“I’ve always felt like I’m on the outside”: Identity and social inclusion among young adults with mental illness and complex needs – a qualitative study

Abstract

Purpose: Addressing social inclusion often involves objective measures and means related to work, education, housing and economy. However, important subjective factors, such as the relationship between identity on social inclusion among young adults with mental illness and complex needs, are understudied. The study objective is to explore how young adults with mental illness and complex needs experience their identity in relation to social inclusion. Materials and methods: The study adopted a qualitative, explorative, and participatory design. Seven young adults (three males/four females, aged 22-29) were recruited though Flexible Assertive Community Treatment (FACT) Teams, and semi-structured interviews were conducted. Reflexive thematic analysis was employed in the analysis. Results: The analysis resulted in two main themes. Theme one, "Who they are", included three subthemes: "A lifelong sense of being someone on the outside", "Feeling different from others", and "Someone who is worthless and doesn't matter". Theme two, "Who they want to be", included two subthemes "Wanting to be someone else", and "The need to redefine oneself". Conclusions: This study underlines the importance of working systematically on subjective aspects such as identity, in addition to objective measures, to address social exclusion in a vulnerable and marginalized group. Future directions for research and the development of a more tangible and holistic approach to promote social inclusion are suggested.