Promising Practices for Social Inclusion: The Key Role of Partnerships and Collaboration to Promote Recovery and Successful Reintegration
October 2011 » Issue 31
Letter from SAMHSA
“Social Inclusion is supported through partnership working. The whole is more than the sum of its parts. Through partnership working, organisations from all sectors can build the bridges required to support community participation, active citizenship and build social capital.”
—Vision and Progress: Social Inclusion and Mental Health
SAMHSA, in its commitment to promoting social inclusion for people with mental and substance use disorders in the United States, recognizes the value of the groundbreaking work already done in the U.K. and all that can be learned from their pioneering efforts.
The above quote from the National Social Inclusion Programme Vision and Progress: Social Inclusion and Mental Health report is one of 10 key messages that guide the work being done in the United Kingdom to achieve social inclusion for people with mental and substance use disorders. Collaboration among government agencies and with the private and nonprofit sectors has enabled considerable progress over the last decade.
Social inclusion refers to a dynamic process by which communities make it possible for people who have been excluded to participate in all the community has to offer. It means the community welcomes them ‘inside’ and acknowledges that those who are traumatized, ill, or otherwise challenged deserve the community’s full support.
Livia Davis from Housing, Homelessness, and Social Inclusion: Essential Elements of Healthy Communities
The essence of social inclusion recognizes that social conditions such as poverty, homelessness, and unemployment contribute greatly to the prevalence of mental health and substance use problems and that individuals with mental health and substance use conditions have been continually marginalized and excluded from access to rights, opportunities, and resources that most of us take for granted. Social Inclusion policies organize a multi-level approach on the national, community, and individual levels that help define effective interventions to address the social determinants of mental health and substance use conditions.
This issue of the SAMHSA ADS Center Information Update will demonstrate social inclusion in action by:
- Promoting innovative approaches and tools for fostering systemic and community change, while supporting individuals in the pursuit of personal recovery and reintegration into society
- Revealing one young woman’s recovery journey and how others made a difference
- Describing a community program that illustrates the key role of partnerships in advancing their social inclusion campaign
- Featuring the Mental Health Impact Assessment, a national model for evaluating the mental health impacts of all legislative, policy, and project proposals
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Teleconference Summary: Forging a Path Toward Social Inclusion—Collaboration among Individuals, Community Partners, and Public Systems
The SAMHSA ADS Center sponsored a free training teleconference on June 23, 2011 entitled “Forging a Path Toward Social Inclusion: Collaboration among Individuals, Community Partners, and Public Systems.” The teleconference, which featured presentations by Jacki McKinney, Dr. John (Jody) Kretzmann, and Lindsey Dawson, highlighted the following topics:
- The dynamics and impact of marginalizing people with mental health and substance use problems, as well as the courage it takes for them to re-integrate into society
- The six assets of an individual and a community that promote social inclusion
- Successful strategies for assessing your community’s strengths and capabilities, and ways to mobilize community involvement to shift systems and achieve social inclusion
If you were unable to participate in the teleconference, or would like to listen to it or view the slides again, you can access it here.
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In My Experience: Recovery with Support from Peers, Family, Friends, and the Academic Community
Jen Pape opens up about the vital role family, a circle of friends, and her college professor played, through their ongoing support, in her recovery and continued mental health:
“Academic, professional, and mental health consumer communities to which I have disclosed my mental illness have provided me with a different sense of connection and network of support with others who empathize or sympathize with my struggles, and recognize that despite them I can still be a contributing member of society and still achieve whatever dreams I set out for. One such professor reached out to me when I was experiencing a depressive episode and had been withdrawing in class. He was concerned because I had missed a few classes and had gotten a lower grade on my exam than he expected given the quality of my contributions to class discussion. It seemed to me to be just the little shake, the slight extended hand that I really needed at that time, because it gave me the motivation I needed to get myself back on my feet and reinvest myself into my classes. I should caution that this isn't to say that his reaching out to me made me snap out of that episode—indeed it is a process and one should not give up if efforts to help do not always seem instantly fruitful—but his reaching out to me seemed to be one of those buffers I needed to help keep myself in check, to get myself out of bed, no matter what seemed to be trying to weigh me down that day.”
Read Jen’s story and support others by sharing your own.
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A Community Model: Oakland, California PEERS
By, Shannon Eliot, Media and Marketing Coordinator, Peers Envisioning and Engaging in Recovery Services (PEERS)
The idea that social inclusion is essential to ending mental health stigma and discrimination is nowhere more apparent than at PEERS, a forward-thinking mental health advocacy nonprofit based in Oakland, CA. A consumer-run organization, PEERS is changing the way society views mental health through the innovative Alameda County Social Inclusion Campaign.
Designed to eradicate both external and internal mental health stigma, PEERS relies on valuable community partnerships in employing its three main campaign strategies of empowerment, outreach, and media.
Empowerment focuses on ending internalized stigma experienced by people with mental health issues through strength-based trainings, spirituality, and education about wellness and recovery. The outreach campaign strategy specializes in the facilitation of contact between people with mental health issues and the general community, educating those who hold the power to change discriminatory practices. Lastly, the media component shapes messages to which society is exposed about mental health. To do this, PEERS both tracks and responds to how mental health is portrayed in media as well as produces its own media (television show, radio, printed materials, and Web site).
None of these strategies would be successful, however, without valuable collaboration and partnerships with the community. To foster true change in the community, PEERS is working with trusted leaders to develop and implement resources, provide tools, and teach skills to those who have the power to change discriminatory practices.
In the first year of the Social Inclusion Campaign, PEERS is focusing its efforts for social change on the African-American community and power holders in the housing sector. By working in collaboration with leaders in these populations, PEERS is discovering and supporting real solutions that arise from the community itself. Examples include the construction of community gardens by consumer and non-consumer participants; Wellness Recovery Action Plan, or WRAP, sessions in housing developments and churches; and television shows and podcasts featuring dialogue between consumers, religious leaders, and housing professionals. By facilitating repeated and positive interaction in the community between consumers and non-consumers, PEERS believes that stereotypes—and their harmful side effects—will be eliminated.
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A National Model: Adler Institute on Social Exclusion
By, Dr. Lynn Todman, Executive Director, Adler Institute on Social Exclusion
There is growing consensus that living conditions and the distribution of power, money, and resources determine the incidence of physical health outcomes such as respiratory, cardiovascular, and infectious diseases; cancers; obesity; and diabetes. By comparison, there is less collective agreement on the impact of social conditions on mental health outcomes. Consequently, mental health prevention and intervention efforts tend to overwhelmingly focus on affecting individual, family, and/or community change to the relative neglect of broader social, political, and economic change.
To address this oversight, the Institute on Social Exclusion (ISE) at the Adler School of Professional Psychology hosted a June 2010 conference entitled “The Social Determinants of Mental Health: From Awareness to Action” to increase awareness of the ways in which social determinants such as cohesion, income distribution, discrimination, and the distribution of public services impact mental health.
One strategy for acting on the social determinants of health is Health Impact Assessment (HIA)—a combination of procedures, methods, and tools undertaken to prospectively assess likely impacts of public proposals (e.g., legislation, policy, programs, and projects) on population health that yield evidence-based recommendations for fostering health equity. HIA also focuses on physical health to the relative neglect of mental health, yielding considerable information on the physical health effects of public proposals, but far less information on their mental health impacts. The ISE has launched efforts to explicitly and rigorously integrate mental health considerations into HIA practice—what we call the Mental Health Impact Assessment (MHIA).
In July 2010, we launched a pilot MHIA to assess the mental health implications of a proposed amendment to the city of Chicago’s Vacant Buildings Ordinance which would hold financial institutions more accountable for securing and maintaining foreclosed properties. The MHIA, based on a literature review and stakeholder input, revealed that the proposal could positively impact the mental health of communities hard hit by the foreclosure crisis. In August 2011, ISE staff provided testimony to the City Council based on the MHIA findings, supporting efforts that led to the eventual passage of the measure.
In January 2011, the ISE, with support from the Robert Wood Johnson Foundation and the W. K. Kellogg Foundation, launched a more ambitious MHIA. Working with the low-income African-American community of Englewood in Chicago, we are assessing the mental health implications of a proposed amendment to the U.S. Equal Employment Opportunity Commission Policy Guidance on the Consideration of Arrest Records in Employment Decisions. The amendment will strengthen prohibitions against the use of arrest records in employment decisions. The MHIA will be completed in summer 2012.
MHIA is useful for helping mental health and other professionals play a role in shaping the social conditions that impact population mental health. As such, it a tool for fostering systemic change and has the potential to be a key element of the mental health promotion and prevention toolkit. Its utility is heightened in a context of spiraling costs and shrinking government funding for mental health. This context requires that government decisions be “smarter”—that they narrow mental health disparities, promote mental health equity, and support population mental health. For more information on our work, please visit the Institute on Social Exclusion and the Mental Health Impact Assessment .
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More Information: Social Inclusion Programs, Technical Assistance Tools, and Research
This section includes highlights from the ADS Center’s online resource collection, a searchable database of 1000+ research articles, brochures, guides, toolkits, and resource organizations.
Please note: The descriptions below are pulled from or based upon the language provided on the organizations’ Web sites.
Promoting Systems Transformation
National Coalition for Mental Health Recovery is a major voice in the development and implementation of health care, mental health, and social policies at the state and national levels, empowering people to recover and lead a full life. Visit http://ncmhr.org to learn more.
The Asset-Based Community Development Institute is a national leader that works with community groups nationwide to help them develop asset-based community projects. These projects include conducting research with community members to identify community strengths and developing publications and resources. Visit http://www.abcdinstitute.org to learn more.
With the support of SAMHSA, the National Network to Eliminate Disparities in Behavioral Health (NNED) works to share community-based knowledge and training in multicultural practices to encourage collaboration and eliminate disparities in treatment services for people with mental and substance use disorders. Visit http://www.nned.net/index-nned.php to learn more.
Recovery to Practice provides resources such as quarterly newsletters and webinars to help behavioral health providers implement recovery-oriented approaches in their work with consumers. Visit http://www2.dsgonline.com/ rtp/resources.html to learn more.
The Centre for Economic and Social Inclusion works with the government, interest groups, businesses, and the public sector in both the United Kingdom and the United States to offer research and policy services and training and consultation to tackle disadvantage and help promote social justice. Visit http://socialinclusionus.org to learn more about the Centre’s work in the United States.
Changing Community Perceptions and Influencing Local Systems
Heartland Consumer Network is a consumer/survivor voice for Missouri that addresses health policies related to mental and substance use disorders and building a recovery focus within local communities. Through their Poetry for Personal Power project, they provide young adults impacted by mental and substance use disorders an opportunity to tell their stories of overcoming adversity through poetry, reaching hundreds throughout Missouri. Visit http://heartlandcn.org to learn more.
Pathways to Promise, working with the American Association of Pastoral Counselors, has launched an education and training initiative on mental health and substance use issues for faith leaders and their congregations. Visit http://pathways2promise.org/nti.htm to learn more.
The Developing a Stigma Reduction Initiative (with CD) guide provides practical tips to plan and implement an initiative, develop materials and templates, build effective partnerships with a wide range of key community organizations, and enhance outreach and resources for developing public education materials. Visit http://store.samhsa.gov/product/Developing-a-Stigma-Reduction-Initiative-with-CD-/SMA06-4176 to access this guide.
ABCD Institute Manual and Workbooks provide community members, leaders, and advocates with tools and strategies of how to make the most of local assets as key components in community development and sustainability. Visit http://www.abcdinstitute.org/publications and http://www.abcdinstitute.org/publications/workbooks to access these publications.
The Mental Illness Awareness Week Guide provides information on awareness activities, including activities tailored to the workplace, schools, and faith communities. This guide shares resources to help develop initiatives and provides a list of resource materials to help raise awareness and promote public education on the topic of mental and substance use disorders. Visit http://www.promoteacceptance.samhsa.gov/archtelPDF/Mental_Illness_ Awareness_Week_Guide.pdf [PDF format - 343 Kb] to access this guide.
Recovery Advocacy Toolkit: Engaging Your Community is a tool that highlights the benefits of recovery on a community and describes ways community involvement in advocacy can change public perceptions and promote effective public policy. To access this toolkit, visit http://www.facesandvoicesofrecovery.org/pdf/Advocacy_Toolkit/ engaging_your_community.pdf [PDF format - 262 Kb] .
Supporting Personal Wellness and Recovery
South Carolina SHARE is a peer-run statewide organization whose workshops, educational materials, and activities are all based on the belief that people with mental disorders can and do recover and that peers can support one another to enable them to live full and meaningful lives. Visit http://www.scshare.com/index.html to learn more.
The Transformation Center provides recovery-oriented peer-support services, trainings, and resources to help empower people with mental and substance use disorders. Visit http://transformation-center.org/index.shtml to learn more.
SAMHSA’s National Registry of Evidence-based Programs and Practices (NREPP) is a searchable online registry of more than 180 interventions which support both prevention efforts and treatment of mental and substance use disorders. Visit http://nrepp.samhsa.gov to learn more about this tool.
Walk in Recovery is a video in which five people share their experiences with mental disorders. This video tool helps others understand recovery and ways to support others in their journey. To watch this video and access the viewer guide, visit http://www.dshs.wa.gov/dbhr/video.shtml.
The Research and Practice Brief 2: Self-Determination, Beneficence, Choice, and Adherence provides direction to providers in highlighting the integration of choice and full engagement of consumers in services. This inclusion has been shown to help individuals with mental disorders make progress with their recovery. To view this document, visit http://www.adherenceandselfdetermination.org/images/stories/ casdrpb042011.pdf [PDF format - 269 Kb] to learn more.
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Information and Research
Boushey, H., Fremstad, S., Gragg, R., Waller, M. (2007). Social Inclusion for the United States. London: Centre for Economic and Social Inclusion. Retrieved from http://inclusionist.org/files/socialinclusionusa.pdf [PDF format - 1.1 Mb]
Mowbray, C. T., Lewandowski, L., Holter, M., & Bybee, D. (2006). The clubhouse as an empowering setting. Health & Social Work, 31, (3) 167–179. Retrieved from http://vaw.msu.edu/core_faculty/deborah_bybee/Articles/ Mowbray,_Lewandowski,_Holter_&_Bybee_(2006).pdf [PDF format - 832 Kb]
Percy-Smith, J. (2000). Policy Responses to Social Exclusion Towards Inclusion? Buckingham, Philadelphia: Open University Press. Retrieved from http://www.mcgraw-hill.co.uk/openup/chapters/0335204732.pdf [PDF format - 78.2 Kb]
Schneider, J.A. (2004). The Role of Social Capital in Building Healthy Communities. Baltimore, Maryland: Annie E. Casey Foundation. Retrieved from http://www.aecf.org/KnowledgeCenter/Publications.aspx?pubguid=%7BCD14730F-ACCC-46D2-B3A7-BFB3EA4D0836%7D
Vedantam, S. (2005, June 27). Social network’s healing power is borne out in poorer nations. The Washington Post. Retrieved from http://www.washingtonpost.com/wp-dyn/content/article/2005/06/26/AR2005062601091.html
Stepping Up: A Social Inclusion Action Plan for Mental Health Reform 2007-2012. South Australian Social Inclusion Board. Retrieved from http://www.publications.health.sa.gov.au/cgi/viewcontent.cgi?article=1015&context=spp
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ABOUT SAMHSA ADS CENTER
This update is from the SAMHSA ADS Center (Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health). SAMHSA ADS Center is a program of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services, Office of Consumer Affairs. We encourage you to share this information with others and to post it in your own newsletters or email lists.