The ghettoization of persons with severe mental illnesses

Date12 February 2019
Published date12 February 2019
Pages53-57
DOIhttps://doi.org/10.1108/MHSI-10-2018-0036
AuthorJanet Laura Stewart
Subject MatterHealth & social care,Mental health,Social inclusion
The ghettoization of persons with severe
mental illnesses
Janet Laura Stewart
Abstract
Purpose The purpose of this paper is to outline the reflections of a person with lived experience of a
severe mental illness (SMI) and former peer support worker in Montreal, Quebec, Canada, who has also
worked for seven years in mental health research. It describes a tendency of resources and services to
create ghettos of peopl e with SMIs by failing to su pport the integration of people with SMIs into the
community at large or in exploring options for meaningful, fulfilling occupation, reinforcing social exclusion
and ghettoization.
Design/methodology/approach This paper shows a reflective and narrative account of personal
experiences and observations of the ghettoizing tendency in mental health services.
Findings Mental healthcare professionals tend to support people with SMIs in engaging activities within
resources for the mentally ill, and not in carrying out activities in the community at large. The range of
activities offered is limited, an obstacle to finding meaningful, fulfilling occupation. Harmful psychological
effects include self-s tigma, low self-estee m and a sense of marginaliz ation, generating a ghe ttoized
mentality. The difficulties encountered in an effort to leave the mental health ghetto are touched on with
examples of how to overcome them.
Practical implications The need for professional support for social integration of people with SMIs is
identified, which could ultimately favor social inclusion of people with SMIs.
Originality/value It is written from the perspective of a user and provider of mental health services, who
also has seven yearsexperience in mental health research.
Keywords Ghettoization, Meaningful, fulfilling occupation
Paper type Viewpoint
1. Introduction
The definition of to ghettoizeis to put in or restri ct to an isolated or se gregated place,
group, or situation(English Oxford Liv ing Dictionaries, 2 018). As a person with li ved
experience of a severe mental illness (SMI) and as a peer support worker on an Assertive
Community Treatment team in the public healthcare system in Quebec, Canada, for two
years[1], I have found that the practice of referring people with SMIs exclusively to resources
that provide socia l and leisure activi ties intended for se rvice users can have a ne gative
impact, amounting to ghettoization (Durocher et al., 2014; Stewart, 2018; Stewart and Park,
in press).
Of course, the intention behind the practice is not to ghettoize service users and keep them
apart from society a s a whole, but to help them im prove their qualit y of life. However, bei ng
grouped together for social and leisure activities with other people with mental illnesses to the
exclusion of anyone e lse, other than supervisory staff, w as restricting me to an isolated group,
as the definition o f to ghettoizegoes. Also, one of the goals of occupational therapy is to
support the engagement of any person in meaningful, fulfi lling occupation ,which includes
leisure, just as much as education and employment. So often, recreational resources for
persons with major psychiatric disorders offer cooking and co mputer classes an d art
workshops, which re stricts them to a limi ted range of activitie s, also a form of ghettoi zation,
according to the definition.
Janet Laura Stewart is based at
the School of Physical and
Occupational Therapy, McGill
University, Montreal, Canada.
DOI 10.1108/MHSI-10-2018-0036 © Emerald Publishing Limited, ISSN 2042-8308
j
MENTALHEALTH AND SOCIAL INCLUSION

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