The meaning of social inclusion to people with enduring mental health problems : a thesis presented in partial fulfilment of the requirement for the degree of Master of Arts in Nursing at Massey University, Auckland, New Zealand

Abstract

The purpose of this qualitative research project has been to explore what social inclusion means to people with an enduring mental health problem. A review of the general literature on social inclusion revealed that little research has been conducted in relation to mental health, particularly in New Zealand. Even fewer studies have investigated the meanings that people with severe and enduring mental health problems place on their experiences. A life story narrative approach was employed in order to explore the experience of social inclusion and enduring mental health problems. Data were collected by way of unstructured, individual interviews with five users of mental health services living in supported housing in a small rural New Zealand town. Thematic analysis was carried out on the narratives, identifying six major themes. The findings indicated that, for this group of service users, social inclusion means having someone to love, something to do and somewhere to live. They want relationships with family and friends, to engage in recreational or leisure activities, to be employed, to have financial security, and to have safe and comfortable housing. The major barriers to achieving these are stigma and discrimination. New Zealand’s mental health services have adopted a recovery approach to mental health. Whereas social inclusion has a broad political and social focus that places responsibility for reducing social exclusion on society, recovery focuses on individuals’ personal journeys towards mental health and well-being. Despite international recognition of the value of social inclusion, New Zealand’s mental health services have not yet embraced it, although policy advisory organisations such as the Mental Health Commission state its aims as desirable for services. However, the concept of recovery sits within the framework of social inclusion and is an integral part of it. Mental health nurses need to understand what social inclusion means to people who experience it, so that they are able to empower them to make a positive contribution to their community, as citizens, friends, family members, employees and neighbours.