Mental health nurses as promoters of social exclusion?

Mental health nurses as promoters of social exclusion?



Mental health nurses as promoters of social exclusion?

Introduction

The relationship between social exclusion and mental health problems is complex, with many of the elements of exclusion being, in different circumstances, both causal factors and consequences of mental ill-health (Link et al. 1997, Sayce 2000, ODPM 2004). Sayce (2001) provides a definition of social exclusion, specifically referring to mental health problems, which draws attention to the interactive relationship between impairment and social role:

. . . the interlocking and mutually compounding problems of impairment, discrimination, diminished social role, lack of economic and social participation and disability. Among the factors at play are lack of status, joblessness, lack of opportunities to establish family, small or non-existing social networks, compounding race and other discriminators, repeated rejection and consequent restrictions of hope and expectation. (p. 121)

Her definition of social inclusion provides a stark contrast:

a virtuous circle of improved rights of access to the social and economic world, new opportunities, recovery of status and meaning, and reduced impact of disability. Key issues will be availability of a range of opportunities that users can choose to pursue, with support and adjustment where necessary. (p. 122)

Aim and objectives of the study

Aim

To examine the attitudes of staff of a residential rehabilitation unit to the social inclusion agenda and its relevance to their practice through the method of focus group discussions.



Objectives

To elicit participants' attitudes surrounding the development of clients' relationships outside of mental health services.

To identify participants' views on their role in providing support to clients seeking employment or education.

To discover participants' opinions on initiatives in place which aim to improve social inclusion.

To draw out participants' views on how service users may perceive mental health services and staff working within them as contributing to their social exclusion.

Methods

Within focus group methods, attempts are made to understand the meaning behind the actions and beliefs of the participants (Bryman 2001). In this study, special attention was given to the views and attitudes of the staff team regarding the concept of social inclusion for their client group. The focus groups aimed to give insight into how people collectively make sense of the concept of social exclusion and constructs meaning around it (Kitzinger 1995). The process of understanding social phenomena is not undertaken by individuals in isolation from each other (Blumer 1969). Instead, it is something that occurs in interaction and discussion with others. In this sense therefore, focus groups more accurately reflect the dynamics of a team discussion within the unit selected for study, and to that extent can be regarded as more naturalistic (Bryman 2001).

Sampling and data collection

Permission to carry out the research was obtained from the team leader of the residential rehabilitation unit, and ethical approval was requested and granted from the local research ethics committee. A purposive approach to sampling was employed because the research aims to explore the values of a highly specific population, therefore participants were to be hand-picked based upon their profession ...