From social to political exclusion

This is the second post in a series about political involvement for mentally ill people. In the previous post I wrote about social exclusion and mental health, this time I want to explain what political exclusion is and what forms it takes.


Political exclusion is an aspect of social exclusion. In the previous post I quoted the wikipedia definition that social exclusion refers to "processes in which individuals or entire communities of people are systematically blocked from rights, opportunities and resources that are normally available to members of society and which are key to social integration." Political exclusion then consists of processes which have the effect that specific groups or people are not or not fully involved in the democratic decision making process; they can or do not make their voice heard or are not listened to. (Note the difference between they can not and they do not make their voice heard, which ties into different ideas about the role of the government: should they involve people just passively or also actively? Is it enough to just give people the right to vote or does the government also have a duty to reach out to those who are not inclined to vote despite having the right to?)

First we should ask what rights, opportunities and resources are normally available to members of society. Political inclusion, involvement, engagement, happens through a number of channels, importantly voting and joining political parties but also charity work, lobbying, and participating in protest marches. Forms of behaviour that have a political effect but that I do not include are buying and selling, which has an influence on the market and which does suggest certain morals and ideas, and talking to friends about politics, thus influencing their ideas. Both of these activities have an effect on politics but very indirectly so; it would be hard to measure. At least for now I am looking only at activities in which people explicitly express their ideas and try to influence governmental politics directly. 


The resource model of political participation
Before I look at political exclusion further, it is important to first understand what normal participatory behaviour is like. I want to know a bit more, then, about how political participation is generally categorised and understood, so I found this article by Henry E. Brady, Sidney Verba and Kay Lehman Schlozman. It details the "resource model" of political participation that they developed to explain why socioeconomic status can predict the amount of participation of an individual quite well. In short, if you have more time, money and organizational skill you can give more of it. This is a reaction to what they call the SES model, which focuses on "components of socioeconomic status: education, income and occupation".

The main reason why their model is very relevant to our current pursuit is that it offers quite precise and well-defined measuring tools; how much income does a person get, how many hours are they in work or day activities (e.g. sport club). The question of whether mental health service users have the right resources available can then be answered, making it easier to distinguish between whether they can not or do not make their voices heard. It would point in the direction of the causes of political exclusion and in doing so the solutions will also become clearer.

Another important thing they note is that different resources can be handy for different types of political activity. This might be useful later on in the research when looking at the question of whether some types of political participation might be especially accessible for mentally ill people.

I have another report here by the Electoral Commission, called "Social exclusion and political engagement", which takes the same stance that "inadequate 'resources' (material wealth, education, and skills and membership of organised groups) constrain or promote [?] participation" (p.7). This shows that Brady, Venda and Schlozman's idea is not unique - maybe for the better, more support is probably not a bad thing. I'm still happy to have found the article as they explain it all very well and try to keep things measurable.


Election exclusion
Knowing a bit more about political participation, we can now look at practical forms of political exclusion. I'll talk about voting first. I don't think I have enough time/resources yet to discuss other types of involvement today in any way beyond pure guesswork (OK I'll posit one hypothesis, see below), but I'll come back to it later.

Voting is the most clear-cut and measurable example of political participation, and therefore also one of the most studied ones. First of all, looking at the law, we find that mental health service users are excluded from the right to vote in many European countries. We can also look at voting statistics to see whether those who have the right to vote, actually do (although this is a bit harder to find out.)

The European Union Agency for Fundamental Rights (FRA) has written a report entitled "The right to political participation of persons with mental health problems and persons with intellectual disabilities". They look mainly at the right to vote and to be voted for. The report was written "in the spirit" of the UN Convention on the Rights of Persons with Disabilities (CRPD) and notes that political participation "exemplifies the three key principles of the disability strategy grounded in the CRPD, namely: non-discrimination, equality and active inclusion." (p.7) (I'm making a note of this because I was happy to find it refers to what I said above about passive vs active inclusion.)

The report shows that the international community is quite divided on whether people who cannot take care of or responsibility for themselves should have the right to vote (also, whether prisoners or convicts should have that right.) In tomorrow's blog post I will discuss arguments for why people with mental illness should be included; for now it is enough to show that they are not. In 16 of the 27 EU countries considered in this report (written in 2010, so Croatia is not yet included) people are denied the right to vote or be voted for if they are under protective measures i.e. guardianship, regardless of their individual level of functional ability. Five countries (including NL!!! go us) have the right to full participation entrenched in their constitution and there are others that make specific provisions. On the UK (not-havers of a constitution) the report notes the following: "The Electoral Administration Act 2006 abolished the common law rule that a person lacks legal capacity to vote by reason of mental health problems." That said, it is slightly shocking how recently that ruling was still current.

On actual voting I have some sources that show that turnout is worse in socially deprived groups and communities. The Electoral Commission report I mentioned above notes that turnout among unemployed people is only 48%, but doesn't compare it to other groups, which is pretty terrible; luckily this website has the stats on the general turnout in 2001, namely 59.1%. It mentions research by Ipsos MORI which "estimates that 68% of social AB groups voted compared with 53% of DEs" (what are AB and DE groups, click here). These are both related to employment status, they also say the proportion of lone parents in a constituency was proportionally related to the turnout there. Although I haven't found any statistics on actual turnout among mental health service users yet, as I tried to explain in my previous post mental illness and social deprivation are very much related to each other, so based on the Electoral Commission data we can at least predict that turnout will be substantially lower.


Hypothesis to end the day's post
Following the line from the Brady, Venda and Lehman-Schlozman article, civic skill is crucial in organizing non-electoral forms of participation. That may contain the key to why it is harder for mentally ill people to get involved, as mental illness can inhibit civic skill; not to say that people haven't been properly educated or involved in their youth because often they have. The observable and obvious though is that mentally ill people have trouble taking responsibility and getting/keeping their life on track. Organisational and communication skills are exactly what one loses when mental illness hits and this is why such activities as charity work and organising protests are harder to get into.

Another post tomorrow, see you all then and thanks for listening.

Click here to see the sources found and used in making this post.

Explaining what social inclusion has to do with mental health

Social exclusion is seen as both one of the drivers and one as the consequences of mental health problems, logically leading to vicious spirals. As a crude example, say someone has a relationship breakdown. They could be depressed and anxious as a result and lose their job, leading to debt, leading to housing problems, leading to low self-esteem and anxiety as well as the obvious perks of being homeless.

I have to catch up on a report for the internship I did between August and December last year for MindWise Mental Health. The main question of the report is what could be done to involve mentally ill people, or "service users" in MindWise terminology, in political decision-making. I'll keep track of my progress here as it's an opportunity to start writing and to break the question down in small pieces - I'm already really noticing the difference to my writing habits. In this post then I will further elaborate on social exclusion, in a/the next one perhaps on political in- and exclusion which is related but more narrowed down.

What makes the link between social inclusion and mental health problems really interesting is that it may be the key to understanding how come mental illness occurs much more in more deprived parts of society. (I think John Read makes the case for this really well in the book he wrote with Loren Mosher and Richard Bentall but I can't find it online to link it here. Here's a review though)

The definition of social exclusion seems pretty clear-cut to me but as with all things in Politics, really, it is an essentially contested concept (because politicians tend to bend and stretch language so it justifies their political decisions. Often intentionally. In this case, some argue talking about social exclusion became popular in politics because it was more acceptable, less inciting than talking about poverty.)

The definition in this report seems to take the contestedness of the concept into account:

The Social Exclusion Unit has always adopted a flexible and pragmatic definition of social exclusion as "what can happen when people or areas suffer from a combination of linked and mutually reinforcing problems".

The definition in the Wikipedia summary for Social Exclusion is perhaps less flexible but easier to understand:

Social exclusion refers to processes in which individuals or entire communities of people are systematically blocked from rights, opportunities and resources (e.g. housing, employment, healthcare, civic engagement, democratic participation and due process) that are normally available to members of society and which are key to social integration.

 I wanted to explain why mentally ill people especially have problems with social exclusion and what further consequences it can have for the people themselves and I have a number of tabs open with reports to read that will help me say it, but I think I explained at least part of that pretty well in the first paragraph; there is a cycle of opportunities that you can only grasp if you have certain other things sorted in your life, for which yet other things need to be in place.

Another big part of it is the stigma associated with mental health. At one hand actual discrimination from potential employers and from the community altogether will stop a person with mental health problems from reintegrating, at the other hand the fear of these things happening will make a service user want to stay in the relative comfort of the service. It will also serve as an obstacle to building up trust and self-esteem. Media contribute to the stigma as mental illness is often only mentioned in relation to crime, e.g. after a murder people will try to prove that the suspect was delusional.

This report further says that lack of clear responsibility and bad cooperation between different mental health organisations also don't help to prevent social exclusion.