Psychiatric Bulletin (2009) 33: 281-284. doi: 10.1192/pb.bp.108.022343
© 2009 The Royal College of Psychiatrists
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Editorial

Community work – a cure for stigma and social exclusion?

Justine Schneider, Professor of Mental Health and Social Care

University of Nottingham, Law and Social Sciences Building, University Park, Nottingham NG7 2RD, email: justine.schneider{at}nottingham.ac.uk

Declaration of interest

None.

Abstract

It is possible to tackle exclusion by altering the nature of transactions between individuals and groups, including mental health services. One way to do this is to cultivate ‘social capital’ or interdependence between individuals and groups – as well as giving, each is entitled, but not compelled, to claim something in return. It is difficult, if not impossible, to sustain stigma and social exclusion when people are meeting mutual needs, building trust and helping each other. Mental health providers can foster social capital by creating community cohesion, namely interdependent relationships between individuals and organisations. This approach has been put into practice in the USA, where providers assert that small investments in building social capital return many times the cost. In the UK there is evidence that community development can make a contribution to mental health but it does not fit well with conventional approaches to mental health services – it calls for different skills and a vision that is collective rather than individualised.