Exclusion and mental health—the relationship context of mental health practice

Abstract

This paper will explore relationship aspects of social exclusion and consider their implications for mental health and for social work mental health practice. Current understandings of the impact of exclusionary social relations tend to focus on their implications for people's capacity to achieve need satisfaction, and thus seek to address the denial of inner and outer resources. However, a further dimension of these relations is that of their meanings for people, arising in discourses involving exclusion from relationships of respect. Evidence indicates that these meanings result in the experience of trauma, which can be shown to make its own contribution to disempowerment in the mental health context. In accordance with this, research suggests that relationships between the worker and service user which involve respect result in good mental health outcomes, and simultaneously provide a foundation for anti-discriminatory practice. The paper suggests that social work education in respect of these issues may be approached using the broad framework of radical empowerment theory, which relates discriminatory social relations to societal discourses. Within this framework, the paper explores particular educational strategies in respect of the trauma-related aspects of exclusion.