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This article considers aspects of the possible impact of social exclusion upon psychosis and the implications of this for mental health social work practice. Against a background of calls for evidence based practice, and increasing recognition of the significance of theories and understandings as the foundations of practice, the article will first explore current and historical ways of viewing and intervening with the relationship between social adversity and mental health. Then, alternative understandings of this relationship, supported by recent research regarding the impact of trauma and extreme 'social adversity upon physiological and physical processes implicated in mental ill-health, will be discussed. These approaches have major implications for social work practice with psychosis, suggesting that experiences of trauma and disadvantage, and interventions seeking to alleviate the inner and outer effects of these experiences-tasks central to the social work remit-can make a significant difference to mental health outcomes. However, this is not to advocate a simple (albeit under-resourced) 'social solution'! On the contrary, the understandings underpinning these approaches recognise biological processes play a role in mental and physical ill-health: importantly, however, they can be shown to question the stigma traditionally attached to the concept of biological disorder in mental health, thus pointing to the value of a truly biopsychosocial approach with psychosis, involving fully holistic interventions that differ from those currently dominant, and which carry implications for more egalitarian worker-user relationships. [ABSTRACT FROM AUTHOR]

In the field of mental health, debates range along opposing axes with the protection of the public on one axis and the citizenship and human rights of the individual on the other. Them is also considerable contestation for ideological and theoretical dominance about how mental distress should be viewed and responded to. Discourses alternatively emphasising protection, control and compulsion, and rights, citizenship autonomy and serf-determination have added impetus when applied to children and young people. This is also a grouping denied a voice both in terms of individual treatment programmes and in the formulation of policy and practice. This article addresses the key debates and appraises the implications of Changing policy and practice for children and young people experiencing mental distress in the UK. Although the discussion is located in a particular national context, the emergent themes have a much broader relevance for debates, policy and practice in the international arena. [ABSTRACT FROM AUTHOR]