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Introduction
In 2008, the Royal College of Psychiatrists set up a Scoping Group to examine the nature of social exclusion and how it affects people with mental health problems and those with learning difficulties. The findings of the group were published as a position statement and as a book examining social inclusion and mental health ([28] Royal College of Psychiatrists, 2009; [1] Boardman et al. , 2010). This paper summarises some of the main findings of the Scoping Group and their implications for mental health services.
What is social exclusion?
The term "social exclusion" belongs in the social policy literature and has emerged comparatively recently, however, its origins are much older. Social exclusion is one way of conceptualising disadvantage, traditionally seen in terms of "poverty", "hardship", "destitution"; all of which focus on material deprivation and the consequent personal distress of want and misery. These are matters that have been historically documented in the UK by, for example, the surveys of [27] Rowntree (1901) and [2] Booth (1889) and the later work of figures such as [35] Townsend (1979). They also still part of contemporary life in the UK and have a day-to-day familiarity to people with mental health problems and those working in mental health services.
The modern use of the term social exclusion appears to have originated in France during the 1970s ([3] Burchardt et al. , 2002a; [21] Morgan et al. , 2007), referring to Les Exclus , people who have slipped through the net of the social insurance system and are thus administratively excluded by the state, such as disabled people, lone parents and unemployed people.
A helpful definition of social exclusion comes from the Centre for Analysis of Social Exclusion at the London School of Economics ([4] Burchardt et al. , 2002a):
An individual is socially excluded if he or she does not participate in key activities of the society in which he or she lives.
This definition highlights the central idea of participation and recognises that social exclusion is a relative concept, relative to the time and place in question. Importantly, this lays an emphasis on the lack of participation as being due to constraint, rather than choice.
There are, however, many competing views about the ways in which exclusion...