“The biggest barrier is to inclusion itself”: the experience of citizenship for adults with mental health problems

Abstract

Background

Citizenship has been promoted within mental health for several decades however, its application in the field of mental health policy and practice is relatively novel. The voices of people who experience mental health problems (MHPs) are often absent in ongoing discourses about citizenship.

Aims

To explore how adults with experience of MHPs and other life disruptions identify potential barriers to citizenship.

Method

A community based participatory research approach was adopted with peer researchers. Six focus groups (N = 40) using semi-structured interviews were conducted, consisting of participants who had experience of MHPs and other life disruption(s) within the last 5 years. The focus groups were audio recorded, transcribed verbatim and analysed in NVIVO using a thematic approach.

Results

Three major themes associated with participants lived experiences of barriers to citizenship were identified: ‘stigmatisation (internal & external) creates further divide’; ‘being socially excluded leads to isolation’; and ‘a sense of difference (as perceived by the self and others)’.

Conclusions

Those who have experienced major life disruption(s) face multi-level barriers to citizenship. An awareness of such barriers has important implications for mental health research, policy and practice. Citizenship-oriented implementation strategies that aim to address multi-level barriers merit further investigation.

Keywords:

• Mental health
• community based participatory research
• peer researchers
• citizenship
• barriers
• stigma

Acknowledgments

We would like to acknowledge the significant contribution made by the peer researchers that facilitated the focus groups. We would like to thank the generous time given by participants in taking part in this research. We would also like to thank Karen Black from Turning Point Scotland for her significant contribution to the research process.

Ethical approval

Ethics: Ethical Approval was granted by the Social Work and Social Policy Ethics Committee. The ethics chair is Dr Dan Heap Email: [email protected].

No reference numbers are used by the ethics committee when projects are approved. The Chair can be contacted for verification of ethical approval. Ethics: [email protected].

Disclosure statement

No potential conflict of interest was reported by the author(s).