A second research paper on social inclusion was prepared for the MDSC and the NMHAC for the Building Bridges 2 project by Barbara Everett, PhD. It includes a review of research literature on social exclusion, inclusion, personal safety and the experience of mental illness, as well as an overview of various government policies aimed at promoting the social inclusion of marginalized people. A summary of the resulting discussion paper – Belonging – appears below. The full report is enclosed as Schedule “B”.

Belonging: Social Exclusion, Social Inclusion, Personal Safety and the Experience of Mental Illness

Everyone wants to belong but it is clear that many people are denied the opportunities that others have and relegated to the margins of society. People with mental illness call this stigma and discrimination. Others call it social exclusion. Whatever language is chosen, it harms.

Around the world, factors such as the globalization of labour, people fleeing war, disaffected second generation children of immigrants, a widening gap between the rich and poor and 24/7 media reports of riots, bombings and terrorism have awakened mainstream society to the threat that marginalization can pose. What we previously thought “could never happen here” is now understood as all too likely to happen here – and soon.

Social inclusion is the formal name given to a fairly recent set of government policies aimed at including marginalized people more meaningfully in society – not only for their sake – but for the sake of protecting social cohesion and lessening threats to economic progress. Examples of social inclusion policies from the European Union, the United Kingdom, Italy, New Zealand and the Australian Ministry of Social Inclusion indicate just how seriously governments are taking the marginalization of certain groups within their borders. These examples also serve to show that social inclusion policies have widened to include not only ethno-racial minorities and immigrants but also the poor and the disabled, including people with mental illness.

Social inclusion policies are not without their critics who most commonly fear that they fail to state strongly enough that they value diversity or at worst, that they are simply assimilation or colonization dressed up in new language.

If adopted as a new way of thinking, would policies of social inclusion benefit people with mental illness? Certainly, examples of social inclusion mental health policies – those from Scotland are a prime example – indicate that yes, they very well may.

The path to belonging (social inclusion) is rooted in recovery which begins with establishing personal physical, relational and emotional safety aided by finding safe places to belong such as peer support, the psychiatric survivor movement, or through mechanisms of cultural safety. From this platform of personal safety, people can venture out into the community to establish (or re-establish) meaningful social roles. However, mental health services are often criticized for being siloed and cut off from their own communities and thus, failing to promote their clients’ independence and integration into society. Policies of social inclusion, if carefully thought through, may provide openings for the second and necessary aspect of recovery – an opportunity for full participation and a chance to belong – in your community, your province or territory and your nation.

Social inclusion is a complicated set of ideas that requires careful consideration – from all angles. It is clear that in some parts of the world, mainstream society has heard the thunder of deep discontent. They are beginning to recognize the harm that marginalization does to people because the marginalized have struck back. Social inclusion policies, even those with teeth, can only do so much. Powerful historical and cultural forces divide the world while those that uniteit are less visible and less commanding. The policies, as reviewed in the enclosed paper, do not speak strongly enough to the preservation of identity and the celebration of difference. Perhaps these ideas are implicit, but comfort for many, will come only from explicit statements and visible actions. Otherwise, social inclusion policies are open to igniting fears that they are really assimilation dressed up in new words. A possible way forward may be to establish the clear distinction between political integration (all groups have rights, protections and access to civic engagement) versus social integration (acceptance is the only passport to all that society has to offer). Is there something here for people with mental illness and their families? A cautious yes – if the goals of potential social inclusion policies are carefully thought through and clearly articulated.

National Consultations and Focus Groups

Original planning for BB2 called for a series of eleven exploratory focus groups to be conducted in strategic locations across Canada aimed at obtaining qualitative information which will support the development of our national strategy on cultural safety and cultural competence in mental health care in Canada. Recruitment of participants for these focus groups was to consist of aboriginal leaders, mental health care providers, researchers and consumers. Participants were also identified in consultation with leadership in the respective regions of Canada.

As a result of a successful collaborative effort between BB2 and the First Nations, Inuit and Métis Advisory Committee of the Mental Health Commission of Canada, our national qualitative research efforts were expanded from 11 to 41 consultations and focus groups in every region and territory throughout Canada. Two teams of facilitators and recorders conducted these sessions in Western and Eastern Canada.