Mental health nurses, promoters of inclusion or perpetuators of exclusion?

The literature identifies that mental health services and those individuals working within them have the potential to facilitate inclusion for their client group, because of their power to initiate potential inclusive opportunities. However, evidence suggests that service users themselves perceive many aspects of mental health services as contributing to the problem of exclusion. This has been attributed to an accumulation of messages, attitudes and disempowering practices that have emanated from mental health care providers over a long period. This study employs focus group methodology in a residential rehabilitation unit in an industrial city in the UK. Discussion of the findings highlight how, in spite of alleged inclusive practices, the attitudes held by members of the unit team could impede the clients' opportunities to become socially included, as a result of defensive practice, paternalistic attitudes, expectations of the local community upon the team and the stagnant views that are embedded in the culture of mental health services. While mental health nurses may see themselves as promoting inclusion, the reality may be quite different.