R+U+OK?+-+The+Importance+of+Social+Inclusion

Social Inclusion- Its importance to mental health
 * __ Topic __****__ : __**

**SERIOUSLY ****, __R U OK? __**
 * __ Artefact: __**

media type="youtube" key="RCKPWs9nrHg" height="315" width="560" align="center"

This artefact is a video taken from the R U OK Australian website. R U OK DAY is a national initiative which aims to prevent suicide by encouraging Australians to connect with someone they care about (What is R U OK day?, 2009). This video opens with a snippet of an advertising campaign for the initiative, showing one of their main celebrity ambassadors, Hugh Jackman. With a few calm words, Jackman explains the simple intention of the project: to ask your friend, colleague or family member, R U OK?. The video continues by demonstrating the amazing extent of people this project has reached over the small period of two years. It demonstrates the extraordinary power of social media and its ability to reach a diverse audience. This video sums up the importance of a simple campaign such as this one, reiterating that ‘A conversation could change a life’ (What is R U OK day?, 2009).

The term mental illness generally refers to an illness that affects the mind or the brain and influences the way a person thinks acts and feels. It can affect people of all ages and walks of life as it is triggered by a variety of factors: physical, social, environmental and genetic. Mental illness is common with almost half of Australians between the ages of 16-85 experiencing a mental disorder at some point in their lives (Australian Government, 2009). Suicide is the most drastic result of poor mental health. In 2008, suicide was ranked the 10th leading cause of deaths in Australia with approximately 2,200 registered suicide deaths. Male suicide continues to outnumber females accounting for over three-quarters of all suicide deaths in Australia (Australian Government, 2007).
 * __ Public Health Issue __**

There are many symptoms and triggers associated with mental illness. One in particular that related to R U OK day is Social inclusion. Social inclusion relates to engaging with friends and peers through employment, leisure and education (Merton & Batema, 2007). As a result from social exclusion, loneliness is a wide spread problem for people with mental illness at a time when they need companionship more than ever. Almost half of people suffering from mental have no close friends, with one in six not having physical contact with another human being for at least 12 months (Barry, 2009). The experience of mental illness can be isolating which is only made worse when combined with the additional experience of social stigma and isolation. People diagnosed can enter into a vicious cycle of social isolation. Diagnosis of a mental issue can be alienating which can make the consequences of the diagnosis worse, leading to greater isolation (Merton & Batema, 2007). Most alarmingly, studies have shown that those who are socially isolated or disconnected from others have between 2-5 times the risk of dying from all causes compared to those who maintain strong ties with family, friends and the community.


 * __ Literature review __**

// If we plant a seed in a desert and it fails to grow, do we ask, //// “What is wrong with the seed?” No. The real conspiracy lays //// in this: to look at the environment around the seed and to ask, //// “what must change in this environment such that the seed can //// grow?” The real conspiracy that we are participating in here //// today is to stop saying what’s wrong with psychiatric survivors //// and to start asking: “How do we create hope filled, humanised //// environments and relationships in which people can grow?” // // Dr Patricia Deegan, //// Keynote Address, TheMHS Conference, 1996, Brisbane //

Social inclusion is a vital factor in the overall health and well-being of an individual. It relates to being able to participate in and contribute to social life in economic, social, psychological and political terms. Much research has been done in regards to the importance of social inclusion for good mental health. Studies have shown that people living with mental illness who are provided with well-planned, comprehensive support in the community have a better quality of life, develop an improved level of functioning and social contact and have fewer relapses (Grinshpoon, Naisberg, & Weizman, 2006). People living with mental illness must have the opportunity to be not just patients, but individuals with complex lives and needs. Participation in society improves mental health, self-discrimination and general functioning and on a broader social level reduces discrimination and stigmatisation (Merton & Batema, 2007).

The concept of mental illness and recovery has changed dramatically over the years. In early Neolithic times (approximately 2000 BC) they believed ailments causes mental illness, and in order to sure it the practice of ‘trepanation’, which consisted of cutting large holes into the skull, cured the disease releasing all the bad (Crystal, 2005). More recently in the 18th century, mental illness was not a considered a medical condition but rather a type of lunacy. Those who displayed signs of this insanity were segregated as outcasts from society in their homes (York, 2009). This same concept continued into the 19th century with the mentally ill sent to isolated institutions for observation. During these periods, it was believed that recovery from mental illness did not occur and that their condition would at best remain constant, and at worst, deteriorate. Thus, their mental health systems were designed to maintain people in a state of illness rather than focus on enabling and supporting recovery (Merton & Batema, 2007). The 20th century was labelled as the ‘decade for recovery’ as it was during this period that the concept of recovery gained credibility, due to the emergence of consistent evidence showing that people could recover. Today, we see mental illness as a group of conditions that can be treated with the process of recovery as an expectation following diagnosis (Merton & Batema, 2007). Though our research and understanding, we now know that supporting each individual’s recovery processes and preventing relapse has significant benefits for the individual, the community and their family and friends, through the reduction of negative impact.

// “Now the times have changed. Those of us who have experienced these symptoms //// are sharing information and learning from each other that these symptoms do //// not have to mean that we must give up our dreams and our goals, and that they //// don’t have to go on forever. We have learned that we are in charge of our own //// lives and can go forward and do whatever it is we want to do. We //// are climbing mountains, planting gardens, painting pictures, writing books, making //// quilts, and creating positive change in the world.” // // S.Mead and M Coperland //// 2007 //

Social connections include engaging with friends and peers, maintaining employment and economic wellbeing, undertaking education, hobbies, and engaging in physical exercise, leisure and recreation activities. These aspects ensure engagement with society to encapsulate the principles of having a sense of purpose and hope for the future.

A number of studies have confirmed this link between social inclusion and recovery from mental illness. In the UK, a study of over 15,000 people demonstrated that low social support increased chances of onset and decrease changes of recovery. Other social factors such as separation, becoming unemployed, health limited daily activities and caring for a sick relative all decreased changes of recovery (Pevalin & Goldberg, 2003). In 2004, a similar study was performed in Finland finding that social support strengthened mental health in all respondents. People who had recently recovered from mental illness identified assistance from other people as the most important aspect to their successful recovery (Victorian Government, 2005). These studies are two of many that demonstrate the direct link that social inclusion has on recovering from mental illness showing that with a vital support network, mental illness can be cured and the incidence of relapse are decreased. However, those suffering with a mental illness are more likely to have smaller social networks, with the average number of people in their close network between 5-13 people as opposed to the general population with 25 people in their close networks (Merton & Batema, 2007). This demonstrates that while social inclusion is so vital in recovery, those suffering still have small if any networks.

Alarming evidence has also arisen in regards to the likelihood of healthy individuals developing a mental illness. Currently, 16% of Australia households cannot afford to participate in social activities such as family holidays, a family night out, children’s involvement in sporting and extra-curricular activities. The number of people living alone has also increased to approximately 2million people. Each of these indicators are directly linked to the likelihood of individuals developing mental illness, with people reporting poor social connectedness being 3 times more likely to experience depressive symptoms (Victorian Government, 2005). As the levels of these indicators increase, the prevalence of mental illness will continue to soar. In order to reduce the prevalence of mental illness, preventative action needs to be taken to ensure that people are not feeling excluded and isolated from society and maintain good health.

While much significant research has taken place in regards to the link between social inclusion and the prevalence of mental disorder, there may be a few limitations in regards to the validity of the data. As each study requires a survey by individuals to judge their feelings and connectedness to society, all responses are self-perceived. This may result in answers being not entirely accurate as individuals have varied perception.

Although few limitations can be seen, it is undeniable that social inclusion plays a vital role in the recovery of those with mental illness. It can also be seen that those healthy who experience social exclusion are far more likely to develop a mental illness. These indicators need to be understood to ensure that mental health treatment focuses not only on medication but on community-based support.


 * __ Cultural and social analysis: __**

When looking at this issue of social inclusion and its importance to mental health, it is crucial to consider the many cultural and social groups, movements, trends and forces that both influence and are affected by this issue. In the broader terms of mental health specific age and gender groups are more prone to mental illness. Mental illness decreases with age with Young adults aged 16-35 have the highest prevalence of mental disorders with approximately 25% suffering (Australian Government, 2009). Overall, women are more likely to experience a mental disorder with 23 % suffering as opposed to 17% of males. This can be related to the pressures created by women’s multiple roles and gender discrimination which combine to account for their overall poor mental health (Australian Government, 2007).

While social exclusion can be experience by anyone, certain groups have been found to be more susceptible, impacting on their health and wellbeing. The recent influence of the global financial crisis is a social factor negatively impacting individuals. Unemployment and homelessness are two of the largest factors influencing an individual’s level of social inclusion. Currently there are approximately 400,000 unemployed and 100,000 homeless people living in Australia (Australian Government, 2009). These social trends are so detrimental to mental health as social inclusion relies mainly on the relationships and connections formed within a family and the workplace. Both family and the workplace are a part of everyday life and the sudden loss of either of these factors has proven detrimental to health. Recent statistics show that of the unemployed, 34% are suffering a mental disorder and of the homeless 80% are suffering (Australian Government, 2009).

In terms of young people, children who are in care, or from low income households, as well as those who experience family conflict, do not attend school, and come from minority backgrounds are at risk from social exclusion ( Hertfordshire County Council, 2001). The reason for their increased susceptibility is that many of the effects of social exclusion are linked. For example, the health and family status of an individual has been found to impact on their educational achievement, this relates to income and employment potential, which in turn relates to the extent of an individual’s awareness of and ability to access services and facilities ( Hertfordshire County Council, 2001).

Another group that is significantly affected by the issue of social inclusion are immigrants, refugees and asylum seekers. These groups of people come to our country to essentially find a safer and secure life however they are at severe risk of social exclusion. Many migrants and refugees experience multiple barriers to inclusion in Australian society.

Some of the areas in which culturally and linguistically diverse communities in Australia experience barriers include language, change in food and means of transport (Ethics Community Council Victoria, 2009). On a more personally level, these people may be experiencing family trauma, feelings of uncertainty and change, and discrimination which results in their exclusion from society. These people are at an extreme risk of developing a mental illness as they have no connections to their new environment.

Each of the discussed social and cultural groups has an increased risk of developing a mental illness. Awareness of this issue is very important so that precaution can be taken to assist those at risk. It is very important that these at risk people understand the importance of being involved and social included assisting their mental health and wellbeing. Awareness also needs to be raised so that the general public are aware and can assist by connecting with these people to ensure that they feel included and loved. It is important that the government develops programs and policies to assist these at risk groups to ensure that they do not go on to suffer a mental illness.

Staying connected and feeling involved with others is crucial in achieving good mental health. The R U OK day project encourages communication and compassion over something as simple as a coffee and a conversation that could change or even save a life. By encouraging conversation to check that your friends and family ‘are feeling ok’, is a simple gesture that could mean the world. To someone who may be feeling down or under the weather, by having a friend or family member showing their love and support could boost their confidence. Social exclusion is an increasing issue in our society that is halting the recovery process of those suffering mental health, as well as increasing the risk of individuals developing a mental illness. The R U OK day initiative is raising awareness of the importance of something simple as making sure your loved ones are ‘ok’. This video represents the success and power of the R U OK Day initiative. After only two years of running, an estimated 58% of the Australian population knew about this national suicide prevention initiative, with 1 in 5 Australians getting involved.
 * __ Leaning Reflections __**

Personally, I believe that this project is revolutionary, demonstrating that a simple concept, to help others can be easily created and shared to a diverse audience. This project shows the importance of a more personally approach when dealing with a health issue. In the future I aspire to be working for the government or a non for profit organisation such as R U OK as a health promotions officer, coming up with campaigns and initiatives to improve the overall health of Australians. This project has made me realise the importance of simple ideas to address the whole health issue. It also reiterates the power social media has in passing a message on and generating hype and awareness. When hopefully working in health promotion in the future, I plan to adopt these simple techniques into my own initiatives to better Australian health and wellbeing.

__** Page: Y Risk it? **__ I thoroughly enjoyed reading your wiki as I believe the topic you discussed is of current great concern. I was impressed at how you addressed three very important issues so clearly and integrated them well. All the statistics in your literature review helped your case by giving very alarming figures to stress the importance of these issues.
 * __ Reflections: __**

Binge drinking amongst underage teenagers is an issue I feel very strong about. I find it hard to believe that some youths are under the impression that the only way to have a good time is with alcohol. In the past alcohol was a beverage that could be enjoyed with friends however now, youths set out each weekend to ‘get drunk’. It is this attitude amongst some gen Y’s that has caused them to be in the spotlight when it comes to health.

I liked how your artefact was a snippet showing the busy life of a teenager, however I agree with critics in saying shows like this can encourage bad behaviour. Shows like this sometimes make serious issues such as those you discussed: alcohol, drugs and sex glamorous and cool and seem normal to the youths watching. Job well done with your wiki, raises some great points!

__**'If you let me play sports, I will learn what it means to be strong'.**__ When first stumbling across the title of your wiki I was unsure what to expect. Your artefact is one of the most interesting I have looked at, and something I haven’t seen before. I was really shocked watching this video to know that just by playing sport girls are far less likely to suffer many health risks. As you mentioned, it definitely demonstrates the amazing benefits of girls participating in physical activity.

One part of the video that particularly stood out for me was the statistic about breast cancer: “Be 60 percent less likely to get breast cancer”. To me, this is jaw dropping. Breast cancer is such a serious issue that has affected so many families. For girls to be 60 percent less likely to develop the disease just by participating in physical activity is huge.

I think this issue is something that is not discussed enough in the Australia media and I would love to see a campaign like the Nike one, in Australia because I do not think people understand the importance of girls participating in physical activity and the amazing benefits it can have on their health. Really enjoyed that you took a different spin on the issue! Well done.


 * __ References: __**

Australian Government. (2007). //Mental Health statistics fact sheet//. Retrieved october 2011, from Health department of Australia: http://www.health.gov.au/internet/mentalhealth/publishing.nsf/content/C5DCE1B680AF5ACACA2577B5007B77B7/$File/mh%20stats%20facts.pdf

Australian Government. (2009). //Mental Illness//. Retrieved October 2011, from Australian Bureo of Statistics: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features30March%202009

Barry, E. (2009, April 12). //Mental illness and loneliness//. Retrieved October 2011, from Body and Soul: http://www.bodyandsoul.com.au/health+healing/news+fe atures/mental+illness+and+loneliness,9441

Crystal, M. (2005). //Introduction To Trepanation//. Retrieved October 2011, from http://www.trepanationguide.com/

Ethics Community Council Victoria. (2009). //Social Inclusion for immigrants and refugees//. Retrieved October 2011, from http://eccv.org.au/library/doc//03Feb09_ECCV_Issue_Paper_Social_Inclusion_for_Migrants_and_Refugees.pdf//

//Grinshpoon, A., Naisberg, Y., & Weizman, A. (2006). A six month outcome of long-stay inpatients resettled in a hostel.// Psychiatric Rehabilitation//, 89-94.//

//Hertfordshire County Council. (2001).// Social Inclusion//. Retrieved October 2011, from Hertfordshire County Council: http://enquire.hertscc.gov.uk/qol/2001/socialexc01.pdf//

//Merton, R., & Batema, J. (2007, September).// Social Inclusion - importance to mental health//. Retrieved October 2011, from Mental Health Coordinating Council: http://www.mhcc.org.au/images/uploaded/MHCC%20Social%20Inclusion.pdf//

//Pevalin, D., & Goldberg, D. (2003). Social Precusors to onset and recovery from episodes of common mental illness.// Psychological medicine 33(2)//, 299-306.//

//Victorian Government. (2005, March).// Social Inclusion as a determinant of mental health and wellbeing//. Retrieved October 2011, from Victoria Health: http://www.vichealth.vic.gov.au/~/media/ProgramsandProjects/MentalHealthandWellBeing/Publications/Attachment s/Social_Inclusion_Final_Fact_sheet.ashx//

What is R U OK day? //(2009). Retrieved October 2011, from R U OK?: http://www.ruokday.com.au/content/what-is-r-u-ok-day.aspx//

//York, S. H. (2009).// Sucide, asylum and luncacy history England//. Retrieved October 2011, from http://etheses.bham.ac.uk/801/1/York10PhD.pdf