2001;5(2):18–23. This review identified 22 relevant measurement tools across the peer-reviewed and grey literature. Over 30% of participants reported symptoms of a mild or above mild level of depression. It typically occurs in the context that the individual or group is believed to possess undesirable characteristics or characteristics deemed unworthy of attention. Med. One paper included a definition of social inclusion apparently composed by the authors themselves [47]. Search Now. No external funding was applied for or used in the conduct of this research. We included a number of review papers, mostly looking at mental health, adding to the likelihood that all relevant individual measurement tools were included. One tool (1/21), the Staff Survey of Social Inclusion (SSSI), was carried out by staff at the mental health service without the relevant patient being involved in the assessment. Omtzigt DJ. Items: 12 / … Dickens G, Weleminsky J, Onifade Y, Sugarman P. Recovery star: validating user recovery. Margrove KL, Heydinrych K, Secker J. Accessed 12 July 2017. The phrase social exclusion originated in 1970s France when Socialist politicians began discussing the adversity faced by ‘les exclus’; a group of citizens who were not provided for by the state social security net [2]. Accessed 14 Jul 2016. The social quality of Europe. Wright N, Stickley T. Concepts of social inclusion, exclusion and mental health: a review of the international literature. 2012; https://doi.org/10.3310/hta16010. POD and KE developed the detailed plan for conduct of comprehensive searches. The literature pertaining to two of the tools in particular, the SCOPE and the LCQ, highlighted that the authors had conducted extensive searches for existing measures of social exclusion and social inclusion prior to beginning their own work. 2010;32(12):1043–50. Van Brakel WH, Anderson AM, Mutatkar R, Bakirtzief Z, Nicholls PG, Raju M, et al. Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. 165-172). The measurement of social inclusion status and its changes over time in patients who are engaging with treatment for mental health problems are seen as tangible outcomes in mental health clinical settings; they are considered useful alongside the more traditional measures of symptom control. A total of 170 documents were included in the final scoping review. In: Hills J, Le Grand J, Piachaud D, editors. © 2021 Springer Nature Switzerland AG. Social exclusion is a multidimensional, dynamic concept which emphasises the processes of change through which individuals or groups are excluded from the mainstream of society and their life chances reduced. London: Palgrave MacMillan; 2000. 2016;52(8):1113–7. The final SEKN report summarised that “social exclusion processes result in a continuum of inclusion/exclusion characterized by inequalities in; access to resources (means that can be used to meet human needs), capabilities (the relative power people have to utilize the resources available to them) and rights. Primary healthcare services, such as general practice, work to alleviate many of the causes and ill effects of social exclusion on a daily basis – primary healthcare professionals understand that to cure or attempt to resolve the health problems of many of their vulnerable patients, they often need to find solutions to the exclusionary processes being experienced by those patients, as well as dealing with the actual medical issues. Soc Indic Res. World Health Organization. Publications for inclusion had to relate primarily to social exclusion or social inclusion and their measurement in relation to health. It’s as simple – and as complicated – as that” [17]. A concept mapping study on social inclusion in Hong Kong. Inclusion Health: Improving Primary Care for Socially Excluded People: Department of Health. 2010. http://webarchive.nationalarchives.gov.uk/+/http:/www.cabinetoffice.gov.uk/media/346574/inclusion-health-evidencepack.pdf. These tools cover a wide variety of domains, perhaps highlighting the differing views of researchers and practitioners on what exactly is meant by the terms social exclusion and social inclusion. Accessed 10 Dec 2016. CAS  These tools vary in the number of items they include, how scores are allocated and in how they are administered. Int J Equity Health 17, 15 (2018). One row of Table 1 is incomplete as we were unable to obtain the original Human Givens (HG) tool [40], and we had to rely on scant secondary information to describe this measure [41]. Accessed 20 Aug 2016. When reviewing the administration of the tools, the number of items or questions included in each tool varied; with 121 questions asked in the long version of the SCOPE too, compared to four questions in the measure of Multidimensional Social Inclusion (MSI). Social exclusion, which is a phenomenon that covers The Social Inclusion Scale (SIS) has three subscales measuring social isolation, relations and acceptance. O’Donnell, P., O’Donovan, D. & Elmusharaf, K. Measuring social exclusion in healthcare settings: a scoping review. More recently, some authors such as Adam and Potvin have taken the work of the SEKN and adapted it to focus more on individual level social exclusion [58]. A subgroup of the Commission, called the Social Exclusion Knowledge Network (SEKN), was established in 2006 to investigate and report definitively on the relationship between these two concepts. Developing the living in the community questionnaire: reporting the social outcomes of mental health care. Davey S, Gordon S. Definitions of social inclusion and social exclusion: the invisibility of mental illness and the social conditions of participation. What advice is there for people on the other side (i.e., sources) who want to minimize its negative impact and preserve their own reputation? Preliminary development and validation of an Australian community participation questionnaire: types of participation and associations with distress in a coastal community. Accessed 14 Feb 2017. The authors summarised that “action to improve the health of disadvantaged populations should …. Lenoir R. Les Exclus: Un Francais sur Dix. There were a number of limitations to this scoping review. 2006. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.469.5761&rep=rep1&type=pdf. 2004. http://www.who.int/mental_health/evidence/MH_Promotion_Book.pdf. Accessed 12 May 2016. Three of the tools (3/21) were based on previous quantitative surveys or national censuses carried out in their country of origin; the Social Inclusion Questionnaire User Experience (SInQUE), the Social Inclusion Scale/Measure (SIS/SIM) and the APQ-6. 2001. http://apps.who.int/classifications/icfbrowser/. 2010;15(1):37–48. Accessed 01 Mar 2016. Occupation for mental health and social inclusion. Social exclusion is multidimensional, and can encompass a lack of access to employment, legal redress and markets; a lack of political voice; and poor social relationships. Hayes A, Gray M, Edwards B. Mental Health and Social Exclusion: Social Exclusion Unit Report Summary: Office of the Deputy Prime Minister. POD drafted manuscript for publication that was commented on by KE and DOD. This resulting review also contains publications across a number of disciplines, and work from a variety of countries is included. Kelly R. Social Inclusion Policy Community & Enterprise Directorate Clare County Council. A review of social inclusion measures. World Health Organization. 1st ed. There is a need for the development of a tool for measuring social inclusion or social exclusion in primary healthcare settings. Patrick O’Donnell. From these documents, 22 tools or measures for the assessment of individual-level social inclusion or social exclusion, or the measurement of very closely related concepts, were identified and charted in Table 1. Ment Health Pract. This implies that inclusion and exclusion are the opposites of each other. 2008. http://www1.paho.org/hq/dmdocuments/2010/PHC_The_World_Health_Report-2008.pdf. Significantly, none of the 22 individual tools discovered were specifically developed or used in general primary healthcare settings. The Hague: Kluwer Law International; 1997. p. 255–62. This scoping review was therefore developed to address the following specific questions: how are social exclusion and social inclusion defined in relation to health, and how are social exclusion and social inclusion measured at the individual level in healthcare settings. The authors were unable to contact all tool authors; this meant having to rely on secondary sources for descriptions of some tools, leaving some sections of the tables incomplete. Soc Inclusion. This continuum results in health inequities. This SDG mentions the effective management of conditions such as HIV and substance abuse and the introduction of universal health coverage among other targets. Dorer G, Harries P, Marston L. Measuring social inclusion: a staff survey of mental health service users’ participation in community occupations. Rate the degree to which you agree or disagree with each statement using the following scale (1 = Strongly Disagree and 6 = Strongly Agree). The majority of the tools included were constructed for engaging with patients in mental health settings. Abbreviations of names of tools in Tables below are suggested; some have been suggested by the creators of the tools themselves, others have been originally used by previous review authors. The European Commission later introduced the term social exclusion into discussions alongside the term “poverty” for many programmes and initiatives from the early 1990s [3,4,5]; this culminated with 2010 being named as the European Year for Combating Poverty and Social Exclusion. In addition, the fact that there are over thirty different domains mentioned across the 22 tools we investigated highlights the fact that work in this area is hampered by the lack of a consensus definition and agreement on the domains that should be accounted for in any measure. A number of review papers were discovered during the searches and these are noted on the table in Additional file 1. Adam C, Potvin L. Understanding exclusionary mechanisms at the individual level: a theoretical proposal. - 40.68.127.93. In Ireland, the term social inclusion has been adopted widely and appears frequently in policy documents across various sectors, particularly in health. Observatory on National Policies to Combat Social Exclusion: Second Annual Report: Commission of the European Communities Directorate General Employment, Social Affairs and Industrial Relations. This scale has been partially validated with arts and mental health project users, demonstrating good internal consistency. Google Scholar. Encouraging the social inclusion and reintegration of people with mental health problems into society has also become an important policy goal internationally [51, 52]. Oxford: Oxford University Press; 2002. p. 30–43. The details of each of the measurement tools included in the final scoping review are displayed in Table 1 under the headings of (i) name of the tool, (ii) whether it mentions primarily social exclusion or social inclusion, (iii) the target population group for the tool, (iv) the purpose of the tool, (v) a brief background on the tool, (vi) the number of items included in the tool, (vii) how the tool reports results, and (viii) how it is administered to participants. Usefulness and Potential (7/22) was concerned with a person feeling able to contribute positively to society and being able to fulfil personal potential. The most common domain seen was Social Networks (referred to in some way in all 22 tools); which included all aspects of interaction with family members and friends, and feeling accepted by them. (DOCX 26 kb). POD is a GP, Clinical Fellow in Social Inclusion and a PhD student at the University of Limerick Graduate Entry Medical School. Heath I. The steps include (i) identifying research questions, (ii) identifying all relevant studies, (iii) selecting significant studies, (iv) charting the relevant data, and then (v) summarising and reporting the results. Fourteen of the tools (14/21) mentioned in Table 1 below look at the measurement of the concept of social inclusion specifically, another tool (1/21) was described as a measure of both social inclusion and social exclusion, and then the remaining six tools discovered (6/21) did not mention the specific measurement of either concept in their supporting literature. Levac D, Colquhoun H, O’Brien KK. 2008. http://www.outcomesstar.org.uk/wp-content/uploads/Q_Outcomes-Star-Impact-and-good-practice.pdf. Cite this article. The impression of an 2008;13(2):4–15. To determine the exclusion of adolescents in social relations, the Social Exclusion Scale … It has not been all smooth sailing, though. The field of primary healthcare is the ideal place to seek to document and analyse social exclusion in relation to health. It is operationalized as a combination of material deprivation, insufficient access … Report of task group 9: social inclusion and social mobility. 2009. http://ec.europa.eu/regional_policy/archive/policy/future/pdf/1_omtzigt_final_formatted.pdf. Topping A. Looting ‘fuelled by social exclusion’. Find reliable measures for use in your questionnaires. Eur J Homelessness. Wolfensberger W. Social role valorization: a proposed new term for the principle of normalization. Hacking S, Bates P. The inclusion web: a tool for person-centered planning and service evaluation. Br J Gen Pract. Efforts were made to obtain a copy of each of the original tools, and all relevant background literature. Popay and colleagues reported that the definitions used to explain the concept of social exclusion generally fell into two broad categories: those that documented the many things that a person or group could be excluded from and those definitions that sought to explain a broader “relational” approach that looked more closely at the mechanisms and societal imbalances that led to and perpetuated social exclusion [8, 21]. Pinfold V. ‘Building up safe havens…all around the world’: users’ experiences of living in the community with mental health problems. Community Ment Health J. Additional file 1 summarises the background literature relating to each of the 22 tools selected for this scoping review. Taket A, Crisp BR, Nevill A, Lamaro G, Graham M, Barter-Godfrey S. Introduction. The relational screening method was used in the study. Social Exclusion How much a person has experienced the feeling of being isolated and ostracized is measured with three, seven-point items. Development and validation of a social inclusion questionnaire to evaluate the impact of attending a modernised mental health day service. These identities are complex, overlapping and they can change over time and vary by … Gill PS, Hegenbarth A. Embedding social inclusion in general practice: time for action. Basingstoke: Palgrave Macmillan; 2004. p. 107–32. It is notable that none of the tools stated that its aim was to measure only social exclusion. One possible reason for this is recognition of the immense, and increasing, economic and social burden of mental ill health worldwide [53,54,55]. This report and the subsequent 2010 WHO Europe report reinforced the significance of the role that health systems and primary healthcare have in addressing social exclusion and improving the health status of populations [26]. Social inclusion: origins, concepts and key themes: Australian Institute of Family Studies. The World Bank. 2015;124(1):127–39. Poverty, social exclusion, and minorities. It is notable that many of the papers cited in Additional file 1 do not have a clear definition of what is meant by social exclusion or social inclusion, despite discussing the measurement of these concepts. In: Lymbery M, Butler S, editors. Geneva: International Labour Organization; 1997. Yanicki SM, Kushner KE, Reutter L. Social inclusion/exclusion as matters of social (in)justice: a call for nursing action. Petersen VA, Ellis P, Lorenz R, Armbrecht E. An interventional study of guiding homeless persons to self-reliance using the outcomes star™ for homelessness. For example, the SCOPE-C was developed by adapting the SCOPE tool from the UK for the language and cultural context of people in Hong Kong. All authors read and approved the final manuscript. Outcome, recovery and return to work in severe mental illnesses. 3/21 resulted in the development of a visual map of the social inclusion status of the person in question (HOS, MHRS, Inclusion Web [IW]). Measuring the degree of social exclusion of a person attending a healthcare service could allow their status to be monitored over time, and potentially show that certain healthcare interventions reduce social exclusion. The literature on social exclusion is, obviously, not for the abstemious. Commentators have discussed the apparent rise in popularity of this relatively new term social exclusion; one wrote that “conventional measures of poverty and deprivation were considered inadequate to capture the alienation, isolation or ‘exclusion’ from socially normative functioning” [13]. One such example is the Poverty and Social Exclusion Survey of Britain ... A 6-item scale for overall, emotional, and social loneliness: Confirmatory tests on … https://doi.org/10.3399/bjgp13X675223. 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