Predictors of social inclusion among adults with severe mental illness: Results of a cross-sectional study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Mara Ohlhoff - , Leipzig University (Author)
  • Alexander Pabst - , Leipzig University (Author)
  • Johanna Breilmann - , Ulm University (Author)
  • Thomas Becker - , Leipzig University (Author)
  • Andreas Allgöwer - , Ulm University (Author)
  • Reinhold Kilian - , Ulm University (Author)
  • Alkomiet Hasan - , Augsburg University, German Center for Mental Health (DZPG) Partner Site Munich-Augsburg (Author)
  • Peter Falkai - , Ludwig Maximilian University of Munich (Author)
  • Klemens Ajayi - , kbo-Isar-Amper-Clinics Munich (Author)
  • Theresa Halms - , Augsburg University (Author)
  • Peter Brieger - , kbo-Isar-Amper-Clinics Munich (Author)
  • Karel Frasch - , Ulm University, Donau-Ries Clinic Donauwörth (Author)
  • Stephan Heres - , kbo-Isar-Amper-Clinics Munich (Author)
  • Markus Jäger - , Ulm University, Kempten District Hospital (Author)
  • Andreas Küthmann - , Memmingen Hospital (Author)
  • Albert Putzhammer - , District Hospital Kaufbeuren (Author)
  • Steffi G. Riedel-Heller - , Leipzig University (Author)
  • Bertram Schneeweiß - , Ludwig Maximilian University of Munich (Author)
  • Michael Schwarz - , Ludwig Maximilian University of Munich (Author)
  • Markus Kösters - , Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus Dresden, Ulm University (Author)
  • Uta Gühne - , Leipzig University (Author)

Abstract

BACKGROUND: Promoting social inclusion is crucial for people living with severe mental illness (SMI), who often experience high levels of social exclusion. However, research that uses a psychometric social inclusion measure to identify factors that determine varying levels of social inclusion in individuals with SMI is scarce.

AIMS: This study aimed to examine to what extent people with SMI feel socially included and to identify factors associated with perceived social inclusion among people with SMI.

METHOD: A cross-sectional multicenter investigation of psychiatric inpatients and day hospital patients with SMI aged 18 to 65 years (n = 358) was conducted. Perceived social inclusion, sociodemographic, and clinical characteristics were assessed using the Measure of Participation and Social Inclusion for Use in People with a Chronic Mental Disorder (F-INK). Hierarchical multiple linear regression was performed to analyse the association between social inclusion and potential predictors.

RESULTS: The participants' overall level of social inclusion was moderate (F-INK social inclusion total score M = 1.9, SD = 0.6). Age, relationship status, diagnostic group, employment status, and living situation emerged as predictors of social inclusion. Greater subjective social inclusion was predicted by older age (p = .027), being in a committed intimate relationship (p = .037), diagnosis of schizophrenia spectrum disorder (compared to diagnosis of depression, p = .020), being competitively employed or in education (compared to being in sheltered employment, p = .022; compared to being unemployed or receiving a disability pension, p = .007), and living with other people (p = .042).

CONCLUSIONS: The results confirm deficiencies in social inclusion of people with SMI. Individuals with SMI who are younger, single, have a diagnosis of depression, are in sheltered employment, are unemployed or receiving a disability pension, and are living alone seem to be particularly at risk of experiencing low social inclusion. These findings highlight the importance of psychosocial interventions in rehabilitative mental healthcare.

Details

Original languageEnglish
Pages (from-to)103-115
Number of pages13
JournalInternational Journal of Social Psychiatry
Volume72
Issue number1
Early online date31 Jul 2025
Publication statusPublished - Feb 2026
Peer-reviewedYes

External IDs

PubMedCentral PMC12827802
Scopus 105012860055
ORCID /0000-0001-7018-6021/work/205992731

Keywords

Keywords

  • employment status, intimate relationships, living situation, severe mental illness, Social inclusion