An innovative approach to social inclusion in Europe has succeeded in increasing the rate of employment among users of mental health services (patients). The researchers who developed the approach suggest it could also be used to help other disadvantaged groups. EMILIA, a European research project financed by the European Commission, showed that lifelong learning educational courses designed with input from the service users themselves can offer significant benefits for those users: it can aid their recovery, facilitate their social inclusion and promote their return to work.
EMILIA (Empowerment of Mental Illness Service Users: Lifelong Learning, Integration and Action) focused on mental health service users who suffered from severe mental illness and had a minimum of three years’ experience of mental health services. These participants were employed as lifelong learning trainers in their local community, using training material designed and developed by mental health service users themselves.
The project involved seven mental health services and one university. In some cases, training was carried out entirely by service user trainers; in others it was undertaken alongside professional trainers. The project designed 11 educational programmes in all, covering such topics as recovery, service user leadership, building on personal strengths etc. (Details of the programmes are available at: http://www.emiliatraining.net). The field work was conducted in a variety of cultural contexts in eight different countries: Bosnia-Herzegovina, Denmark, France, Greece, Norway, Poland, Spain and the United Kingdom.
EMILIA’s research utilised the five-step process anchored in the European Union’s lifelong learning policy:
The service users in EMILIA were paid to perform a number of social inclusion roles. These included assistant researchers, health service workers, peer support workers, part-time teachers, and university social work and nursing course assessors.
The researchers found that employing mental health service users as trainers made the training more credible in the eyes of the students and benefited service user trainers by empowering them and aiding their recovery. It also constituted a first step toward preparing them to teach health care professionals and student nurses. Enabling mental health service users to act in a professional training role helped overcome the feeling of difference between ‘them and us’.
The study produced evidence that these approaches led to significant reductions among the sample group in hospital admissions. Beyond that it increased levels of employment, the number of hours worked per week, the amount of disposable income, as well as the degree of social inclusion, empowerment and employability. The project employed quantitative and qualitative methods to assess the project at two follow-up points.
The researchers found clear evidence of the positive impact of the project after it had been in operation for 20 months. This included: a doubling of paid employment from 7.3 to 14.6 per cent and a similar increase for voluntary employment; significant increases in disposable income and quality of life; an increase in the average number of hours per week worked from 0.3 to 3.23; an average reduction of days in psychiatric hospital from 14 to 7; self-reported increase in levels of self-confidence, efficacy and hope, and increased skills and knowledge leading to increased employability.
The project also found that universities and health care centres involved in the study benefited from the knowledge and experience of mental health service users. Moreover, it found that consulting them made programmes on health care management and education more valid and meaningful.
The EMILIA project has developed a suite of innovative tools to help achieve goals of increased employment and social inclusion among disadvantaged groups. These include:
Eleven lifelong learning training programmes designed by the service users themselves, available free to all via the EMILIA training website: http://www.emiliatraining.net
Recommendations for improving inclusion for all disadvantaged, socially excluded and disempowered groups:
European countries with a strong tradition of strong welfare benefit support (for example, Scandinavia, the UK, and France) should reduce the impact of the ‘benefit trap’, where disadvantaged individuals fear that new learning and occupational opportunities could mean they lose welfare benefits.
European countries with a less well established tradition of welfare support, such as Bosnia-Herzegovina, Greece, Poland or South Eastern Europe should consider establishing and promoting government bodies and/or NGOs specialising in providing lifelong learning to disadvantaged groups.
Provide free lifelong learning for all disadvantaged groups, for example those with physical disabilities or drugs/alcohol dependencies, accessing for example http://www.emiliatraining.net
, which is downloadable for free.
Develop, in collaboration with disadvantaged groups themselves, lifelong learning opportunities relevant to the lives of recipients, highlighting the valuable connections between recovery and lifelong learning.
Recommendations specifically for improving inclusion of mental health service users:
Disseminate and make permanently available lifelong learning packages, training-the-trainers packages and PDP tool, currently available at http://www.emiliatraining.net
1 See: http://www.promise-mental-health.com/
EMILIA – Empowerment of Mental Illness Service Users: Life Long Learning, Integration and Action (duration:1/9/2005 - 28/4/2010) was an Integrated Project funded under the 6th Framework Programme for Research of the European Union, Thematic Priority 7 – Citizens and governance in a knowledge-based society.
Contact: Peter Ryan, firstname.lastname@example.org