Social Inclusion of People with Mental Illness

Cover......Page 1
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Preface......Page 9
1.1 Disabilities produced by the illness......Page 13
1.3 Attitudes of the public......Page 14
Stigma in the community......Page 15
1.5 Self-stigmatising attitudes......Page 16
1.7 Discrimination in housing and employment......Page 17
1.8 Human rights......Page 18
Part I: The origins of stigma......Page 19
2.1 The range of course and outcome......Page 21
2.2 Outcome in developed and developing countries......Page 22
2.3 Relatives' expressed emotion......Page 24
2.4 Variations in EE across populations......Page 25
2.5 The nature of negative symptoms......Page 26
2.6 The origins of negative symptoms......Page 27
2.7 Does medication worsen negative symptoms?......Page 28
2.8 The contribution of institutional practices to negative symptoms......Page 29
2.9 Conclusions......Page 30
3.1 What constitutes stigma?......Page 31
3.3 Findings from surveys......Page 33
3.4 Stereotype versus reality......Page 36
3.5 Mental illness and violence......Page 37
Sociodemographic factors......Page 38
Contact with mentally ill people......Page 39
Do attitudes differ with diagnosis?......Page 40
Variation in attitudes by country......Page 41
Attitudes of professionals and relatives......Page 43
Labelling theory and its modification......Page 45
Effects on lifestyle and choices......Page 46
Self-esteem and depression......Page 47
Stigma in the workplace......Page 48
Revealing one's mental illness......Page 49
Speaking out......Page 50
3.9 Conclusions......Page 51
4.2 Social networks of long-stay users......Page 53
4.3 Social networks of people with schizophrenia over time......Page 54
4.4 Changes to the networks of users discharged to the community......Page 55
Negative symptoms and social withdrawal......Page 56
4.7 The location of residences for users......Page 58
4.8 Availability of daily activities......Page 59
4.9 Homelessness......Page 60
4.10 Poverty and quality of life......Page 62
4.11 Conclusions......Page 63
5.1 Optimising medication......Page 65
Cognitive coping strategies......Page 66
5.2 Cognitive-behavioural therapy for psychotic symptoms......Page 67
5.3 Coping with paranoid delusions......Page 68
Reviving interests......Page 69
Dealing with lack of energy......Page 70
Reducing social avoidance......Page 71
5.5 Social skills training......Page 72
5.6 Conclusions......Page 73
Coping with stress......Page 74
6.1 The legacy of the past......Page 75
6.2 The past is still with us......Page 76
What happened to industrial therapy?......Page 77
Rehabilitation......Page 78
6.4 Problems with psychiatric admission wards......Page 79
The acute day hospital......Page 80
Crisis houses......Page 81
Crisis homes......Page 83
6.6 The location and size of staffed residences for users......Page 85
6.7 Changing staff attitudes......Page 86
6.8 Conclusions......Page 87
7.1 Using the mass media to influence public attitudes......Page 88
7.2 Targeting high-school students......Page 89
7.3 Targeting neighbours......Page 90
7.4 Working with family carers......Page 92
Family support......Page 93
Police training......Page 94
Judges, attorneys and probation officers......Page 95
Establishing a local action committee......Page 96
Setting up a user speakers’ bureau......Page 97
7.7 Conclusions......Page 98
8.1 Normalising unusual experiences......Page 99
8.2 Working with the family......Page 100
8.3 Cognitive therapy for low self-esteem......Page 101
Family attitudes and self-esteem......Page 102
8.4 Creative activities......Page 103
Creative activity......Page 104
8.5 The rise of the user movement......Page 105
8.6 Promoting social inclusion......Page 106
Adult education classes......Page 107
8.7 Conclusions......Page 108
Part II Overcoming obstacles to employment......Page 111
Work......Page 113
Work......Page 114
9.2 Macro-statistical evidence for benefits of work on the course of schizophrenia......Page 115
Work and self-esteem......Page 121
9.4 Conclusions......Page 125
10.1 Disincentives to employment in entitlement programmes......Page 126
Economic disincentives to work......Page 128
10.2 National variations in disability benefits systems......Page 130
How can research help?......Page 131
Raising the earnings disregard......Page 132
Wage subsidies......Page 133
Bolder steps......Page 134
Less bold steps......Page 135
10.4 Conclusions......Page 136
11.1 What are the options?......Page 137
11.3 Supported employment and transitional employment......Page 139
Competitive employment is the goal......Page 141
Continuous assessment and support......Page 142
Personalised benefits planning is part of the package......Page 143
11.5 Sheltered work: does it have a future?......Page 144
11.6 Conclusions......Page 146
12.1 Italian cooperatives......Page 147
12.3 Social firms around the world......Page 150
Britain......Page 151
New Zealand and Australia......Page 152
Canada......Page 153
The USA......Page 154
12.4 Recipes for success......Page 155
12.5 Conclusions......Page 158
13.1 An economic development approach......Page 159
13.2 Employing consumers in the psychiatric service system......Page 161
Working as a consumer residential aide......Page 162
13.4 Cooperatively owned housing......Page 164
13.6 Conclusions......Page 166
14.1 Consumer advocacy......Page 168
Drop-in centre......Page 170
The clubhouse......Page 171
The clubhouse......Page 172
14.4 The recovery model......Page 174
The recovery process......Page 175
14.5 Conclusions......Page 176
Empowerment......Page 177
References......Page 178
Index......Page 195