How Might Community Development Improve the Mental Health of Service Users and the Wider Public?

There is a growing body of evidence that suggests the most marginalised or least powerful members of society, for example, the poor, the young, and minority groups, especially those with mental health (MH) needs experience the greatest vulnerabilities, instabilities, stigmatisation, disconnection and discrimination. Each of these experiences can, and often does lead to social exclusion within the context of ‘community’, their local residential area and connecting geographical areas, and the population within them (Open University, 2015: Christens, 2012).

It is important to recognise the broad factors the concept of ‘social exclusion’ is associated with such as poverty, unemployment, individuals, groups and even communities. Its experience is a breeding ground for wealth and health inequalities, social injustices and disadvantage (Wright and Stockley, 2013). There is empirical research suggesting the cause and effect of MH problems and social exclusion are difficult to differentiate between because of their sensitive and complex nature. Davie (2005) cited in (Wright and Stickley, 2013) for example suggests medical categorisation and ‘socially excluded’ labelling of individuals accessing MH services can exacerbate not only a loss of autonomy but also further stigmatisation and exclusion; social separation from mainstream society. This exclusion diminishes social capital; social relationships (networks), social roles and identity, opportunities including civic and economic participation and prosperity. Reinforcing the relationship between discrimination and mental illness (Chidanyika and McSherry, 2015).

Hence social relationships and inclusion have value for all. Positive and meaningful contact with family, friends, fellow MH service users and practitioners have all been shown to have a stabilising effect on an individual’s MH and wellbeing. However, it can be difficult for an individual with MH needs to consolidate and sustain reciprocal social relationships outside of their ‘identity community’; other service users and MH orientated organisations and services (Wright and Stickley, 2013). The support a service user can receive from these, often peer lead environments, is emotionally valuable and often specific to shared experiences; promoting understanding, empowerment, resilience and a sense of belonging. It can also, however, increase exclusion from mainstream society, and exclude mainstream society from their identity community, increasing barriers that prohibit inclusion, for all (Open University, 2105).

In an attempt to drive social change by challenging the oppressive norms and ideologies that serve to isolate or marginalise, community development (CD) works at a community level to support collective change and strengthen civil society by social, economic and environmental policy and empowerment (RSA, 2015). CD programmes recognise the value of and, work within the core social principles that underpin human rights, respect for all, social inclusion and equality for all. It supports democratic life, promotes autonomy, breaks down barriers of exclusion by building stronger links within a community; promoting action and potential for individuals to organise and resource themselves to respond to the issues and needs they may share as a community (Scottish Community Development Centre, 2014). By tackling prejudice and building social networks they can ‘connect and include’ all members of a local community, such as those of geographical location, identity and those communities organised around specific themes or policy initiatives. To connect, for example, those with MH needs to community activities and mainstream services can increase participation, empowerment, resilience, understanding, opportunity and choice (Seebohm et al., 2012).

RSA’s (2015) report - Community Capital - The Value of Connected Communities further demonstrates how individuals, informal groups and organisations working with communities can connect people to one another in their local community, strengthening social networks and the capacity of each of its members to become active citizens. Conversely, Seebohm et al., (2012) identifies how a lack of directly related statistics can impact government community empowerment policies and short-term funding, and how these policies could make better use of CD to interlink community and professionals working together on an equal platform for sustainable and long-term integration and positive outcomes; mental wellbeing and recovery (Seebohm et al., 2012). Also, it is important to remember, whilst many MH services users find a sense of connectedness and belonging within their ‘identity community’, ultimately it is their choice as an individual as to whether they engage in CD activities - some may still feel the cost of social integration outweighs the benefits, and many may still fear further exposure and
experiences of discrimination, stigmatisation and prejudice.

Author:  Anita Steer Couns, Dip. Registered (MBACP).

 

References 


Chidanyika, J., and McSherry, R. (2015) ‘The barriers of stigma for service users: A critical realist viewpoint’, British Journal of Mental Health Nursing, vol. 4, no. 1, pp. 12-19.

Christens, B. D. (2012) ‘Targeting empowerment in community development: a community psychology approach to enhancing local power and well-being’, Community Development Journal, vol. 47, no. 4, pp. 538-554.

RSA, (2015). Report: Community Capital - The Value of Connected Communities [online]. Available at https://www.thersa.org/discover/publications-and-articles/reports/community-capital- the-value- of-connected- communities (Accessed 27 January 2017).

Scottish Community Development Centre (2014) What is Community Development? [Online]. Available http://www.scdc.org.uk/who/what-is- community-development/ (Accessed 27 January 2017).

Seebohm, P., Gilchrist, A., and Morris, D. (2012) ‘Bold but balanced: how community development contributes to mental health and inclusion’, Oxford University Press and Community Development Journal, vol. 47, no. 4, pp. 473-490.

The Open University (2015) Mental Health and Community: Workbook 2, Milton Keynes, The Open University.

Wright N., and Stickley, T. (2013) ‘Concepts of social inclusion, exclusion and mental health: a review of the international literature’, Journal of Psychiatric and Mental Health
Nursing, vol. 20, no. 1, pp. 71-81.