Barriers to Social Inclusion in Mental Health - Essay Example

Barriers to Social Inclusion in Mental Health Social exclusion of mentally ill persons in the society is attributable to social and cultural constructs of mental illnesses. Barriers to social inclusion take various forms of marginalization experienced by individuals suffering from mental conditions. Patients of mental illness experience some form of exclusion from the society which makes it difficult for the appropriate interventions from the medical and psychiatric fraternity to make an impact. Perhaps one of the most disturbing revelations that these professions must come to terms with is the cultural and social bias that stands in the way of their intervention and contribute to mental health like any other health concern. Infiltration of biases across societies has conditioned policy makers to take mental health issues with a lesser concern than expected. The following discourse highlights the barriers to social inclusion of mental health concerns against the backdrop of social and cultural constructions. According to McDonald and Olley (2002, p.52), social inclusion entails the recognition of the interests of a particular group of persons in the society and the subsequent endeavor in meeting their needs as an itemized priority. The authors introduce an important aspect of diversity that the group in contention introduces to the entire society and the importance that the management’s accommodation of the diversity to the development of the society. In this light, it appears that the group in considerations is adversely affected by elements of withdrawal from the attention of the society. It is therefore important to highlight the tendency of the society to sideline mentally disturbed persons due to some form of stigma. One of the main forces of social exclusion is institutional, which classifies together all health facilities and institutions in the limelight of their willingness and capacity to handle mental health concerns in the society. While the community may bear much responsibility in the direct dealing with mental illness at source, the nature of service delivered at the mental health institutions may make it difficult to deal with arising concerns. Many institutions lack the appropriate resources to deal with mental illness as a special form of a health concern. The health institutions’ staff attitude towards patients suffering from mental conditions may affect the delivery of services to the society. As an illustration, the use of insensitive language to the community and patients seeking mental health assistance can cause panic and create the feeling of a hostile reception likely to make things difficult in the service delivery. While policy frameworks may be delivered by higher health offices for compliance by the implementing institutions, it may be difficult for compliance to be rolled out due to difficulties at the implementation phase. A case of poor policy implementation at the health facilities is therefore a huge setback to the social inclusion needed to improve mental health. Secondly, personal factors aggravate the level of social inclusion of persons suffering from mental illnesses. Attitudes and perceptions of mental conditions at the patient’s, families’ and friends’ level affect the general outlook that the society makes of mental illness. Seeking mental health services can be difficult in case the deep rooted perceptions are directed towards sidelining the victim from the limelight. Negative perception on the mental health procedures by the person and close family members contributes to the social inclusion barriers (McDonald and Olley, 2002, p29). Support services offered to the mentally disturbed are viewed negatively by many individuals, which may contribute to withdrawal from the system that assists victims of such conditions. Perceptions of discrimination may force individuals and their care takers to avoid seeking assistance for the mental condition. Discrimination against victims of mental illnesses may be direct or indirect depending on the perceptions that the individual and close family members and friends may withdraw the patient from the negative attachment associated with a discriminatory system. Language barriers may also cause the patients and their families to miss information or fail to communicate the challenge that the mental illness requires for treatment to be availed. There may be feelings of inadequacy of the appropriate assistance from the institutions around the patient’s environment which aggravates the situation making social inclusion further remote. Thirdly, environmental factors contribute to the apparent social exclusion experienced by the patients of mental illnesses. For the patient to feel excluded from the society, there must be some form of stigma harbored in the society making it difficult for the initial stage of acceptance of the condition difficult. A society with negative perceptions regarding mental illnesses is likely to heighten stigma to the cultural level where it becomes a traditional experience to sideline and discriminate against patients of mental conditions. The victim may not get access to mental assistance due to the geographical barriers to mental health institutions. Transport linkages to remote villages may be poor hence contribute to the exclusion of the patients from the system of treatment. Additionally, lack of appropriate policies may facilitate the existence of social exclusion as experienced by victims of mental health issues. While lack of resources and specialized mental health facilities across mental institutions may be attributed to poor management policies, a different perspective draws attention to the role of governments on the situation of poor social inclusion for mentally ill persons. Governments have worked hard to curb nearly all forms of discrimination such as racial, ethnic and gender with programs and polices put in place to cater for their sustainability. However, mental illnesses continue to be associated with discrimination and social exclusion with little intervention from the government. Mental health services are not localized for easy access by the society at a less specialized level which could assist in fighting off the attached stigma. The government policy that can sufficiently handle the mental illness concerns of social exclusion must also highlight increasing the capacity of various attendants through training and campaigns. Skills required to handle mental health must handle the community issues and appear to fight off discrimination and negative attitudes on either sides of the service delivery. Broken social networks must be targeted by the campaigns to arrest the deplorable social inclusion ratings in terms of mental illnesses. The control of negative portrayal of mental illnesses and disorders by the media and other social tools must be heightened by the government in order to facilitate the appropriate transition into efficient mental health systems. Advantages of these approaches of social approaches of mental illness highlight the centrality of the society in errant attitudes which occasion isolation of persons suffering from mental illness. Social environment is important in molding attitudes particularly the way mental state should be controlled through perceptions. Such constructions are important in facilitating positive attitudes in social settings facing different challenges. However, these perspectives fail to explain every aspect of mental illnesses such as in cases of healthy social relations. Culture and its factors are important determinants of the way mental illnesses are perceived. The cultural setting in which a mental condition occurs determines the amount of interest that it gains from the various sections of the society (Taylor and Timimi, 2004, p8). While it may be easy to diagnose a mental condition in the western culture which has a clinical understanding of its occurrence, several other cultures may struggle to find mental care as a reasonable intervention due to cultural constructions. In many traditional cultural settings across the world, mental illnesses were perceived to be as a result of possession by evil spirits. It therefore follows that the past encounters with cultural interpretations could be used against seeking assistance and healthcare if the causative factors are beyond human interventions in such traditional settings. Beliefs and spirituality among a people play an important role in explaining mental illness as a phenomenon among them (Chung et al, 2002, p230). Certain religions and beliefs understand illnesses are as a result of a punishment from the gods while some may interpret them as a test to be overcome. The level of acculturation of the living generations greatly influences the magnitude of reliance on perceptions of the past generations regarding certain mental conditions. As an illustration, immigrants into the Western culture may take three generations before being accustomed to the medicalization of mental health established in the western culture. The importance of cultural construction as an explanation to existence the existence of different interpretations of mental illnesses is the clarity with which cultural disparity extends to health care interpretations. Psychoanalysis theory was conducted in the western culture which was found to be too rigid to fit across all cultures, prompting the establishment of psychodynamic approach. One weakness in this approach is failure to explain the entire picture of mental illness across every setting as attempts prove futile (Seitz, 2010, para. 3). In terms of understanding of the mental condition and its nature, interpretations of social concepts and perceptions on the condition facilitate the creation of social illness with certain social implications. This implies that despite the clinical diagnosis of the various medical conditions that a society faces, mental conditions have a distinct social attachment that defines the sociology of the particular setting (Barker and Conrad, 2010, p69). Mental conditions are only aggravated in terms of interpretations by the view that the society has on the social impact of the condition. Three main theories are applied in the sociological approach of mental illnesses. Stress theory, diathesis stress theory as well as labeling theory explain the various social attachments that mental illnesses have. Stress theory was developed by Seyke in 1956 upon which it was found that animals have a particular way of responding to a negative stimuli which culminates sin exhaustion and illness. Stress as a negative stimulus in this application has been demonstrated to cause mental illnesses when the breaking point or exhaustion is reached and exceeded. Contributions by Holmes and Rahe (1967, pp216) further identified major life events at which the human body is subjected to extremes of negative stimuli which require extra caution in form of coping to avoid reaching the breaking point. When an individual has too many life events crowded together in quick succession or overlapped, it is difficult for the individual to cope, which translates into exposure to mental exhaustion. Mental illnesses can easily result when too many life events are experienced by the individual, particularly if the coping potential is too low. Diathesis stress theory explains the origin of more complex mental cases, with the exposure to the environment stimuli being secondary to some more potent cause of the condition (Stockton, n.d, p14). The author reckons that more severe factors of exposure are attributable to the origin of mental illnesses. Genetic predisposition, traumas as well as defective early socialization are some of the factors that determine the occurrence of mental illnesses according to the theory. Structural strain theory attaches stress to the social organization and classification of individuals in occasioning negative responses. The society’s perceptions of life’s important achievements for instance can lead to a mental breakdown and illness if its members are not able to realize the achievement. The associated classification and differentiation is a social construction that isolates those who fail in the society and banishes to mental illness. Disadvantaged groups are therefore likely to be on the receiving end of social constructions thereby manifesting higher prevalence that other social classes. Labeling theory explains that certain individuals are at higher risk of mental illnesses due to the society’s apparent attachment of such a destination from the labeling that is usually based on behaviors. Deviant and delinquent behaviors in the society are taken as references to labeling individuals as dangerous and eventually leading to isolation. From the isolation, deviant individuals are likely to find time to associate creating a negative identity of a mental patient culture. The biomedical model of mental health does not highlight various classes and environmental factors and focuses on the presenting challenge in the individual as a clinical manifestation of a disturbed system (Serendip, 2006, para. 1). Mental illness can be viewed as a construction of cultural and social settings that the victim is exposed to, thereby a general creation out of human thinking. Towards handling of the mental illness as created by the society, medicine and other sciences such as psychiatry have come up with criteria to classify the mental illnesses just as any other clinical conditions with symptoms, diagnosis procedures, treatment and vocabulary. Integrating mental illness into mainstream medical interventions having initially recognized it as a creation of the society can be critiqued to illustrate that the creation presents certain dangers and benefits to the society. While we accept that it is beneficial to make interventions and alleviate suffering among human beings on one hand, it is critical to implore central intention of the hype behind the creation. It is important that advancements in knowledge and skills are applied for the comfortable living of the human race through contributing to a less suffering. In this light, medicalization and scientific approach to mental illness is a positive gesture that deserves lauding. On the other hand, it is pointless to create an unending hype attracting sophisticated intervention if it is a mere creation. It beats logic why the mental health, a creation of biased perceptions, can be transformed into a fully professional arena with a highly sensitized market. It is like the proverbial house built on a weak foundation and whose collapse can be at the mercy of the slightest provocation. Further injury to the condition has been added by psychological theories which are based on mere assumptions that appear to be too true to dispute. There is little professional empathy, empowerment as well as development skills that the patients require (Walker, 2006, p76). The author picks issues with the medicalization of mental conditions which gives them a highlight of the medical vocabulary such as pathology and treatment, creating an idea of abnormality since it can only lead to isolation from the society. In conclusion, the social structure and profile can be blamed on the adverse situation of mental health, which is also partly attributable to culture and individual perceptions. The modern society with all the advancement may be better suited to handle discrimination of mentally ill persons than other settings but it is not the case. Social status and categorization has created some aspect of achievement yardstick which the western culture uses to measure accomplishment. In order for an individual to feel accomplished, they have to for instance acquire wealth and education or consider themselves as failures if otherwise. Continued creation of social classes based on possessions and achievements generates structural strain on the social setting for those who fail to acquire the standards. Feelings of isolation create an anomie gap leading to mental breakdowns and illnesses. Using such an organizational setting, certain groups will be at a disadvantage in terms of mental illnesses occasioned by the pressure felt from such a failure if unable to cope. Capitalist roll qualifies and disqualifies individuals in the social class based on their material wealth status, which is a measure of achievement and satisfaction. Failures are discriminated against the system causing pressure on the lower social classes or the less disadvantaged. Western culture is generally based on a system where success is associated with material possession than many other factors, which becomes the central discrimination point for the poor. Inequality and distribution of resources fall under Karl Marx theory where the have-nots cannot be socially equated to the haves. As a result, achievement pressure piles on the lower classes causing problems in their mental health. References Barker, K. & Conrad, P. (2010) The Social Construction of Illness: Key Insights and Policy Implications. Journal of Health and Social Behavior, vol. 51, no. 1, pp.67-79 Chung, H., Kramer, E., Kwong, K. & Lee, E. (2002) Cultural Factors Influencing the Mental Health of Asian Americans. Western Journal of Medicine, vol. 176, no. 4, pp.227-231 Hall, L. () Conceptions of Mental Illness: Cultural Perspectives and Treatment Implications. [Online] Available from [Accessed 14 November 2011] Holmes, T. & Rahe, R. (1967) The Social Readjustment Rating Scale. Journal of Psychosomatic Response. 11, pp.213-218 McDonald, V. & Olley, D. (2002) Aspiring to inclusion: a handbook for councils and other organisations. Suffolk, UK: Suffolk County Council Seitz, J. (2010) Social Construction of Mental Illness: Social and Cultural Aspects of Physical Illness. [Online] Available from [Accessed 14 November 2011] Serendip (2006) Models of Mental Health: A Critique and Prospectus [online] Available from: [accessed 12 November 2011] Stockton, (n.d) Sociological Approaches to Mental Illness, [online] Available from [13 November 2011] Taylor, E. & Timimi, S. (2004) ADHD is Best Understood as a Cultural Construct. British Journal of Psychiatry, 184, pp8-9 Read More