Report condemns social exclusion of people with mental illness

BMJ 1999;319:1312 ( 13 November )

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Report condemns social exclusion of people with mental illness

Gavin Yamey, BMJ

People with mental health problems are excluded from employment, education, and social services, according to a new report by the mental health charity Mind.

The report was based on oral and written testimonies from a range of individuals and organisations, including mental health service users, high street retailers, voluntary agencies, and NHS trusts. An independent panel used these submissions to identify the extent and causes of exclusion, and to make recommendations to promote inclusion.

The Mind inquiry discovered many openly discriminatory practices in workplaces with regard to mental illness. It also found that employers were underprepared and underinformed in dealing with mental health issues and that psychiatric services did not see work promotion for service users as part of their role.

The 1995 Disability Discrimination Act, which makes it unlawful to discriminate against disabled persons in connection with employment (BMJ 1996;313:1346-7), was seen as a positive step, although many respondents doubted its efficacy and questioned whether it took sufficient account of mental health problems.

One interviewee said: "One fairly notorious case was somebody diagnosed with schizophrenia who had just been released from hospital. He was found not to be disabled under the Disability Discrimination Act because the tribunal was impressed that he was capable of living on his own and capable of working�despite the fact that he'd been sacked."

The inquiry found widespread lack of access to education and training opportunities. Practical support mechanisms�such as benefits advice and transport�were rarely provided for people with mental health problems in further and higher education.

Mental health service users experienced difficulties in establishing social networks and were prevented from fully accessing everyday goods and services. Many respondents felt that the media had shaped and reinforced the widespread stigmatising attitudes of the public (23 October, p 1092).

Mind has urged the government to tackle social exclusion at national policy level and to replace the current Disability Discrimination Act with enforceable legislation based on a wider definition of disability. It recommends a national initiative to promote employment of mental health service users and a public education campaign to challenge the perception of mentally ill people as dangerous.

The report also states that the improvements outlined in the National Service Framework for Mental Health (9 October, p 940) are "meaningless if clinical mental health issues are divorced from the everyday reality of people's lives."

Ivan Massow, chairman of the inquiry, said: "People [with mental health problems] lost business interests because of company law, they lost access to financial services, courts denied them access to their children. As if to rub salt into the wound, social exclusion resulting from psychiatric diagnosis is even excluded from the government's own Social Exclusion Unit."

Creating Accepting Communities is available from Mind Publications (tel 0181 221 9666), price £9.99.
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