Exploring Mental Health Service Users' Experiences of Social Inclusion in Their Community Occupations

By Smyth, Genevieve; Harries, Priscilla et al. | British Journal of Occupational Therapy, July 2011 | Go to article overview

Exploring Mental Health Service Users' Experiences of Social Inclusion in Their Community Occupations


Smyth, Genevieve, Harries, Priscilla, Dorer, Gemma, British Journal of Occupational Therapy


Introduction

Social inclusion and recovery approaches have formed a major framework for mental health service provision in the United Kingdom (UK) over the past 10 years, including extensive policies that set out to tackle the complex relationship between mental health, social exclusion and recovery (National Institute for Mental Health in England 2004, Office of the Deputy Prime Minister 2004, Welsh Assembly Government 2005, Scottish Executive 2006, Bamford 2007). Occupational therapists have instinctively supported this work with an understanding of how occupation can deliver and facilitate inclusion and recovery (College of Occupational Therapists 2006a). However, as the National Social Inclusion Programme (2009) ended and was replaced by No Health without Mental Health (HM Government 2011) and Big Society (Conservative Party 2010), and with a global recession having an impact upon National Health Service (NHS) resource allocation (NHS Confederation 2009), evaluations of progress and considerations of future directions are required.

Social inclusion has been identified as fair access to opportunity in order to enable mental health service users to live side by side with the rest of society (Bates 2002, Repper and Perkins 2003). Recovery emphasises the importance of having a hopeful, self-determining and meaningful life, with or without the experience of mental health symptoms (Repper and Perkins 2003). Evaluation of the implementation of these values is challenging because of multifaceted contributing factors, such as poverty, stigma, unemployment, lack of social networks and low expectations (Sayce 2001). While some evaluation needs to consider quantitative aspects, such as how many people are in employment, qualitative understanding is also needed in order to examine whether individuals actually feel included and a part of their local communities (Berman and Phillips 2000).

Literature review

Research considering various aspects of social inclusion was identified by searching the databases Allied and Complementary Medicine, British Nursing Index, Cinahl, Medline and PsycInfo for research published between 2000 and 2007, using the search terms 'mental health', 'social inclusion/exclusion' and 'occupation'. Fifteen studies were found, with seven quantitative, seven qualitative and one mixed methodology. They considered the extent to which mental health service users are socially included, and the possible factors that influenced levels of social inclusion.

Shimitras et al (2003), Minato and Zemke (2004a) and Dorer et al (2009) conducted studies in the UK and Japan, collecting data on a total of 517 service users categorising time use over 24 hours or 7 days. These time use studies used quantitative methodologies to measure occupational engagement and levels of participation in community occupations. The studies demonstrated that service users spend extensive time alone at home, sleeping or engaged in passive leisure, with little engagement in community occupations. However, the validity of time use studies needs consideration: accurate recording of time use may be compromised because of the reliance on retrospective recall. In contrast, Bejerholm and Eklund (2006) used a mixed methodology to triangulate findings: they collected data from 20 service users in Sweden using 24-hour diaries, as well as conducting qualitative interviews about time use. This revealed more variation in levels of community participation than the previous studies suggested, and highlighted the benefits of using mixed methodologies with the same sample to add depth to the research findings.

Symptoms of mental distress can impede participants' ability to engage in community occupations. Qualitative interview studies from Canada and the UK revealed how mental health symptoms restricted participants' involvement in employment and leisure (Pieris and Craik 2004, Woodside et al 2006). In contrast, a Swedish correlation study found few significant relationships between time use and self-rated health scales (Leufstadius et al 2006). …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • A full archive of books and articles related to this one
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Exploring Mental Health Service Users' Experiences of Social Inclusion in Their Community Occupations
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

    Already a member? Log in now.