Social inclusion and mental illness

© 2014 Dr. Kate Maree FiliaBackground: Social inclusion is increasingly recognised as an important contributor to good mental health and greater mental health outcomes, in particular for people with mental illness. Despite increased understanding of the positive impact that social inclusion can have, the potential to make progress has been slowed by some key limitations. The key, underlying problem regarding social inclusion, is the lack of a specific operationalised definition, with only some consensus regarding what it means to be socially included. This lack of specificity has made it difficult to accurately measure the impact of initiatives designed to improve social inclusion. Nonetheless, several attempts at developing measures of social inclusion have been made, in particular for use with people with mental illness. Psychometric testing has been conducted on some, but not all of the measures, and has not been completed on any of them. The overall aim of this thesis was to develop a measure of social inclusion for use with people with mental illness. The measure was designed in a series of studies ensuring the representative input of people with a lived experience of mental illness. The measure was titled the SIMI-LE, an abbreviation of a measure of Social Inclusion for people with Mental Illness – Long Edition. Method: The development of the SIMI-LE took place over three sequential studies. The first study involved a thematic analysis of literature regarding social inclusion to obtain the opinions of professionals regarding key contributors of social inclusion. Seventy-one pieces of literature were reviewed (academic literature regarding social inclusion in general n=25, academic literature regarding social inclusion and mental illness n=26, and organisational reports n=20). The second was a Delphi study, conducted to obtain a consensus between three groups regarding the importance or relevance of contributors identified in the first study. Participants included 32 consumers of a mental health service, 32 carers of a person with mental illness and 40 community members. The third study involved the construction of the measure, and preliminary testing with a sample of ninety participants (30 consumers, 30 family members of a person with mental illness and 30 community members). Results: A comprehensive list of contributors was compiled during the first study. A consensus across three groups regarding how important or relevant each of these contributors were, was obtained during the second study. Finally, the SIMI-LE was constructed and preliminary testing conducted. The measure was seen to have good face validity and was highly acceptable to participants. Preliminary findings demonstrated poorer outcomes for people with mental illness as compared to those without, with differences seen in each of the five categories. Discussion: Overall, the aim of developing a measure of social inclusion for use with people with mental illness was achieved. In the process of developing the measure, a greater understanding of social inclusion from the perspective of people with mental illness was obtained. The measure has demonstrated excellent preliminary psychometric properties and has displayed the ability to differentiate between groups, as expected. Implications for use and suggestions for future research are detailed