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Social Inclusion
Evidence & Policy
See evidence & policy for other inclusive practices and domains
From Social Exclusion to Inclusion?
Written by Helen Spandler, this paper critically explores notions of social inclusion in mental health and considers some of the problems associated with its wide scale adoption as a policy driver and moral imperative.
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Connect and Include
This exploratory study was commissioned and funded by the National Social Inclusion Programme (NSIP) at the Care Services Improvement Partnership and managed by the Community Development Foundation.
The study, written by Patience Seebohm and Alison Gilchrist, comprised a brief review of literature relating to relevant policy and practice, a survey and 39 interviews including community development practitioners, people with experience of mental ill-health, and staff from mental health services.
The report is concerned with the individual and the community. It explores how community development can contribute to an individual's ‘recovery' from mental ill-health and also how it can promote ‘community well-being' within a locality or community of interest. The findings suggest that by bringing people together to address their own concerns, facilitated by community development practitioners and supported through partnerships, it is possible to reduce stigma, create new community-led resources and develop new connections between individuals, groups and organisations.
Visit the National Social Inclusion Programme website
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Big Society is a new idea in government but, in many local areas, the NHS and local authorities are already supporting services and projects that use a Big Society approach to support people with mental health difficulties. The report explores and identifies the overlaps between Big Society ideas and changes that many people with mental health difficulties have long argued for.
By supporting the development of community groups, local charities and social enterprises either directly or via other bodies, the NHS has already been laying the foundations for people with mental health difficulties to make things happen for themselves away from state services.
Better Mental Health in a Bigger Society asks how the NHS and local authorities can become enablers for people and communities to take forward their own visions of mental health and wellbeing?
The provision of ‘safe space' for people with mental health problems is an important function of day services, but what it means and how it is created is by no means clear cut, and may be different for different people.
So what are the key features and characteristics of ‘safe space', what are the different ways it can be provided and how can it fit within a socially inclusive day service?
‘Defining Safe Space in Mental Health Day Services', which was recently produced through discussion between service users, trustees and staff at Bromley Mind, goes some way to answering these questions and taking forward a conversation about ‘safe space' in day services.
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These capabilities for socially inclusive practice are intended to be a resource for reflection, challenge and practice change.
Their purpose is to enable the range of organisations and practitioners involved in mental health, whether as commissioners, providers or educators, to make the values of recovery and social inclusion a reality.
Develop partners are discussing how to use this framework to enable local services to continue supporting people who use Bromley's services to realise their full potential through acknowledging their aspirations as contributors to their local communities, advancing their choices, independence and participation.
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From Social Care to Social Inclusion
This report sets out the findings of a survey of senior managers within Social Services Departments across Yorkshire and Northern England.
It seeks to identify their priorities and concerns for the future development of mental health services, to set our key issues for futher discussion and areas for potential development activity.
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Abstract from the 2002 British Psychological Society Division of Clinical Psychology in Association with the Sainsbury Centre for Mental Health and the Department Of Health Conference, chaired by Develop's Fabian Davis.
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Speaker notes taken from presentation at the 2008 Social Exclusion Conference by Ann Watt, Deputy Director of the Social Exclusion Task Force
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Mobilising NHS foundation trust governors and members to promote social inclusion through community engagement
This article describes the National Social Inclusion Programme's Communities of Influence workstream, the premises on which it was founded, the innovative social inclusion practice it proposed, what was learned and how the work will be
taken forwards in the future.
Written by Develop's Fabian Davis, and Naomi Hankinson, Stafford Scott, Rosemary Wilson and David Morris.
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On your doorstep
Published in 2000 by the Sainsbury Centre for Mental Health, this study aimed to look at these issues in the context of community development.
By focusing on two community based organisations, as well as a range of mental health and mainstream statutory sector agencies in those localities, they explored the perceptions of people involved in these projects, either as volunteers, users and workers, as well as commissioners and other partner agencies.
The reference group for this study included Develop's Fabian Davis and Richard Sutton from Values in Action.
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Connected Communities is an action research programme that employs social network analysis as a means to understand, plan for and foster the kind of communities that residents want to live in.
This is a multi-faceted programme of interrelated research projects that share the aim of better understanding the conditions under which a new civic collectivism, or social productivity, may emerge - one that is organic, spontaneous, and bottom-up.
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A New Horizons strategy for local well-being service networks (discussion paper)
This paper provides a detailed explanation of the proposed Connecting Communities model, describing a basic local network, the function of each focal service’s Connecting Communities Network (CCN) champion, the technologically supported network assessment and referral system and audit/outcome measurement relating to both intra-service efficacy and inter-service/network reciprocality.
Discussion paper examples Develop's Fabian Davis's work in this field (page 7).
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Discussion paper written in 1999 by Ewan King from the Office for Public Management.
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The mental health of Black and minority ethnic children and young people
Black and minority ethnic children and young people are being overlooked in the planning and provision of services that can address their mental health needs.
Enjoy, Achieve and Be Healthy is the result of a policy overview and consultation with 11-25-year-olds. The report, which was launched on July 7, 2011, highlights the emergence of BME children receiving insufficient and ineffective consideration due to their age and ethnicity.
Development worker Mhemooda Malek, author of the report, said: “The overall picture is that mainstream public services and programmes, with some notable exceptions, are failing to meet the mental health needs of BME children and young people. They are more likely to come to the attention of services at the point of crisis, yet there appears to be no significant progress in redressing this injustice.”
From Exclusion to Inclusion
This report presents an overview of the situation of social inclusion of people with mental health problems across 27 Member States of the European Union.
It is based on national reports, which have been prepared by MHE members with experience in the field of mental health and social inclusion.
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From the National Mental Health Development Unit, a short document outlining key facts and figures on public mental health and wellbeing.
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From the National Mental Health Development Unit, a short document outlining key facts and figures on Equalities in Mental Health.
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From the National Mental Health Development Unit, a short document outlining key facts and figures on stigma and discrimination in mental health.
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On Thursday, 26 June 2008 the Minister for Women and Equality, the Rt Hon Harriet Harman QC MP, made a statement to the House of Commons, repeated in the House of Lords by Baroness Andrews, setting out the main themes of the Equality Bill which will be introduced in Parliament in the next session.
On the same day the Government Equalities Office published Framework for a Fairer Future - the Equality Bill, which outlines the steps which will be taken to streamline and strengthen the law.
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The project aims to demonstrate the link between mental health problems and social exclusion. The focus is in particular on existing best practices that can contribute to tackling the inequalities that people with mental health problems encounter, in access to health and social services, employment, education, training services, housing, transport, leisure activities as well as the protection of their civil and human rights.
Through transnational exchange and comparison of effective practices, policy proposals to achieve greater social inclusion will be prepared.
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The Care Services Improvement Partnership (CSIP) has identified an inspirational collection of organisational initiatives to achieve the seven outcomes which are changing health and social care services and the lives of people who use them. Section 9 is about social inclusion.
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Evidence and key themes
A Social Exclusion Unit interim report
Improving Services, Improving Lives is part of the Government's overall strategy to tackle poverty and social exclusion.
This report was produced in 2005, and The Social Exclusion Unit's work programme, Improving Services Improving Lives, consists of five integrated projects that focus on a number of key groups and issues. Its overall objective is to make public services more effective for disadvantaged people, in order to improve their life chances.
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This report by the SCIE is aimed at those involved in developing, providing and leading personalisation and social inclusion for mental health. It is also aimed at those developing the leaders of the future. It explores three key questions:
- What is at the heart of the personalisation and social inclusion challenge in the contemporary and future mental health context?
- What are the leadership challenges in transforming mental health social care to deliver more personalised support, inclusion and care choices?
- What, therefore, are the implications for the development of leaders and leadership?
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Mental Health and Social Inclusion Statement
This position statement has been produced by the Social Inclusion Scoping Group of the Royal College of Psychiatrists.
The Scoping Group was set up to examine the nature and extent of social exclusion among people with mental health problems and those with intellectual disabilities and the implications for the organisation, structure and culture of future mental health and intellectual disability services and the future practice and training of psychiatrists.
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Written in 2007 by Alex Bird Business & Social Economy Consultancy, this research was commissioned to look into a number of key questions for Social Enterprises who work with disadvantaged people, helping them back into the world of work.
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Making the most of ourselves in the 21st century
The aim of the Foresight Project on Mental Capital and Wellbeing has been to use the best available scientific and other evidence to develop a vision for:
The opportunities and challenges facing the UK over the next 20 years and beyond, and the implications for everyone's "mental capital" and "mental wellbeing".
- What we all need to do to meet the challenges ahead, so that everyone can realise their potential and flourish in the future.
- The Project seeks to highlight where action is most important, and how we can better allocate available resources.
The analysis provides an independent look at the challenges ahead and how they might best be addressed. As such, the findings do not constitute Government policy. Rather, they are intended to inform the strategic and long-term choices facing Government departments, business and society as a whole.
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Written in 2004 by the Democratic Health Network, this briefing summarises and comments on a report by the Office of the Deputy Prime Minister's Social Exclusion Unit on action to address the full range of issues affecting people with mental health problems, rather than focusing solely on medical needs.
The action identified will be primarily the responsibility of local authority and primary care trust chief executives.
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Improving quality and value for money
The National Health Service (NHS) faces a productivity gap of some £14 billion over the next three years, as a result of which it needs to make productivity improvements of around 4 per cent per year. Mental health accounts for 12 per cent of the commissioning budgets of primary care trusts (PCTs) and will need to play its part in responding to the financial challenge.
The evidence presented in this report demonstrates that there is scope to improve
productivity in mental health care, and that there are also opportunities for mental health services to support productivity improvements in other areas of the NHS and in public spending more widely.
Special report produced by Oxford Economics
"A substantial number of people in the UK suffer from a mental health illness with around one million people claiming incapacity benefit due to mental and behavioural disorders and over ten million working days lost due to stress, depression and anxiety.
There are substantial benefits to both the economy and the Exchequer from helping people either gain or retain a job or miss fewer working days. Estimates suggest that mental health costs the economy over £10 billion a year and the Exchequer more than £6 billion. Our econometric analysis, and results from existing research, suggests that it is likely that many schemes aimed at helping people with mental health illnesses have been, or could be, of net value to both the economy and Exchequer. However, given the range of conditions that can be described as a mental health related illness, ranging from anxiety to schizophrenia, the cost and potential benefits of supporting someone in work, or helping them return to work, will vary enormously."
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Mental health and social inclusion
Working paper 2
Produced in 2005 by Jennifer Rankin of the Institute for Public Policy Research, this paper aims to add to the momentum for change, for good mental health to become ‘everybody’s business’, as well as a core objective for social policy.
It is a short and selective study, unified around the theme of the links between mental health problems and social marginalisation. The paper considers the subject of work, because it is a key aspect of the inclusion agenda.
It also looks at the role of community networks, which provide pathways to work and help give people a sense of future. It moves on to consider the different but related disadvantages experienced by some carers. Finally, the paper concludes with some recommendations for change.
The National Institute For Mental Health (England) co-ordinated the overall delivery of the Mental Health and Social Exclusion report and brought together individuals and organisations from a range of backgrounds and social inclusion expertise.
The national social inclusion programme team had cross-government representation as well as voluntary sector, service user, mental health professionals, and cross programme membership.
NSIP ceased operation on 31st March 2009 but the website continues to function, and is now managed by the Inclusion Institute at the Internationl School for Community Rights at the University of Central Lancashire.
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Good mental health is fundamental to the well-being and prosperity of England. In the last decade, greater investment and reforms have transformed mental health care; but now we need to go further.
We need to target the root causes of mental illness and support the local development of higher quality, more personalised services.
New Horizons sets out ideas for achieving this. It explores the prevention of mental illness and earlier intervention when things go wrong. It also looks at how services can become more innovative and work more effectively together.
In particular, New Horizons focuses on how Government, services and communities can work together to: get everyone to play their part in improving mental well-being; make it easier for people to get the right help; promote equality and make society fairer; and reduce the stigma that people with poor mental health experience.
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From Segregation to Inclusion: Where are we now? A review of progress towards the implementation of the day services commissioning guidance, was published by the Department of Health and the National Social Inclusion Programme on the 24th January 2008.
The review provides an insight into current provision across the country and highlights common issues in the restructuring and provision of day services featuring lessons learned, practical discussion of the issues and case studies. It will prove useful to anyone involved in managing change or improving the effectiveness of mental health day services.
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This Vision and Progress report sets out the National Social Inclusion Programme's (NSIP's) work since the Social Exclusion Unit's 2004 publication Mental Health and Social Exclusion.
It reviews the progress made over the last four years at national, regional and local level across the statutory and non-statutory sectors in promoting the social inclusion agenda for people with mental health problems.
The report also provides an assessment of the remaining and continuing challenges that need to be addressed for improved outcomes for people with mental health problems.
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Recovering Ordinary Lives
Identifying the unique contribution of occupational therapy within mental health services, this strategy provides direction for the development of the profession in this field.
The strategy aims to reassert the profession's belief that occupation is core to health and wellbeing, and create a strategic vision for the future of occupational therapy services in mental health across the UK.
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Presentation from the University of Bristol in 2006, this explored the possibilities of secondary analysis of existing data sets to look at the dynamics of ‘deep exclusion' or multi-dimensional disadvantage.
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The Bamford Review of Mental Health and Learning Disability (Northern Ireland, 2007) sets out a clear vision for ‘Promoting the Social Inclusion of People with a Mental Health Problem or a Learning Disability’.
This includes valuing individuals and ensuring that they have ‘full rights to citizenship, equality of opportunities and self determination’, and sets out some key principles such as partnership with users and carers in the development, evaluation and monitoring of services.
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Discussion paper produced by the British Psychological Society, with its main contributors including Develop's Dr Fabian Davis.
This, the Society's first paper of many to come on social inclusion, attempts to illuminate some increasingly familiar and hopefully widespread aspects of the considerable breadth and depth of activity that is required to create an inclusive societal process that supports the integration of people with mental health problems as full contributing and valued citizens.
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The All-Party Parliamentary Group on Libraries, Literacy and Information Management's 'Inquiry into the Governance and Leadership of the Public Library Service in England' report was published in September 2009.
The APPG report was launched at the CILIP Public Library Authorities Conference on 7 October 2009, one year after the initial announcement of the Inquiry.
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A National Strategy for Social Inclusion
Executive Briefing (2004)
Responsibility for All - A National Strategy for Social Inclusion, by Catherine Howarth, Peter Kenway and Guy Palmer, was the result of a year-long study conducted by the New Policy Institute and the Fabian Society in 2004.
This report considered how the programme to eradicate poverty should develop from
then on. Its principal conclusion is that what the government should do is launch a
national strategy for social inclusion at the start of its second term of office.
Taking co-production into the mainstream
People’s needs are better met when they are involved in an equal and reciprocal relationship with professionals and others, working together to get things done. This is the underlying principle of co-production – a transformational approach to delivering services – whose time has now come.
Now is the right time to move co-production out of the margins and into the ainstream. This report provides the basis for a better understanding of
how to make this happen.
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Disability and Society Paper
This article points a spotlight on useful insights in both social capital and social inclusion approaches that may help in the development of learning disability services, and notes some of the hazards of an unthinking adoption of either of these frameworks in isolation from the other.
The article by Peter Bates (NDT) and Fabian Davis (Chair of Develop) covers issues that have interesting parallels in mental health services which is why it appears here.
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This National Indicator Set (NIS) underpins the performance framework for local government and meets the then government’s commitment, as set out in the local government White Paper Strong and Prosperous Communities, to introduce a clear set of national outcomes and a single set of national indicators by which to measure them. The NHS Information Centre collects information on 12 of the indicators which relate to social care and mental health services.
The mental health information in this report is supplied by NHS trusts providing specialist mental health services. This report includes the final data for the two indicators (NI149 and NI150) that relate to people in contact with secondary Mental Health services.
Various reports by the Social Exclusion Unit produced in 2004, outlining the progress made in tackling Social Exclusion and future actions plans.
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The Review followed the publication of the global Commission on Social Determinants of Health, also chaired by Sir Michael Marmot and published by the WHO. The CSDH advocated that national governments develop and implement strategies and policies suited to their particular national context aimed at improving health equity. The English review is a response to that recommendation and to the government's commitment to reducing health inequalities in England.
The aim of the Review was to propose an evidence based strategy for reducing health inequalities from 2010. The strategy includes policies and interventions that address the social determinants of health inequalities.
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Taking stock and looking to the future
Emerging Findings
Produced in 2004, this paper is part of a programme of work being undertaken by the Social Exclusion Unit aiming to provide a clearer understanding of how Government policies have worked to tackle social exclusion and identify future priorities.
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Published by the Department of Health, This is the sixth annual report presenting the results of the finance mapping exercise carried out as part of the autumn review process.
It provides details of the level of investment in adult mental health services in England for 2007/08 and compares it with the reported results in the five previous years.
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Why England needs a new care and support system
On Monday 12 May, Prime Minister Gordon Brown and Health Secretary Alan Johnson launched a public debate about the future of the care and support system for England from May until November.
The debate builds on the current transformation programme set out in Putting People First (a cross government commitment in partnership with local government, the NHS and the social care sector to the transformation of social care), and is focussed on developing long term solutions for care and support that deliver what people want well into the future - it aims to find an affordable, fair and sustainable way of delivering and funding a first class care and support system for the 21st Century.
Below you can download the PDF document that sets out the scope for the debate and feed in your views - the findings of the debate will be used to inform the development of reform options for a Green Paper in 2009.
Statutory Code of Practice
The Disability Rights Commission (DRC) wrote and produced this Code of Practice on the disability equality duty for the public sector.
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Agents of Social Exclusion for people with a mental illness?
Section of UK Health Watch 2006 paper, published by Nimira Lalani and Carlyle London which focusses on the British media's perception of mental illness, and its reporting responsibility which is likely to influence its readership.
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Social exclusion – so much more than poverty
Develop's Fabian Davis interviews Naomi Eisenstadt, ex-Director of the Social Exclusion Task Force, for a special edition of The Psychologist magazine dated January 2010.
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The Understanding the Risks of Social Exclusion Across the Life Course research project comprises four studies that map the risk of social exclusion among people and families at key life stages.
This new research from the Universities of Bristol and York and from the National Centre for Social Research explores the risks of social exclusion among people and families across four key life stages:
- Children and families
- Youth and young adulthood
- Working age without dependent children
- Older age
The research uses an innovative approach to gain insights into the different triggers and risks that can lead to social exclusion. Understanding who experiences these risks and how they can impact on the lives of individuals and families is vitally important for improving public services. Findings from the research will be used to help policy makers and service providers to better identify those most in need of help. These studies provide further evidence supporting the Government's drive to deliver more personalised and responsive public services.
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Executive Summary
Making social inclusion a reality for people with severe mental health problems
Everyone has the right to fulfil positive social roles and contribute to their local community including people with mental health problems.
This major publication from The Sainsbury Centre for Mental Health provides the first in-depth analysis, with examples, of how mental health and other agencies can support people with mental health problems to engage in a full life in the community.
It provided numerous case studies including schemes in the fields of education, employment, primary care, mental health promotion, police and local government. There are a number of chapters and examples by present and past members of Develop too!
Download an exeuctive summary of Working for Inclusion as a PDF file:
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