Recovery, social inclusion and the practice of psychiatrists
| Date | 15 August 2011 |
| Published date | 15 August 2011 |
| Pages | 143-150 |
| DOI | https://doi.org/10.1108/20428301111165735 |
| Author | Alan Currie |
| Subject Matter | Health & social care |
Recovery, social inclusion and the practice
of psychiatrists
Alan Currie
Abstract
Purpose – Being excluded blights the lives of the mentally ill. Exclusion is both cause and consequence
of mental ill-health and extends beyond material deprivation to exclusion from the activities which give
meaning to life. Promoting inclusion is central to the work of all mental health practitioners and the
purpose of this paper is to advance the practices which support this.
Design/methodology/approach – The literature on what supports social inclusion and the related
concept of recovery is reviewed. The working practices and prevailing theoretical models in psychiatry
are also considered in the context of understanding how these practices and models can support
socially inclusive and recovery-orientated ways of working.
Findings – Social inclusion and recovery interact dynamically. Central to being ‘‘in recovery’’ is the
experience of being included. Social inclusion is also a platform on which to participate in life’sactivities
and to learn to ‘‘live well’ ’ again. The practices which support these approaches are consistent with
medical models of care, with the bio-psychosocial model that prevails in psychiatric practice and with
existing guidelines on the nature and purpose of the therapeutic relationship.
Originality/value – Obstacles are described that impede adopting new practices and these include
creating additional work, increased risk in a risk averse environment, and incompatibility with current
models of medical practice. This paper seeks to describe the cost of exclusion, the value of inclusion,
the practices which support recovery and social inclusion and to refute the arguments for not adopting
these ways of working.
Keywords Social inclusion, Social psychiatry, Mental illness, Recovery, Exclusion
Paper type Research paper
If you can’t get listened to in a ward round you don’t believe that you have a chance of getting
what you want in the outside world (A quote from a service user).
The term ‘‘social exclusion’’ captures many of the disadvantages that are the everyday
experiences of many people with mental health problems. A modern concept of social
exclusion extends beyond material poverty and includes non-participation in the key activities
of a society (Morgan et al., 2007; Burchardt et al., 2002). This encompasses exclusion from
employment, leisure activities, relationships, education and the daily activities which give
meaning and purpose to life.
Psychiatric training equips psychiatrists to understand this kind of material and social
disadvantage. Those who work in mental health services are familiar, through long and
repeated exposure, with social exclusion as both a cause and consequence of mental health
problems. Furthermore, they see that exclusions are often multiple and that the excluded are
often absent from many educational, vocational, housing and leisure opportunities.
Recovery
Social inclusion is closely linked to the concept of personal recovery in the face of
enduring illness. The use of the term recovery in this setting can be confusing for some
DOI 10.1108/20428301111165735 VOL. 15 NO. 3 2011, pp. 143-150, QEmerald Group Publishing Limited, ISSN 2042-8308
j
MENTAL HEALTHAND SOCIAL INCLUSION
j
PAGE 143
Alan Currie is a Consultant
Psychiatrist in an Assertive
Outreach Team with
Northumberland, Tyne and
Wear NHS Foundation
Trust, Cramlington, UK.
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