: About 192 service users (55% with psychotic disorder; 26% with common mental disorder; 19% with personality disorder). Current social inclusion did not vary according to diagnosis, except for the sub-domain of productivity, where individuals with personality disorder were more socially included than the other two groups. Lower social inclusion was associated with older age ( p = .008), lack of higher education ( p < .001), more previous admissions ( p = .005), severity of current symptoms and greater experienced stigma ( p = .006) and anticipated stigma ( p = .035). Greater social inclusion was associated with better quality of life ( p < .001) and less loneliness ( p < .001). Conclusions: Barriers to social inclusion in individuals with severe mental health problems include factors related to the illness, such as symptom severity and external factors, such as stigma and discrimination. Social inclusion is a recovery goal and should be routinely assessed. Increasing people’s social inclusion benefits service users in terms of improved mental health, better quality of life and reduced loneliness.

A Web-Based Tool to Assess Social Inclusion and Support Care Planning in Mental Health Supported Accommodation: Development and Preliminary Test Study

“…Social exclusion can be conceptualized as both a cause and a consequence of mental illness [ 12 ]. Furthermore, greater social inclusion is associated with better quality of life and lower levels of loneliness among those with severe mental illness, suggesting that social exclusion is an important area for mental health practitioners to try to address [ 13 , 14 ].…”

“…However, stakeholder feedback from a previous study testing the SInQUE indicated that the measure may be useful in clinical practice to assess social inclusion, facilitate important conversations with service users, and guide care and support planning [ 34 ]. Furthermore, a consistent research recommendation from the developers of the SInQUE tool has been to investigate whether the measure has utility as a care-planning tool to promote social inclusion in routine mental health practice [ 13 , 34 ].…”

Development and preliminary testing of an online tool to assess social inclusion and support care planning in mental health supported accommodation

“…Furthermore, a consistent research recommendation from the developers of the SInQUE tool has been to investigate whether the measure has utility as a care planning tool, to promote social inclusion in routine mental health practice [13,34].…”

“…Social exclusion can be conceptualized as both a cause and a consequence of mental ill-health [12]. Furthermore, greater social inclusion is associated with better quality of life and lower levels of loneliness among those with severe mental illness, suggesting that social exclusion is an important area for mental health practitioners to try to address [13,14].…”

“…However, stakeholder feedback from a prior study testing the SInQUE indicated that the measure may be useful in clinical practice to assess social inclusion, facilitate important conversations with service users, and guide care and support planning [34]. Furthermore, a consistent research recommendation from the developers of the SInQUE tool has been to investigate whether the measure has utility as a care planning tool, to promote social inclusion in routine mental health practice [13,34].…”