Measuring social inclusion: People with experience of mental distress and addiction

Measuring social inclusion: People with experience...
01 Sep 2011
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Discrimination is one of the biggest barriers to recovery for people with experience of mental illness or addiction. British and New Zealand research has shown that people with experience of mental illness report discrimination in all aspects of their lives, from employment and housing to discrimination from friends, family and the community as well as from those providing mental health services. Consequently, they often feel excluded from many activities of daily living.

Measuring Social Inclusion is a joint collaboration between a group of agencies that have come together to assist each other in working towards reducing discrimination, promoting social inclusion and the rights of people with experience of mental illness and addiction. Known collectively as the Multi-Agency Group (MAG), their aim is to advance a recovery perspective that involves an overarching, strategic focus on improving outcomes across New Zealand.

This publication is the first of its kind to address discrimination using a social inclusion lens. It includes 14 important indicators across 10 life domains to measure how included people with experience of mental illness and addiction are in society. Underpinned by a human rights framework and a holistic view of mental health, the publication’s purpose is to inform policy-makers and planners.

In New Zealand, there has been no in-depth study in the area of mental health or addiction using a social inclusion lens. To fill this gap, MAG has chosen to undertake this joint work to measure the change in social inclusion experienced by people with mental illness and addiction.

This is the first release of Measuring Social Inclusion, and this is a work in progress. We have been very fortunate to be able to utilise the rich information from the New Zealand General Social Survey, which has greatly enhanced the evidence base on social wellbeing in New Zealand. However, that survey has only been through one cycle of collecting information, and as such, indicators that use this survey information are not able to report on trends. It is hoped that further publication of these indicators will address this issue as well as ensuring continual improvement occurs.

Purpose

The purpose of this publication is to provide a framework for how social inclusion is experienced by people with mental health and addiction issues. The Multi-Agency Group (MAG)[1] has been working intersectorally to address the prevalence of stigma and discrimination towards people with experience of mental illness. As part of this work, a set of measures was collated to provide a better understanding of the experiences of social inclusion. Adults with mental health problems are said to be one of the most excluded groups in society (Social Exclusion Unit, 2004).

 

This publication continues the work of the Mental Health Commission (the Commission) as presented in an occasional paper Mental Health and Social Inclusion Concepts and Measurements (2009), as well as the Commission’s work outlined in its Statement of Intent 2010–2013 (2010). This publication will provide the scope for on-going projects that are focused on social inclusion issues that impact on people’s wellbeing and recovery from the experience of mental illness and/or addiction.

The members of MAG are the Human Rights Commission, the Mental Health Foundation of New Zealand, the Ministry of Health, the Office for Disability Issues (of the Ministry of Social Development), Office of the Health and Disability Commissioner, two representatives from regional consumer networks, and the Mental Health Commission.

 

Key Results

The measures have shown that people with symptoms of mental distress feel less included in society than other New Zealanders at major cost to them and their communities. This has major significance for policy-makers across a number of social domains.

Relationships

There is a clear relationship between symptoms of mental distress and the isolation that people feel. In 2008, 25 percent of people with no symptoms of mental distress felt isolated from others in the last 4 weeks, compared with 49 percent of people with mild symptoms, 67 percent with moderate symptoms and 77 percent of people with severe symptoms.

People with symptoms of mental distress are less likely than people with no symptoms to be partnered, with the likelihood decreasing with the severity of symptoms. In 2008, 41 percent of people with severe symptoms of mental distress were partnered, compared with 65 percent of people with no symptoms.

Health

Outcomes in the health domain were relatively positive. People with symptoms of mental distress had a similar level of self-reported physical health as people with no symptoms of mental distress.

Visits to the GP within the last 12 months ranged from 80–91 percent across the population. People with moderate or severe symptoms of mental distress used GP services significantly more than people with no or mild symptoms of mental distress. In 2008, 91 percent of people with severe symptoms of mental distress visited GP services within the last 12 months, compared with 80 percent of people with no symptoms.

Civic participation

Overall, 79 percent of people reported voting in the last general election. For people with mild or moderate symptoms of mental distress, there was no significant difference in the proportion voting in the last general election. However, people with severe symptoms of mental distress (68 percent) were significantly less likely to report voting than people with no symptoms of mental distress (80 percent).

In total, one in 10 people felt they had been treated unfairly or had something nasty done to them in the past year because of the group they belong to or seem to belong to. People with symptoms of mental distress are more likely to have felt discriminated than people with no symptoms of mental distress. In 2008, 27 percent of people with severe symptoms of mental distress felt they had been discriminated against, 20 percent with moderate symptoms and 14 percent with mild symptoms.

Among those with moderate or severe symptoms of mental distress, the most common reasons given for being discriminated against were their nationality, race or ethnic group (37 percent) or their skin colour (36 percent), and 14 percent thought the discrimination was because of a disability or health issue.

Safety

People with symptoms of mental distress were significantly more likely than those with no symptoms to report having a crime committed against them. However, the level of severity of those symptoms made no significant difference to reporting having a crime committed against them. One-third of people with severe symptoms of mental distress (31 percent) reported having a crime committed against them in the past year, compared with 17 percent of people with no symptoms of mental distress.

Cultural identity

People with symptoms of mental distress were significantly less likely than those with no symptoms to find it easy to express their identity in New Zealand. However, the level of severity of those symptoms made no significant difference to how easily people were able to express their identity in New Zealand. In 2008, 69 percent of people with severe symptoms of mental distress found it easy to express their own identity in New Zealand, compared with 85 percent of people with no symptoms.

Leisure and recreation

Three-quarters of people reported that there are free-time activities or interests they would like to do but can’t or there are free-time activities or interests they would like to be able to do more of. However, people with symptoms of mental distress were significantly more likely to report difficulty in doing free-time activities than people with no symptoms of mental distress. Nine in 10 people with severe symptoms of mental distress reported difficulty in doing free-time activities.

Knowledge and skills

People with severe symptoms of mental distress (55 percent) were significantly less likely than people with no symptoms (67 percent) to have gained a level 2 or higher educational qualification. Also, people with severe symptoms of mental distress (12 percent) were significantly less likely to gain a qualification than people with no symptoms of mental distress (20 percent).

Employment

People with symptoms of mental distress were less likely to be employed and have been satisfied with their job than people with no symptoms of mental distress. A quarter of people with severe symptoms of mental distress (27 percent) were employed and satisfied with their job, compared with 68 percent for those with no symptoms.

Standard of living

People with symptoms of mental distress were more likely to be living in hardship than people with no symptoms. In 2008, 57 percent of people with severe symptoms of mental distress were not living in hardship, compared with 87 percent of people with no symptoms.

People with symptoms of mental distress are less likely than people with no symptoms to be satisfied with the housing they are currently living in. In 2008, 63 percent of people with severe symptoms of mental distress were satisfied with the housing they are currently living in, compared with 89 percent of people with no symptoms.

Transport

There was no significant difference between people with varying symptoms of mental distress in having no access or being dissatisfied with their access to public transport. Rates ranged from 27–29 percent.

Page last modified: 15 Mar 2018