Measuring the costs and benefits of promoting social inclusion
| Pages | 165-174 |
| DOI | https://doi.org/10.1108/20428301111186804 |
| Date | 17 November 2011 |
| Published date | 17 November 2011 |
| Author | Geoff Shepherd,Michael Parsonage |
| Subject Matter | Health & social care |
Measuring the costs and benefits
of promoting social inclusion
Geoff Shepherd and Michael Parsonage
Abstract
Purpose – The purpose of this paper is to review representative literature on social inclusion and
evaluate the usefulness of the concept in current mental health policy.
Design/methodology/approach – The paper employs a selective review of the cost-effectiveness of
interventions aimed at improving social inclusion in children, young adults with first episode psychosis
and unemployed adults of working age.
Findings – Social inclusion remains a useful concept in understanding both the causes of mental health
problems and how these might best be addressed. Although measurement is not easy, it can be
operationalised through a mixture of subjective and objective indicators. There is strong evidence for the
effectiveness and cost-effectiveness of interventions aimed at improving social inclusion for the groups
selected. These findings provide strong support for prioritising these interventions,especially in times of
severe financial restrictions.
Research limitations/implications – The selection of literature for review limits the generalisability of
the conclusions.
Originality/value – The paper sets out a clear andsimple analysis of the concept of social inclusion and
how it may be measured. It also brings together the cost-effectiveness literature on attempts to improve
social inclusion for three, key high-risk groups. The paper strongly supports the value of retaining the
concept of social inclusion, despite the fact that it has become temporarily unfashionable.
Keywords Social inclusion, Policy, Costs, Benefits, Outcomes
Paper type Conceptual paper
Introduction
With the advent of the recent coalition government the concept of social inclusion seems to
have dropped out of the policy vocabulary. This is unfortunate. ‘‘Social inclusion’’ is a useful
concept, it is difficult and complex, but it seems to us to have an important contribution to
make to our understanding of the causes and outcomes of mental health problems. In this
paper, we will discuss the problems of measuring social inclusion and the principles of
cost-effectiveness evaluations in the context of health services, which are struggling to cope
with reduced funding. We will then review the evidence and cost-effectiveness of three
attempts to improve the long-term health and social outcomes through early intervention in
three key high-risk groups:
Bchildren and young people with behavioural problems;
Byoung people experiencing a first episode of psychosis; and
Badults of working age with mental health problems who are excluded from the labour
market.
Finally, we will relate these findings to the current policy context associated with the new
mental health strategy, No Health Without Mental Health (HMG/DH, 2011).
DOI 10.1108/20428301111186804 VOL. 15 NO. 4 2011, pp. 165-174, QEmerald Group Publishing Limited, ISSN 2042-8308
j
MENTAL HEALTHAND SOCIAL INCLUSION
j
PAGE 165
Geoff Shepherd is Senior
Policy Advisor and
Recovery Programme Lead
and Michael Parsonage is
Senior Policy Advisor, both
are based at the Centre for
Mental Health, London, UK.
This article is based on a
chapter entitled ‘‘Social
inclusion: research and
evidence-based practice’’,
in Social Inclusion and Mental
Health, RCPsych Publications,
London (Boardman et al.,
2010).
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