1 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.
2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
Int J Soc Psychiatry. 2019 Aug;65(5):413-424. doi: 10.1177/0020764019852657. Epub 2019 Jun 4.
Social inclusion is increasingly understood to have positive and beneficial implications for the mental health outcomes of people with severe mental illness. The concept is plagued by definitional inconsistencies and a lack of consensus regarding what it means to be socially included, in particular for groups most vulnerable to social exclusion, such as people with mental illness. The aim of this study was to obtain a consensus regarding the key contributors to social inclusion from the perspective of people with and without a lived experience of mental illness (consumers of mental health services, carers, and general community members).
Delphi methodology was employed to reach consensus agreement. The Delphi questionnaire was based on a previous review of the literature and consisted of 147 items categorized into 13 domains. It was presented to participants over three rounds. Participants ( 104) were recruited into three groups (32 consumers, 32 carers of people with a mental illness, and 40 members of the general community - neither consumers nor carers). Retention of participants from Round 1 to Round 3 was 79.8%.
Similarities and differences were observed between the groups. A number of items were very strongly endorsed as key contributors to social inclusion, relating to social participation, social supports, housing, neighbourhood, community involvement, employment and education, health and well-being and service utilization.
Findings supported previous work, indicating the importance of having a strong sense of connection with others as well as the importance of safe and stable housing, support services and personal motivation and hope. We obtained a well-rounded perspective among groups regarding the key contributors to social inclusion, with a particular relevance to people living with mental illness. This perspective has significant clinical and research utility.
社会包容越来越被理解为对严重精神疾病患者的心理健康结果具有积极和有益的影响。该概念受到定义不一致和缺乏共识的困扰，特别是对于最容易受到社会排斥的群体，例如精神疾病患者，关于社会包容的含义是什么。本研究的目的是从有和没有精神疾病（精神卫生服务的消费者、照顾者和一般社区成员）的人角度，就社会包容的主要贡献因素达成共识。
采用德尔菲法达成共识。德尔菲问卷基于对文献的回顾，包含 147 个项目，分为 13 个领域。它分三轮呈现给参与者。参与者（104 人）被招募到三个组中（32 名消费者、32 名精神疾病患者的照顾者和 40 名一般社区成员 - 既不是消费者也不是照顾者）。从第一轮到第三轮，参与者的保留率为 79.8%。
观察到组之间存在相似点和差异。许多项目被非常强烈地认为是社会包容的关键贡献因素，涉及社会参与、社会支持、住房、邻里关系、社区参与、就业和教育、健康和幸福感以及服务利用。
研究结果支持了先前的工作，表明与他人建立强烈联系的重要性以及安全稳定的住房、支持服务以及个人动力和希望的重要性。我们从各个组中获得了对社会包容的主要贡献因素的全面视角，特别是对于那些患有精神疾病的人。这种观点具有重要的临床和研究实用价值。
