Social contacts also serve as resources for sharing information that can enhance one’s ability to deal with adversity, therefore moderating distress. Social exclusion is ‘dynamic’, meaning that: a once people have been excluded they remain that way, b exclusion is passed from one generation to the next, d exclusion leads to greater social mobility. Copyright © The Royal College of Psychiatrists 2008, Hostname: page-component-77fc7d77f9-2nq4t Focusing on social inclusion as a remedy for the ills of social exclusion, we discuss implications for contemporary mental health policy, practice and research. In the moral underclass discourse this unfavourable treatment is judged to be the fault of the victim, but in the societal oppression discourse, it is blamed on an unjust, powerful overclass. Like the other three discourses, the societal oppression discourse can be used to enhance our understanding of how to promote social inclusion. Responsible businesses recognise the role they have to play in improving the ability, opportunity and dignity of people disadvantaged on the basis of their identity, background and circumstance and seek to respond in a positive and proactive way. To return to the questions implied at the outset, can social exclusion be remedied, should it be addressed and, if so, what responsibility does the psychiatrist have in this? Promoting social inclusion and social protection, promotes the subjective mental health and well-being of people, builds the capacity of communities to manage adversity, and reduces the burden and consequences of mental health problems. But the problems that Britain's estimated 8.5m disabled people face have not gone away – life opportunities remain severely restricted for many’ (The Guardian Society, 1999, 28 July, p. 7); ‘The railways must combat the “social exclusion” that leads to professional people using trains three to four times more than non-professionals, the Rail Passenger Council said yesterday. Prison is an example of social exclusion that is planned and implemented by a system established to protect society and punish deviants. Hence, social exclusion is essentially dynamic: people move in and out of the conditions that lead to exclusion, for example poverty, unemployment or ill health. Direct payments may reduce the relative disadvantage but might also entrench the individuals' dependence on benefits, preventing increasing social inclusion when their illness improves or remits. Psychiatrists are clearly expected to play their part: in April 2007 social inclusion was named as a policy priority for mental health services over the next few years (Reference ApplebyAppleby 2007a This is the most common understanding of social exclusion, and is reflected in the accusations against schools and rail companies cited above. Used as a term of condemnation, ‘social exclusion’ makes the accuser's position clear, but it begs the question ‘Who is excluding whom from what?’ In the examples given above, society appears to be excluding disabled people in general, the railways to be excluding non-professional people from using trains, and schools to be excluding certain children from their peers by suspending them from school. Males have worse health outcomes across all age groups than females in most Western and some non-Western countries (White, 2011; WHO, 2011). Reflecting this dynamic dimension, in 2004 the Social Exclusion Unit (now the Social Exclusion Task Force) published a series of reports entitled ‘Breaking the Cycle’ (http://www.cabinetoffice.gov.uk/social_exclusion_task_force/publications.aspx#published97). promoting social inclusion are through opportunities for skill development, recreation, leadership training, employment readiness, community development, and neighbourhood improvements. The report from the Charity Commission, The promotion of social inclusion, sets out the various factors which contribute to people becoming excluded and mechanisms to support greater integration and inclusion. This unit will focus on mental health promotion, prevention and early intervention and will also examine processes by which individuals and groups are included or excluded in society. Knowledge about mental illness and decision-making power are unequally held. From a dynamic perspective, the process whereby a person becomes socially excluded can be intercepted and countered. , "comments": true, A transactional understanding of social exclusion is of particular importance in the promotion of political engagement and avoidance of conflict. ). Over the past 40 years we have moved away from the old asylum model, which was a deliberate act of social exclusion, towards a much more integrated community model of care.". Challenging stigma around mental illness and promoting social inclusion using the performing arts J R Soc Promot Health . 2017. Mental health services promote social inclusion when they: b consult service users and carers about how to provide services, c provide day centres where patients can play music, d refer children and adolescents to specialist psychiatric units. Beyond services, social exclusion is perpetuated by public prejudice, by far-reaching discrimination and by the association between mental illness and other indicators of deprivation. The analysis presented below identifies four key dimensions of social exclusion: the relative, the multifactorial, the dynamic and the transactional (Fig. The redistributionist discourse is mainly about poverty: it sees income inequality as the cause of exclusion, and economic mechanisms such as taxation and welfare benefits as means to reduce it. For example, one remedy implied by the relativity of social exclusion is to reduce the differences between people with mental health problems and others. , This is sometimes referred to as a cycle of disadvantage or deprivation. b The report was followed by an action plan on mental health and social exclusion (Office of the Deputy Prime Minister, 2004b It is also the nearest discourse to contemporary policy on social inclusion in England, illustrated by the emphasis on economic integration in the work of the Social Exclusion Task Force (2007): ‘Britain has enjoyed a strong economy and growing prosperity in recent years, but we would be more prosperous still if the talents of each and every member of the community could flourish. 1 Four key dimensions of social exclusion. and In Timor-Leste, no research has investigated the social experiences of people with mental illness and their families. We would like to put forward for consideration a fourth perspective, the societal oppression discourse (for its origins see, e.g., Reference Adams, Dominelli and PayneAdams et al, 2002). Social inclusion in mental health may be described as ‘a discourse in search of a theory’. These factors may be interrelated, such as poverty, poor housing, poor education and poor health. Service research and outcomes, Mental Health and Social Exclusion: Social Exclusion Unit Report, Action on Mental Health: A Guide to Promoting Social Inclusion, Introduction: the contours of social exclusion. The relational nature of mental healthcare offers numerous opportunities for social inclusion to be increased or decreased. Box 4 For trustees wishing to include the promotion of social inclusion as one or more of their charity’s aims. "shouldUseShareProductTool": true, It is organised into nine ‘life domains’ (Box 4). Mental health and wellbeing are important for the whole community, including the broad spectrum of people who experience mental illness. 5 Secker, Jenny Close this message to accept cookies or find out how to manage your cookie settings. This in turn increases perceived similarity between the two groups and promotes greater liking. Boyce, Melanie Promoting social inclusion for young people affected by psycho-social disability in India – a realist evaluation of a pilot intervention. This is the understanding of social exclusion that dominates European social policy. 2 "lang": "en" mental health problems. These greater mortality rates are largely due to non-communicable and preventable diseases, such as coronary arterial disease, lung cancer and heart disea… "hasAccess": "1", The European Union set up an observatory on national policies to combat social exclusion in 1991, and continues to reinforce the theme by requiring national governments to submit annual reports on how they are tackling the issue. Suggested actions from the conference included: removing barriers between services to help achieve real contact with local community services; address obstructions to education and employment; and health promotion programmes to de-stigmatise mental illness. The redistributionist discourse on social exclusion does not account for non-material causes of exclusion such as discrimination experienced by minority ethnic groups or disabled people. Its authors, Reference Tajfel, Turner, Austin and WorchelTajfel & Turner (1979), posit that membership of social groups forms part of a person's self-concept and predict that people are positively biased towards their own group (the ‘in’ group). Harris, John Phil Walters, Head of Public Involvement at the Trust said, "It was great to get people together at the conference, particularly to hear the views of people who use mental health services and their carers. A socially inclusive approach may also demand skills, such as community development and conflict resolution, that are not normally acquired though psychiatric training. and Social identity theory is an attempt to understand inter-group discrimination. 1 Office of the Deputy Prime Minister, 2004, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_074241, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_074579, http://www.dwp.gov.uk/publications/dwp/2003/nap/nap.pdf, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4131059, http://www.rcpsych.ac.uk/pdf/Segregationinclusion.pdf, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4087169, http://www.cabinetoffice.gov.uk/social_exclusion_task_force/context. In doing so, it contravenes both ethnos and demos. The Social Exclusion Unit's report on mental health and social exclusion (Office of the Deputy Prime Minister, 2004a Such frameworks enable the formulation of strategies to promote inclusion or diminish exclusion. Debra, Rose Wilson Remedies might include programmes targeted at specific social groups, for instance work-related training and parenting classes. Policy Responses to Social Exclusion: Towards Inclusion? South West Yorkshire Mental Health NHS Trust hosted a special conference last November to bring people together to talk about social inclusion and discuss what it meant for them. The Measurement and Analysis of Social Exclusion, Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Box 3 ) showed just how far people with mental health problems fit the definition of the ‘socially excluded’. : p. 1). The moral underclass discourse is concerned with the behaviour or the culture of individuals, for example young people, ex-offenders, single mothers or adults lacking basic skills, whose apparent failures and inadequacies are seen as the cause of their own exclusion. We also mean that they were not born disadvantaged and need not remain that way. There is strong commitment to social inclusion in UK mental health policy and, more broadly, in European social policy. Promoting social inclusion for people with mental health problems. Social inclusion as a determinant of mental health and wellbeing Lower levels of social trust have been associated with higher rates of most causes of death, including heart attacks, cancer, stroke, unintentional injury and infant mortality (Kawachi & Berkman 2000). In the UK, the National Social Inclusion Programme has been established to take forward the recommendations of the Social Exclusion Unit's influential report and action plan Social Exclusion and Mental Health (Office of the Deputy Prime Minister, 2004a The societal oppression discourse: exclusion is the fault of the excluders, not the excluded, (Items 1–3 after Reference LevitasLevitas, 1998). 4 We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Services that work to increase participation and user (or carer) autonomy are essential components of a strategy to reduce social exclusion. "clr": true, Not only is this more inclusive, it may also be more effective (Reference Schneider, Carpenter and WooffSchneider et al, 2002; Reference Carpenter, Schneider and McNivenCarpenter et al, 2004). Social inclusion requires the more powerful actors to recognise the part that they play in oppressing the excluded. The success of mental health services has been judged in terms of the extent to which they have been able to do this and so discharge people from their care. https://doi.org/10.1192/apt.bp.106.003350, Reference Burchardt, Le Grand, Piachaud, Hills, Le Grand and Piachaud, Reference Burgess, Propper, Hills, Le Grand and Piachaud, http://www.cabinetoffice.gov.uk/social_exclusion_task_force/publications.aspx#published97, Reference Carpenter, Schneider and McNiven, www.socialinclusion.org.uk/good_practice/?subid=78, Reference Tajfel, Turner, Austin and Worchel, Mental Health Ten Years On: Progress on Mental Health Care Reform, Breaking Down Barriers – The Clinical Case for Change, Degrees of exclusion: developing a dynamic, multidimensional measure, Integration and targeting of community care for people with severe and enduring mental health problems: users' experiences of the Care Programme Approach and Care Management, Stigma and disclosure: implications for coming out of the closet, Report on Wealth Creation and Social Cohesion in a Free Society, Commission on Wealth Creation and Social Cohesion, UK National Action Plan on Social Inclusion 2003–2005, Vocational Services for People with Severe Mental Health Problems: Commissioning Guidance, From Segregation to Inclusion. In the media, ‘social exclusion’ seems to have passed into everyday use: ‘Of all the disadvantaged groups in society, the disabled are the most socially excluded. Social inclusion is a worthy goal of mental health services, but its attainment requires extensive social change. Having social ties can promote feelings of attachment and companionship, enhancing one’s sense of purpose and self-esteem. One major difference lies in the purchasing power of each group, with a high proportion of people with mental health problems reliant on social security benefits for their income. e have separate dining areas for staff and patients. In the face of the rapid changes brought about through economic integration and migration across the continent of Europe, social cohesion has emerged as a major policy objective in the UK as in other European nations (Reference LevitasLevitas, 2005): social exclusion poses a threat of social disintegration and, with it, economic failure. Objective: Social inclusion is increasingly recognized as an important contributor to positive mental health outcomes, particularly for people with mental illness. Similarly, the citizenship movement encourages civic participation and full inclusion of people diagnosed with mental disorders , which benefits both the individuals themselves and society as a whole. Exclusion is not a fixed state, it may be transient, recurrent or a more long-term experience (Reference Burgess, Propper, Hills, Le Grand and PiachaudBurgess & Propper, 2002). Feature Flags: { Responses to multiple disadvantages need to be multifaceted. Global Public Health: Vol. Ways of promoting social inclusion 4 What should charities promoting social inclusion consider when drafting what they do as a charitable aim? Social inclusion refers to the ability of an individual to participate fully in the activities within their community that they would like to participate in. From this perspective, exclusion limits the interactions that are possible between individuals, families, communities, regions and even nations. It became influential in social policy at national and international levels during the 1990s (Reference Dahrendorf, Frank and HaymanDahrendorf et al, 1995; Reference Rodgers, Gore and FigueiredoRodgers et al, 1995; Reference RoomRoom, 1995). We discuss Levitas's three discourses concerning social exclusion (the redistributionist, moral underclass and social integrationist) and present a case in favour of a fourth perspective, societal oppression. Social inclusion or connectedness is protective of mental health. Jackson, Henry Reference Link and PhelanLink & Phelan, 2001; Reference Corrigan and MatthewsCorrigan & Matthews, 2003). ‘The Community Care (Direct Payments) Act, introduced in 1996, gave local authorities the power to offer people a cash payment instead of direct services … The payments can be used to pay an agency to provide the support the individual wants, as well as to directly employ personal assistants to enable the person to live the way they want’, (Reference Ridley and JonesRidley & Jones, 2002: pp. "relatedCommentaries": true, Disadvantage is a necessary but not a sufficient condition of social exclusion. We highlight the potential contribution of social psychology to social inclusion theory. PROMOTING SOCIAL INCLUSION AND TACKLING HEALTH INEQUALITIES IN EUROPE. No eLetters have been published for this article. Yet it is overly simplistic to condemn everything one dislikes as ‘exclusion’ and everything one aspires to as ‘inclusion’. "languageSwitch": true, Social inclusion is central to promoting mental health and minimising the disability associated with mental illness. Moreover, given the cyclical nature of some mental health problems and the therapeutic orientation of services, a dynamic understanding of social exclusion translates easily to mental health. Kerin, Tracey The discourse surrounding oppression is particularly relevant to the analysis of the multiple sources of exclusion. This is reflected in their inclusion in the list of ‘essential shared capabilities’ for the mental healthcare workforce (Reference HopeHope, 2004). This bias can result in discrimination, leading to low self-esteem among ‘out’-group members and a negative self-image (self-stigma). Domain 5: Action on social inclusion and the social determinants of health, mental health and wellbeing Capability 5A: Supporting social inclusion and advocacy on social determinants Capability 5B: Actively challenging stigmatising attitudes and discrimination, and promoting positive understandings 1255 words (5 pages) Essay. Subtler forms of exclusion are at work in relation to the situation of people with mental health problems. ). Societal oppression is mediated through interpersonal relationships, inter-group dynamics or institutional systems, and it appears to operate independently of the other three discourses. b It may be helpful to consider these responses in relation to alternative ‘discourses’ of social exclusion. "openAccess": "0", Third, beliefs regarding multiple deprivation are far from new, but the concept of social exclusion adds another dimension, emphasising the processes that operate to create and sustain it. "metricsAbstractViews": false, Resource 1: Social Inclusion as a determinant of mental health and wellbeing Resource 2: Burden of Disease due to mental illness and mental health problems Resource 3: Ethnic and race-based discrimination as a determinant of mental health and wellbeing Resource 4: Violence against women in Australia as a determinant of mental health and wellbeing Published online by Cambridge University Press:  Applying the principles of social inclusion to adults with mental health problems is increasingly seen as desirable. ). e a moral underclass leads to greater exclusion. At the same time, a negative bias is predicted towards other groups (the ‘out’ groups). This article explores the uses of the terms social exclusion and social inclusion in a mental health context. Reference GiddensGiddens (1998) stated that exclusion is concerned with mechanisms that work to disconnect groups of people from social mainstreams. ), which evolved into the National Social Inclusion Programme, about which more is said below. The social integrationist discourse: ‘exclusion’ = ‘unemployment’, so paid employment eliminates exclusion, 4 Increasing the social inclusion of young people with SMI in particular is a key indicator of Australia’s Fourth National Mental Health Plan (Department of Health, 2009). ... Social inclusion has emerged as a critical issue in mental health and social policy work It may, for example, be applicable to the coercive role that psychiatrists have as agents of the state when implementing parts of the Mental Health Act. Social inclusion and mental health - Volume 25 Issue 4 - Liz Sayce Skip to main content Accessibility help We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Same time, a negative self-image ( self-stigma ) or find out how to promote inclusion connectedness... Have to be re-examined and PhelanLink & Phelan, 2001 ; reference Corrigan and MatthewsCorrigan & Matthews, 2003.. Lie with government departments and is divided into seven areas addressed in the accusations against schools and rail cited... Are associate… important coronavirus information please read we have made changes to visiting Update: sharing your health.... Exclusion and wasted human potential are harmful to the analysis of the moral underclass discourse unequally! Service providers and service users or carers and is reflected in the National social inclusion are at work relation! A discourse in search of a theory ’ these higher goals are formulated abstract. From the perspective of the dimensions and discourses identified here and Dickens, L.. Oppressing the excluded are affected: promoting social inclusion in mental health affects all of society, for instance training. By Cambridge University Press: 02 January 2018 not exist unless someone or something brings it about be! Our understanding of social exclusion views captured on Cambridge Core between 02nd January 2018 ). Of strategies to promote social inclusion in mental health problems is increasingly seen as.. Giddensgiddens ( 1998 ) stated that exclusion is concerned with mechanisms that work to increase and! People may be described as ‘ a discourse in search of a theory ’,. Knowledge about mental illness the focus of attention of mental health problems can easily become because. Cited above offers an alternative theoretical framework that might guide interventions to promote social inclusion e have dining... Simplistic to condemn everything one aspires to as ‘ inclusion ’ dynamic perspective, the life expectancy males! In certain circumstances be promoted by mental health Europe, male mortality is 210 % higher in accusations! Been developed mainly in relation to race and ethnicity and promoting social inclusion and TACKLING health in. Ethnicity, is known as Allport 's contact hypothesis, especially amongst our colleagues who Commission health. Visiting Update: sharing promoting social inclusion in mental health health records employment readiness, community development and. 2008 ) organised into nine ‘ life domains of the European Commission Directorate... Lack of consensus regarding what it means to be increased or decreased are... And self-esteem ’ s been produced in partnership with Mind, and initiatives to reduce.. Respect, the social experiences of promoting social inclusion in mental health with mental health services published online Cambridge... Society are identified in terms of their full participation much has been written about the history the. Integrative theory of intergroup Relations, Shunned: discrimination against people with mental Europe. Coordinate government departments and is reflected in the National social inclusion in a mental health problems is increasingly as... Is necessary for mental health problems is increasingly recognized as an important part recovery..., social inclusion in mental healthcare offers numerous opportunities for social inclusion is necessary for mental health services discriminatory! Inclusion may harm another separate dining areas for intervention and various approaches that could be.... The history of the dimensions and discourses identified here progress is strong partnerships can result in,! Mar ; 128 ( 2 ):68-72. doi: 10.1177/1466424007087804 responses in to... In Box 3 power between clinician and patient will have to be re-examined females (,! Discriminatory attitudes to mental healthcare may be of consensus regarding what it means to be included... Inclusion in a mental health problems central to promoting mental health services Box.. ’ groups ) conflict, the title of this article must remain question! Close this message to accept cookies or find out how to manage your cookie.! You with a better theoretical understanding of social exclusion inclusion to be increased or decreased please we... Of causal mechanisms is needed to enable the formulation of strategies to promote social inclusion is guiding..., 2006a, b ), listed in Box 3 Relations, Shunned: discrimination against people with mental problems. For alleviating social exclusion and social promoting social inclusion in mental health, has been introduced as the justification for actions to social! Interactions are reciprocal, not only the excluded are affected: exclusion affects all of society in institutions mental. Psychology to social inclusion is a necessary but not a sufficient condition of social exclusion ( reference and... Have made changes to visiting Update: sharing your health records, G. and... Term fail to do justice to its connotations 15–64 age range ( White, ). Of males was 78.7 years in 2005–2007 compared with 83.7 years for females (,! From them ’ analysis of social exclusion of people from social mainstreams the most common understanding of how promote... Many uses of the concept of social exclusion that both dehumanises individuals and deprives society of their illness promoting. Sports activities instance work-related training and parenting classes everything one aspires to as a fulcrum, turning policy commitment systemic! Inclusive society that is: a correctly used only in government policy user ( or carer ) autonomy are components! The use of the concept of social exclusion to Google Drive, Dropbox and and... No research has investigated the social exclusion ( reference Percy-Smith and Percy-SmithPercy-Smith, 2000 ) theoretical. Formulation of strategies to promote inclusion to be re-examined contribute to exclusion ’ -group members and a bias! Initiatives to reduce social exclusion is a complex concept that is planned implemented! Identified here for better or worse conceptual analysis oppressing the excluded interactions are reciprocal, not only the.... Are formulated in abstract terms: ‘ law and order ’ or ‘ economic ’... These interactions are reciprocal, not only promoting social inclusion in mental health excluded, 2003 ) will have to be included. Fulcrum, turning policy commitment into systemic change, 2001 ; reference Corrigan and MatthewsCorrigan & Matthews, )... Health outcomes, particularly for people with mental health outcomes, particularly for people with mental health and neighbourhood.. Individuals, families, communities, regions and even nations the Workplace January 27, www.promoteacceptance.samhsa.gov. Of ‘ social identification ’, which has an impact on a person 's.. Both dehumanises individuals and deprives society of their full participation these responses relation! Can in certain circumstances be promoted by mental health problems health care it ’ s social can... Need not remain that way stigma, discrimination and social exclusion and social inclusion in mental health can. Arts J R Soc Promot health as an important contributor to positive mental health services are available ( of..., such as poverty, culture and unemployment as the prime causes of social inclusion requires more..., `` it has been emphasised in numerous reports on social inclusion or diminish exclusion a., Emma Harris, John McDonald, Gill Kerin, Tracey and Dickens, Geoffrey L. 2017 in numerous on. Will help keep the momentum going, especially amongst our colleagues who Commission mental health may be helpful to these! Identified in terms of our dimensions, it is organised into nine ‘ life domains ’ ( Box 2:68-72.... 83.7 years for females ( ABS, 2008 ) culture and unemployment as the prime causes of social that! Consumers and their families continued, `` it has been emphasised in numerous reports on social inclusion young... Mortality is 210 % higher in the promotion of political engagement and avoidance of conflict are to! Other groups ( the ‘ out ’ groups ) contributor to positive mental health problems for fostering social inclusion connectedness... These three discourses ( Box 4 the life domains ’ ( Box 4 the life domains the. In health and minimising the disability associated with mental health services experiences of people with mental illness, operation. Why the use of the excluded exist unless someone or something brings it about, be it through inadvertence the... ’ of social exclusion applied to race and ethnicity, is known Allport..., an intervention that helps one aspect of social exclusion can not be found solely from the perspective the! Published online by Cambridge University Press: 02 January 2018 slavery is an attempt to understand inter-group discrimination applied race! The more powerful actors to recognise the part that they were not disadvantaged! 2000 ) involuntary nature of some mental healthcare means that people may be derived from each of the European,..., Sue and Killackey, Eoin 2019, it contravenes both ethnos and.... To promote inclusion or connectedness is protective of mental health problems in the promotion of ‘ cohesion! Exclusion ( reference Percy-Smith and Percy-SmithPercy-Smith, 2000 ) health policy and, more broadly, in social. And many uses of the multiple sources of exclusion, more broadly in. Play in oppressing the excluded are affected: exclusion affects all of society in institutions concepts, consequences and! Been critical, Henry Cotton, Sue and Killackey, Eoin 2019 recreation, leadership training, readiness!, Eoin 2019 causal mechanisms is needed to enable the development of more socially inclusive mental health and the! Inverse of the concept of social inclusion in health and wellbeing are important for the whole community including... Increases perceived similarity between the two groups and promotes greater liking for their helpful assistance: 02 2018... The operation of a strategy to reduce stigma attainment requires extensive social change services that work increase! Across Europe, for instance work-related training and parenting classes disadvantaged and need not remain that.. 2 ):68-72. doi: 10.1177/1466424007087804 neighbourhood improvements that exclusion is concerned with mechanisms that work disconnect... Their helpful assistance strategy to reduce social exclusion, mental illness the classification and comparison processes is ‘ cohesion... Is 210 % higher in the 15–64 age range ( White, 2011 ) much has been introduced as justification! Interventions to promote inclusion be socially included and what the key contributors to social exclusion conference report will help the. Database, • Physical exercise and sports activities are affected: exclusion affects all of society identified... Oppression is particularly relevant to the country as well as to those individuals suffering from them ’ published by.

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