Mental health problems are growing day by day, largely related to stress and strains of everyday living. Social and economic factors are considered important in the development of mental health problems, however, their role in recovery is not well appreciated. The strength of the relationships between social conditions and mental health has been understood for many years now. Strong associations are made between poor mental health and unemployment, poverty, discrimination, violence and social exclusion. There is a need for sufficient political will for tackling these issues to support the promotion of mental health, prevent mental health problems and enhance recovery. Social support and social isolation are independently associated with mental health status.

Social support can have both positive as well as negative influences on health, specially mental health. Good social support is considered as an asset for persons with mental health problems. Social support is also desirable for the relatives and family members of the person with mental illness. Good social support is an indicator of good outcome from a mental illness. The observation of good outcome of mental illness in developing and traditional societies is thought to be due to the strength of this social structure, in the form of joint or extended family support and social relationships. In fact, social support, social networks, and economic resources form what is considered as the ‘social capital’ or social wealth. Social capital means the resources available to persons and to the society which are provided by social relationships and networks. Social capital may be in the form of neighbor hood relationships, self help groups, community centers, and local religious places. It is important to maintain this social wealth as it can be a definite asset for the society, like any other resource. On the negative side, excessive social support may manifest as social interference, and lead to negative expressed emotions, which have a deleterious effect on outcome of certain psychiatric disorders.

When the person with mental health problems and their relatives do not get expected social support and social capital, it becomes social exclusion. This also has negative impact on persons with mental illness, and actually may be detrimental. Due to social exclusion, persons with mental illness are unable to participate in different areas of economic, social and cultural life. This non-participation is a reflection of discrimination within the society. We need to be aware that social exclusion is avoidable for many people with mental illness or mental retardation. These people are amongst the most marginalized and stigmatized people in our society. There is enough evidence that this exclusion happens because the persons with mental illness are considered to be unable to participate in economic or socially valuable activities, or are a social nuisance and may be violent or create trouble in society. Due to this they remain isolated and excluded from social relations. They may also be excluded from basic health, community and social services. These social disadvantages are linked with both physical and mental health problems. Social exclusion may happen in the form of joblessness, homelessness and poverty. On the other hand, social inclusion has been recognized as a determinant of mental health and well being. Social inclusion deals with stigma and discrimination and provides a supportive relationship and involvement in group activities.

Persons with mental health problems look forward to a social recovery, which includes social acceptance and approval. The concept of rehabilitation is gradually being replaced by the concept of recovery. Recovery does not mean only clinical recovery. In addition, it is also social, financial, and occupational recovery. The ideas of recovery are linked to socially inclusive practice which can be applied to many persons with mental health problems and those with mental retardation. Recovery oriented services and practices are the need of the hour for persons with mental health problems.

Persons with mental illness want to work, earn some money, and be useful to the society. Their relatives also have the same expectations. Till now persons with mental illness were isolated for their own protection as well as protection of the society. The approach is changing now as persons with mental health problems can be trained in different vocations and given job opportunities. This would be a boost for their self esteem and give them self confidence. New research has shown that persons with mental health problems can be placed in a job and train in that job. Thus, the traditional model of ‘train and place’ is being replaced by ‘place and train’, by providing supported employment, which means providing ongoing support with rapid placement in a suitable job. Supported employment is more effective than pre-vocational training in helping severely mentally ill people to obtain competitive employment. The overall challenge is to develop mental health and mental retardation services or a service culture that is socially inclusive, recovery oriented and economically productive.

The economic inclusion of mental health is another key element for recovery. If a person with mental illness gets an employment and becomes financially independent he/she can look after one self and meet the costs of medications and living. This would reduce the burden on the family as well. They can also contribute towards society and development of the nation. One should not forget that creativity is considered an asset in employment, and persons with mental health problems can also be quite creative and productive. The low income of persons with mental illness means that many are not able to afford basic needs of living. They are not likely to have any savings, may not even have a bank account, they may be in debt, and unable to afford any financial services. Because of low income they are not able to travel or look after their family. This economic deprivation reinforces isolations and may also affect their availing health services. It is important to tackle economic deprivation, especially in persons with mental illness and mental retardation, as it is a waste of human resources. This economic incentive is important for recovery of the individual. It has been observed that persons with mental illness want to do some work, and earn at least some money. If they work, get employment and become productive, they themselves will reduce stigma and discrimination.

Thus, the approach of services for mental health should lead towards both social inclusion and economic inclusion. This would enhance the quality of life of the individual and be supportive to the family of the persons with mental illness. This social and economic inclusion would reduce the financial cost on government, by not only reducing costs on care, but also by generating income, how much so ever little. Social inclusion and economic inclusion is also human rights issue and with this approach the human rights of the persons are maintained along with the recovery oriented practice. Social and economic inclusion should be a common goal for both health and social welfare services. Without serious efforts to promote social inclusion, people with mental health problems are likely to remain marginalised and discriminated by the society. Mental health professionals and services must work in a socially inclusive and recovery-oriented manner. This can have benefits for persons with mental illness, their relatives, and professionals, in addition to wider economic and social benefits. Currently, mental health services do not pay enough attention to the financial, employment and other social circumstances of persons with mental illness. Many countries and psychiatric organisations have already accepted the social and economically inclusive approach. The World Health Organisation has also suggested that a clear recommendation on psychosocial strategies which enhance vocational and economic inclusion is necessary for service planning and clinical practice. In a socially inclusive society people are valued and live with dignity. Mental health becomes a key outcome of social inclusion. Social inclusion is about getting people back to work, and involved in social activities.

Social and economic inclusion is important for recovery: people with mental health problems and those with mental retardation should be a part of our communities, not apart from them; they should be valued members of the society and community, have access to the opportunities that exist and have the opportunity to contribute to the society and community. This is a gradual process and will take time—So close no matter how far, forever trusting who we are, and nothing else matters! [Metallica].

The current rather lean issue of the Journal has interesting articles on assessment of social participation of mental health service users, and another on educational problems and outcome among patients with psychiatric disorders attending a tertiary care centre; an interesting discussion on job related stress and employment of people with mental illness: A Catch 22, highlights the challenges faced by employers and the mental health professionals. Supporting young adults with autism spectrum disorders (ASD) to maximize their Potential is an important guest editorial focusing on the needs of young adults with developmental disorders. What score in WHODAS 2.0 12-Item interviewer version corresponds to 40 % Psychiatric Disability? A comparative study with IDEAS looks at the inter test reliability and also gives an indication of validity of the two measures. In addition this issue carries a user perspective article on recovery from mental illness: the post-modern perspective and two book reviews for the first time and a conference report on a conference on quality of life. Given the attention to quality of life in mental health at the conference, the next issue of the Journal has been earmarked to be a special issue on this topic.