Social exclusion and mental health: conceptual and methodological review.
BACKGROUND
The concept of social exclusion is now widely used in discussions about the nature of disadvantage, and there are ongoing initiatives to promote social inclusion among those with mental health problems.


OBJECTIVE
To conduct a conceptual and methodological review of social exclusion, focusing initially on the origins and definitions of the concept and then on approaches to its measurement, both in general and in relation to mental health.


METHODS
We used two main strategies. First, we utilised expertise within the study team to identify major texts and reviews on social exclusion and related topics. Second, we searched major bibliographic databases for literature on social exclusion and mental health. We adopted a non-quantitative approach to synthesising the findings.


RESULTS
There is no single accepted definition of social exclusion. However, most emphasise lack of participation in social activities as the core characteristic. There are a number of approaches to measuring social exclusion, including use of indicator lists and dimensions. In the mental health literature, social exclusion is poorly defined and measured.


CONCLUSIONS
If social exclusion is a useful concept for understanding the social experiences of those with mental health problems, there is an urgent need for more conceptual and methodological work.
Health Service and Population Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. spjucrm@iop.kcl.ac.uk
Craig
C
Morgan
Tom
T
Burns
Ray
R
Fitzpatrick
Vanessa
V
Pinfold
Stefan
S
Priebe
D016022:Case-Control Studies; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D015995:Prevalence; D012918:Social Alienation; D012944:Social Support