WE MUST BECOME MORE INVOLVED | Behavioral Healthcare Executive Skip to content Skip to navigation


January 1, 2007
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Ending provider organizations' social isolation will help end clients' social marginalization

Many people in our communities still fear individuals with mental illness, which is not surprising given that the general public continues to see distorted, hurtful images of mental illness through the media. In fact, not long ago I watched a TV program that showed persons supposedly with mental illness locked up in a forensic psychiatric unit demonstrating frightening behaviors.

Those who suffer from mental illness, along with their families, often are marginalized in our communities. Mental health provider organizations also are frequently marginalized. This situation is not unique to the United States. Mental health provider organizations in other countries, such as Great Britain and New Zealand, also are acknowledging their own and clients' marginal social status. This has led to growing international recognition and discussion of social inclusion and community engagement among mental health provider organizations, consumers of mental health services, and their family members.

A marginalized existence is not good for either our clientele or our organizations. It only serves to promote the exclusion of persons with severe mental illness from being accepted into mainstream community life. Provider organizations, therefore, need to accept the responsibility of helping communities develop the necessary capacity for full social inclusion of persons with mental illness. This responsibility involves ending provider organizations' own social marginalization.

This takes effort. We, as provider organization executives, need to understand how our communities are organized to get their work done. We need to learn who does what, who controls what, how decisions are made and carried out, and who has resources. We need to go where community leaders spend their time, establish our visibility, and initiate relationships with them. We can join or help to form community partnerships and alliances, and leverage resources for the benefit of our consumers.

When I mention to my community mental health executive peers that my organization is directly involved with community development efforts (i.e., housing and jobs development), they usually are amazed, since community mental health executives are seldom invited to join such critical community endeavors. Yet decent, affordable housing and employment are critical needs for persons with severe mental illness. We can ill afford to be bystanders as decisions are made regarding these critical community resources, which deeply affect our clients' quality of life and recovery.

We can claim that such community involvement is not our responsibility and/or that we simply do not have the skills and expertise to become involved. Nevertheless, if we do not become involved, the status quo continues—and persons with mental illness will continue to be socially excluded and isolated.

As mental health providers, whether individual providers or provider organizations, we often assume the full responsibility for, and perceive ourselves as, the totality of our communities' mental health systems. We convey the message to our communities that since we are the trained experts, we will take care of the community's mental health needs. I assert that if we want to reduce and eliminate marginalization of persons with mental illness, then we need to help our communities join with us to become a truly overarching community mental health system.

For full social inclusion of our consumers, we must work to create a community arena where the odds are not so tipped against their success. We need to socially include ourselves in our communities, and not function on the margins, if we expect to achieve real gains in social inclusion of persons with mental illness. We need to be visible and engaged in the center of our communities' mainstream activities, working daily to enlighten our communities.

Kenneth Jue is CEO of Monadnock Family Services in Keene, New Hampshire. He is also on the Board of Directors for the Mental Health Corporations of America, Inc.


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