“having no social capital or economic power relegates valuable and dynamic individuals to situations and communities where…”

For those living with serious and persistent mental illness, interpersonal relationships can be fragile at best. The reoccurrence of symptoms can undermine if not destroy what is already precarious. Occupation, relationships, healthy activities and even housing can be disrupted. The energy expended in rebuilding the basic elements of existence leaves little in the way of motivation or resources to devote to self-directed social inclusion and patients can become dependent on formal interventions and services which can highlight and perpetuate powerlessness and the perception of such. 

Feelings of worthlessness and exclusion are in a way simply a mirror of how society inadvertently and outwardly segregates mental illness and addictions. Having more than one alternative available for social inclusion becomes difficult when finances and housing are barriers themselves. Safe and affordable housing is one key to ensure that individuals with mental health difficulties are able to invest in communities outside of the ‘psychiatric community’. New hospitals are designed to be healthy and beautiful spaces but community housing here in Canada often falls far short. If community planners could incorporate housing that is integrated, affordable, safe and healthy, patients would have more opportunities to develop relationships within social mainstream and the effects of stigma and stigma itself would be lessened. Supportive housing can become or simply is ‘stigmatized housing’.

Mental health patients form relationships among themselves because of common experiences but economic similarities are also predominant in determining social mobility. This can be an effect of stigma but it also perpetuates stigma as individuals with serious and persistent mental health difficulties are inadvertently quarantined from spaces and situations where the general population could witness their humanity and gifts. 

Economic factors often impede recovery, social inclusion and the formation of a positive identity. The financial limitations that a disability income imposes leaves fewer options and opportunities for experimenting with interests or forming friendships outside of the ‘psychiatric community’. Individuals are often relegated to housing and facilities in areas which are substandard and exacerbate mental health difficulties. Individuals are at times forced to navigate neighbourhoods where addiction, crime and violence are more prevalent. Gentrification often disposes and quarantines this vulnerable segment of the population. 

A disability income can become a barrier. It can be a safety net when illness is predominant but in times of equilibrium and remission it can undermine self-determination and it accentuates weaknesses. A disability income tethers a persons identity to that disability. In a culture where identity is synonymous with what employs a person, to answer with ‘I have a disability’ is a mantra of defect, defeat and disgrace. In social situations where a person might find connection, having no social capital or economic power relegates valuable and dynamic individuals to situations and communities where this is not a concern or it is accepted if not expected. Economics can be exclusionary and gaining independence is complicated by being a dependent.

Workplace exclusion is basically societal exclusion. Without gainful employment the ability to contribute financially to self-care and opportunities of community, social inclusion or interpersonal relationships is undermined. This form of societal exclusion also undermines an individuals ability to contribute financially to society and fractures a sense of belonging or contributing. Financial restrictions lead to a dependence on traditional healthcare services and furthers a dependence on these social supports and the community offered there. Limited employment opportunities and or dependence on social services limits an individuals exposure to healthcare workers outside of psychiatry; for example a massage therapist or a yoga teacher. Being able to contribute financially enhances self-efficacy, self-esteem, self-determination and social status which in turn enhance wellbeing and leads to the confidence required for social activity.

Disability support can become a ‘sentence’ as much as a service. Opportunities for self-improvement, social integration, social mobility and even relationship status become limited and can lead to a further withdrawal from activities and excursions into mainstream culture. ‘Money can’t buy happiness’ but by confining individuals with mental health difficulties and or addictions to the poverty line; self-determination, social status, self-efficacy and self-esteem stagnate. The seriousness of these factors is that they perpetuate and exacerbate underlying difficulties which is costly socially and economically for all citizens.

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