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This chapter outlines concepts related to social exclusion that are relevant to people with mental health conditions. These concepts highlight the political and civil nature of exclusion (citizenship, equality and human rights, choice); the importance of material (poverty and deprivation), social (social capital, stigma, and discrimination) and individual factors (participation, choice, and agency); and a means of identifying and describing causal factors for social exclusion (agency and process, dynamic dimensions, multifactorial causes, life course, and longitudinal perspectives). It also covers personal recovery, which provides a bridge between the literature on social exclusion and that on mental health conditions.
Many psychiatrists in the UK may be surprised to find that the Government ratified a convention ten years ago that suggests compulsory mental health treatment be prohibited. The Convention on the Rights of Persons with Disabilities is arguably the most important legal instrument that no one in psychiatry ever discusses, but if moved from ratification to enforcement it would have enormous effect on day-to-day practice. Here, Dr Paul Gosney argues that the convention if enforced would be damaging for the people it aims to protect, whereas Professor Peter Bartlett defends it as a necessary challenge to the inequalities in our current system.
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