Predictors of social inclusion among adults with severe mental illness: Results of a cross-sectional study

TL;DR

This study finds that older age, being in a relationship, certain diagnoses, employment status, and living arrangements are linked to higher social inclusion in people with severe mental illness.

Contribution

The study identifies specific psychosocial predictors of social inclusion using a validated measure in individuals with severe mental illness.

Findings

Older age, being in a committed relationship, and diagnosis of schizophrenia are linked to greater social inclusion.

Employment in competitive jobs or education, compared to sheltered work or unemployment, predicts higher inclusion.

Living with others is associated with greater perceived social inclusion among individuals with severe mental illness.

Abstract

Promoting social inclusion is crucial for people living with severe mental illness (SMI), who often experience high levels of social exclusion. However, research that uses a psychometric social inclusion measure to identify factors that determine varying levels of social inclusion in individuals with SMI is scarce.

This study aimed to examine to what extent people with SMI feel socially included and to identify factors associated with perceived social inclusion among people with SMI.

A cross-sectional multicenter investigation of psychiatric inpatients and day hospital patients with SMI aged 18 to 65 years (n = 358) was conducted. Perceived social inclusion, sociodemographic, and clinical characteristics were assessed using the Measure of Participation and Social Inclusion for Use in People with a Chronic Mental Disorder (F-INK). Hierarchical multiple linear regression was performed to analyse the association between social inclusion and potential predictors.

The participants’ overall level of social inclusion was moderate (F-INK social inclusion total score M = 1.9, SD = 0.6). Age, relationship status, diagnostic group, employment status, and living situation emerged as predictors of social inclusion. Greater subjective social inclusion was predicted by older age (p = .027), being in a committed intimate relationship (p = .037), diagnosis of schizophrenia spectrum disorder (compared to diagnosis of depression, p = .020), being competitively employed or in education (compared to being in sheltered employment, p = .022; compared to being unemployed or receiving a disability pension, p = .007), and living with other people (p = .042).

The results confirm deficiencies in social inclusion of people with SMI. Individuals with SMI who are younger, single, have a diagnosis of depression, are in sheltered employment, are unemployed or receiving a disability pension, and are living alone seem to be particularly at risk of experiencing low social inclusion. These findings highlight the importance of psychosocial interventions in rehabilitative mental healthcare.

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